Systems framework for post-hospital follow-up care of small and/or sick newborns: A pathway to sustainable and scalable quality care in low-resource, high-burden countries.

South Asian and Sub-Saharan African countries, disproportionately overrepresented in the World Bank's low- and middle-income categories, bear a high burden of small and/or sick newborns. It is important to acknowledge that, in addition to reducing mortality, creating opportunities to enhance their health and well-being, thereby improving quality of life, is an essential metric for evaluating neonatal care success. With increased survival rates for small and/or sick newborns in most high-burden, resource-constrained settings, developing and strengthening specialized, structured neonatal follow-up programs to provide high-quality post-hospital care is imperative for optimizing outcomes and quality of life. This paper proposes a Systems Framework for Neonatal Follow-Up of small and/or sick newborns. While this framework applies to all settings, it is particularly pertinent in low-resource, high-burden countries, considering their unique contextual settings. This framework will provide a significant opportunity to foster meaningful engagement and partnership with a wide range of relevant local stakeholders, including families with small and/or sick newborns, as well as to identify areas for increased strategic investment. Furthermore, a multidimensional checklist aligned with the proposed framework provides a comprehensive tool for assessing neonatal follow-up readiness in health systems. The goal is to accelerate progress by transforming the delivery and accessibility of neonatal follow-up for small and/or sick newborns, thus improving the prospects for favorable long-term outcomes in this highly vulnerable population.