High-risk neonatal follow-up care in India: A systematic review of observational and intervention studies

High-risk neonatal post-NICU discharge follow-up care is crucial for infant health. We conducted a comprehensive search for studies from 2011 to 2024, focusing on the impact of follow-up care on maternal and infant clinical outcomes. Out of 1772 articles, 27 studies conducted in India (16 observational and 11 intervention studies) were included and analyzed. The findings highlight the importance of healthcare providers' communication, maternal training, and emotional support for sustainable high-risk neonatal follow-up care. Geographical disparities and social determinants, such as parental education, health literacy and financial support significantly influenced maternal and infant clinical outcomes after NICU discharge. Integrating family-centered care with digital health and navigation models showed promise in bridging follow-up gaps and improving maternal and infant well-being with appropriate healthcare system support. However, gaps persist in addressing social determinants in standard follow-up visits, which is crucial for enhancing regular neonatal care and survival rates. This study underscores the need for comprehensive, family-focused approaches to high-risk neonatal follow-up care, acknowledging the diverse contextual factors influencing outcomes and advocating for targeted interventions to address these disparities.