Gastroschisis is a congenital birth defect, leading to the outward protrusion of bowel content. Although it is a treatable condition, significant disparities exist with mortality rates being less than 5% in high-income countries, but 60-95% in low-income countries, particularly in sub-Saharan Africa. In Uganda, gastroschisis mortality exceeds 95%. Midwives and nurses are often the first providers to encounter affected newborns, yet many lack the training and resources to initiate early management. With appropriate instruction, non-surgical healthcare providers can play an important role in surgical task-sharing by initiating resuscitation, applying silos, and directing babies to pediatric surgical care.

Commercial gastroschisis simulation models exist, but high-costs limit and limited availability make them inaccessible to low-income countries— creating a significant barrier to training. To address this gap, our team developed a low-cost, non-perishable gastroschisis simulation model designed specifically for use in low-resource settings. The model was created using low-cost and easily accessible materials. Throughout the development of the model, feedback was obtained from pediatric surgeons in both the U.S. and Uganda. Several adjustments were made to improve anatomical accuracy, texture, and ease of use. 

The model was piloted in hands-on gastroschisis management and training programs in Uganda and Rwanda, with over 160 nurses, midwives, pediatric residents, and pediatric surgeons. Participants expressed strong satisfaction with the model’s realism and its effectiveness in enhancing their understanding and confidence in silo placement. Following the trainings, several newborns have since presented to referral hospitals in Uganda with silos already applied—highlighting the model’s potential to translate training into life-saving practice.

Further research and follow-ups efforts are being conducted to evaluate the model’s clinical impact, potential for scalability and integration into neonatal surgical training programs across other low- and middle-income countries.