Globally, 98%–99% of neonatal deaths occur in low- and middle-income countries (LMICs)1–3 with root causes including preterm birth, severe infection, asphyxia and low birth weight.4 Suboptimal neonatal care often means poor child health, development and well-being, making neonatal, infant and child health significant concerns and key sustainable development goal targets.5 6 Evidence shows that most newborn deaths are preventable and treatable,2 3 7 8 but healthcare interventions are needed spanning from conception through postpartum and beyond.9 10

As newborn deaths decrease, the importance of postnatal and postdischarge care for maternal and newborn health grows.11–13 A 2013 systematic review indicated that postdischarge neonatal mortality in LMICs was as high as or higher than in-hospital mortality.14 The WHO’s standards, previous research and a proposed model for scaling up care in LMICs all emphasise the need to improve postdischarge care.15–17 Yet, despite its importance, postdischarge care remains under-researched, with the literature placing more emphasis on in-hospital care.14 18 19

Recent literature highlights obstacles to improving postdischarge care (eg, at home or in follow-up consultations at the hospital or in community settings) for newborns in LMICs, including caregiver non-compliance with medical instructions20 21 and lack of coordination among healthcare providers without a standard follow-up schedule.18 22 23 Clinical documentation often includes inaccuracies, and there is insufficient monitoring of the quality and completeness of discharge summaries.24 Caregivers also require extra support to be able to look after their sick newborns after discharge,25 with effective communication between caregivers, healthcare teams and community workers becoming key.22 23 26 Lack of support and ineffective communication can lead to caregivers feeling isolated, thus hindering home care provision.22 23

Health information is necessary at every level of the healthcare system for a wide range of purposes, such as informing decisions and monitoring services.27 According to WHO, the provision of accurate and timely health information is fundamental in well-functioning healthcare systems, contributing significantly to the quality of care.15 27 In postdischarge care for newborns, information sharing varies based on the clinical condition and the type of follow-up care required. Typically, to provide adequate follow-up care for newborns, clinicians need access to information including measures of growth and development (eg, height, weight), the primary diagnosis, length of hospitalisation, prescribed medication and supplements.21 28

A number of information and record-keeping tools have been introduced in LMICs to support postnatal care, including paper tools (eg, the Maternal and Child Health (MCH) passport), electronic systems (eg, Electronic Health Records (EHRs)) and hybrid approaches (use of electronic and paper sources). These tools usually contain crucial maternal, newborn and child health information, including immunisations, visit history, laboratory findings, prescriptions and management of illnesses and chronic conditions.29 30 Record-keeping tools have the potential to improve care, enhance patient–provider communication, empower caregivers and increase vaccination rates among children.31

In this review, we focus primarily on information needs and tools relevant to the care of ‘vulnerable’ newborns. We use the term ‘vulnerable’ to refer to high-risk populations, recognising that it remains challenging to define vulnerability in this context. For example, the term ‘vulnerable children’ has been used to refer to children more susceptible to exposure to risk and poor life outcomes compared with their peers.32 Tickell et al emphasise clinical risk factors (eg, undernourishment, acute or chronic illnesses), defining vulnerable children as those small and sick in need of hospitalisation.33 We will refer to ‘vulnerable’ newborns as small and sick newborns admitted to the hospital following birth and then discharged.

Our review takes a sociocultural perspective to explore how caregivers engage with, resist and reframe health-related information, going beyond traditional conceptions of information as a tangible artefact (eg, written information). 34 This perspective allows us to examine the dynamics of information within healthcare systems, focusing on the interactions, experiences and practices of caregivers and mothers seeking health-related information for themselves and their dependents.34 By integrating an understanding of sociocultural dimensions, we aim to provide an in-depth view of how vulnerability emerges in the context of restricted information flows, underpinned by the complexity of health conditions but also broader social determinants such as poverty, access to care and cultural practices. This approach enriches our understanding of information flows and their significance for health outcomes.34 35