Smart Discharges for vulnerable refugee children: a cohort study to validate prognostic algorithms for post-discharge readmission and mortality among children living in refugee settings

Uganda hosts over 1.5 million refugees, many in northern districts such as Lamwo. Severe infectious diseases are the leading causes of death in both refugee and non-refugee populations in Uganda, and post-discharge mortality has been demonstrated to be a major contributor to paediatric deaths in low-resource settings. Yet, there is currently no data on post-discharge vulnerability and outcomes for refugee or host community children living within this context, alongside a lack of effective tools to support transitions to community care.

This dataset relates to a prospective observational cohort study conducted at three health facilities in Lamwo District, northern Uganda, between April 2023 and September 2024, enrolling children under 13 years of age. The study aims to validate, calibrate, and refine the Smart Discharges risk-prediction algorithm in a representative cohort of refugee children, and to describe post-discharge mortality, health-seeking patterns, and the discharge process at the three facilities. Clinical and demographic data were collected at enrolment, and children received phone follow-up from study staff at 2, 4, and 6 months after discharge, with verbal autopsies conducted for children who died following discharge. All study sites also underwent a Facility Scan to assess discharge-related quality improvement priorities, repeated at baseline and 4 months later to measure change in facility readiness over time.

This dataset supports validation of the Smart Discharges approach to improve post-discharge outcomes among refugee children, building towards a generalisable, inclusive solution for paediatric post-discharge care in humanitarian settings.

This dataset relates to R2HC funded study: Smart Discharges for refugee children: Improving hospital-to-community care transitions