The Pediatric Development Clinic Study
Condition: Pregnancy, Puerperium and Perinatal Conditions
Study type: Observational [Patient Registry]

Summary: 
      Many preterm, low birth weight and other high-risk infants are surviving the early neonatal
      period. However, upon discharge from the neonatal units, this at-risk population has little
      support for their health, nutrition and development in the community. To address this
      emerging need, Partners In Health in collaboration with the Ministry of Health and UNICEF,
      has created a pediatric developmental clinic (PDC) to follow the high-risk infants after
      discharge from hospitals and health centers.
    

Detailed description: 
      Neonatal health and improving neonatal mortality has become one of the top priorities
      globally. In Rwanda, hospital care has advanced significantly with the development of
      national neonatal care guidelines and widespread provider training. As advances in technology
      and resuscitation become more commonly available, many preterm, low birth weight and other
      high-risk infants are surviving the early neonatal period. However, upon discharge from the
      neonatal units, this at-risk population has little support for their health, nutrition and
      development in the community. To address this emerging need, Partners In Health in
      collaboration with the Ministry of Health and UNICEF, has created a pediatric developmental
      clinic (PDC) to follow the high-risk infants after discharge from hospitals and health
      centers. Prior to implementation, a community-based descriptive study assessing the baseline
      medical, nutritional and developmental needs of low-birth weight and preterm infants who are
      the target population of the pediatric development clinic was conducted (Baseline Phase One).
      Subsequently, after 1-2 years of implementation an evaluation of clinical, nutritional and
      developmental outcomes of children followed in PDC will be conducted in comparison with the
      baseline study outcomes (Post-PDC Phase Two). Ongoing research on PDC implementation will
      focus on research on patient and provider experiences, overall clinic processes,
      cost-effectiveness, expansion of the PDC model, decentralization to health centers, and
      longer term outcomes of children enrolled in the PDC to further help refine the PDC model
      (Post-PDC Phase Three)
    

Intervention name(s): Pediatric Development Clinic (PDC)
Intervention type(s): Other
Intervention description(s): All children enrolled in PDC will be at screened for any medical condition they may have and be referred for treatment as required. Nutrition and development support are also provided to clinic enrollees, based on clinic protocols which include regular monitoring and intervention.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        All under-five children in need of formal follow-up with the following medical condition
        will be enrolled in PDC

          -  children born premature

          -  children born with an extremely low birth weight (ELBW)/ very low birth weight (VLBW)

          -  infants born at term with HIE or Central Nervous System infections (cerebral malaria
             and meningitis)

          -  children with developmental delays,

          -  children with trisomy 21, hydrocephalus, cleft lip/palate

          -  children less than 12 months of age discharged from the hospital following
             malnutrition treatment.