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Innovation of High-risk Infants Follow-up Surveillance System in Iran
Behzad Jodeiry1, Mohammad Heidarzadeh1, Kayvan Mirnia1
1Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
A new surveillance system for high-risk infants (HRI) was designed and piloted to improve early childhood development and reduce health inequities. This system facilitates timely intervention for HRI health issues post-discharge.
Area of Science:
- Neonatal care and public health surveillance.
- Child development and social determinants of health.
Background:
- Early childhood development is a key social determinant of health, crucial for reducing health inequities.
- Despite advances in neonatal care, a gap exists in post-discharge surveillance for high-risk infants (HRI).
- Lack of follow-up systems hinders timely intervention for HRI health problems.
Purpose of the Study:
- To design and pilot a high-risk infant follow-up (HRIF) surveillance system.
- To establish a system for identifying HRI and their health issues for early intervention.
- To address the need for a structured follow-up system in neonatal care.
Main Methods:
- Qualitative research involving international document review and focus group discussions to define HRI criteria.
- Delphi technique used to finalize the assessment timetable.
- Pilot implementation of the designed HRIF surveillance system at Alzahra Hospital, followed by expert panel assessment.
Main Results:
- Development of an HRIF surveillance system including evidence-based HRI criteria.
- Establishment of a dedicated follow-up team and a regulated assessment timetable.
- Creation of a health certificate notebook for HRIs and design of database software for data management.
Conclusions:
- The designed and piloted HRIF surveillance system was successfully institutionalized at Alzahra Hospital.
- The system is a foundation for national application after further quantitative outcome assessment.
- Further development in East Azarbijan is recommended before nationwide implementation.
Background:
Early childhood development is one of the most social determinants of health that must be notified in order to reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow-up surveillance system to identify high-risk infants (HRI) and their health problems for timely intervention after discharge. This study was carried out to design and pilot high-risk infant follow-ups (HRIFs) surveillance system, in Alzahra Hospital, a tertiary level center of Tabriz University of Medical Sciences (TUOMS), in 2012-2013.
Methods:
In this qualitative research after studying international documents, consensus about criteria of HRIs accomplished by focus group discussion. Then, Delphi agreement technique was used to finalizing assessment timetable. In the second phase, we piloted the designed surveillance system in Alzahra Hospital, a tertiary level center of TUOMS. Pilot study was implemented by follow-up team organized in designed model at the first phase of the study. Then, the findings of the pilot study were being assessed by an expert panel. If the members agreed on made decisions, they were being placed on the agenda of the national committee of development care of newborns for final approval.
Results:
High-risk infants follow-up surveillance system was designed in following steps: Defining of evidence-based criteria of HRIs, organizing the follow-up team, regulating the organs and neurodevelopment assessment timetable, publishing a health certificate notebook for HRIs, and designing Access database software for data collection, report and evaluation.
Conclusions:
We designed and piloted HRIFs surveillance system, so this system was institutionalized in Alzahra Hospital, finally. It can be prepared to apply in the whole country, after detecting the quantitative outcomes and developing the program in East Azarbijan.
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