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Improving care and survival of newborns with surgical conditions in Tanzania (TINY Tanzania): a focus on gastroschisis

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Topic overview

This implementation science study describes the nationwide scale-up of gastroschisis care in Tanzania, training 420 providers across seven regions and establishing a centralized database tracking 332 patients. While decentralization proved feasible and increased access to care using preformed silo bags, overall survival reached 28.5%, with late presentation and infection remaining major barriers to achieving the 60% survival rates seen at the initial referral center.

Key takeaways

  • Gastroschisis mortality in sub-Saharan Africa exceeds 90%; implementation of a Care Bundle at MNH increased survival to 60%.
  • Step-wedge implementation trained 420 providers across 7 Tanzanian regions, making decentralized gastroschisis care feasible and acceptable.
  • Nationwide database captured 332 patients in 1 year; 90% treated with preformed silos achieved 28.5% overall survival across all centers.
  • Late presentation and infection remain primary barriers to survival despite protocol dissemination and provider training.
  • Context-relevant implementation science strategies are essential for sustainable improvement in neonatal surgical outcomes in resource-limited settings.

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How to cite: GlobalCastMD. Improving care and survival of newborns with surgical conditions in Tanzania (TINY Tanzania): a focus on gastroschisis. GlobalCastMD Medical Library. 2024-09-06. https://dev.library.globalcastmd.com/article/9131?via_space=staycurrentmd

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