Challenges and Adaptations for Neonatal Surgical Care in LMICs: The Rwandan Gastroschisis Experience

Gastroschisis outcomes are disparate around the world. In high-income countries (HICs), favorable gastroschisis outcomes rely on well-coordinated multidisciplinary efforts beginning before birth. Many of the elements HICs employ to optimize gastroschisis outcomes are currently rare or inaccessible for most patients born in low- and middle-income countries (LMIC), including prenatal diagnosis, parenteral nutrition, pediatric anesthesia, and neonatal critical care and surgical care.

Over the last decade, improved training, healthcare access, and advocacy for children’s surgical care have supported significant advances in gastroschisis care and survival at dedicated pediatric surgical centers in several LMICs.

In this article, we will review the challenges and adaptations for neonatal surgical care in low-resource settings, specifically focusing on gastroschisis management in LMICs through the experience of a tertiary referral hospital in Kigali, Rwanda.