In low- and middle-income countries (LMICs), gastrostomy care quality improvement is vital for enhancing patient outcomes. First, a recent scoping review highlights significant clinical gaps in these regions. Although gastrostomy tubes provide essential nutrition for patients, maintaining these devices presents unique challenges in resource-limited settings. However, healthcare providers can address these barriers through systematic changes. Consequently, there is an urgent need for standardized intervention models and multidisciplinary engagement.

Strategies for Gastrostomy Care Quality Improvement

Because improving patient outcomes requires a structured approach, experts recommend the formation of multidisciplinary care teams. For example, these teams should include surgeons, gastroenterologists, specialized nurses, and dietitians. Furthermore, implementing standardized protocols for tube insertion can significantly reduce initial complication rates. Additionally, hospital-based care bundles have shown success in decreasing emergency department visits. Similarly, focused training programs help caregivers manage the tube safely at home, which prevents accidental dislodgement.

Meanwhile, the scoping review found that adult complication rates vary from 10% to 25%. On the other hand, paediatric complication rates are often much higher, ranging from 10% to 55%. Specifically, these issues include stoma site infections, leakage, and granulation tissue formation. For this reason, focused caregiver training is essential before hospital discharge. Moreover, training programs must be culturally sensitive and address specific local resource limitations. Therefore, education must cover daily site cleaning and the recognition of early infection signs.

Improving Outcomes via Multidisciplinary Engagement

Successful gastrostomy care quality improvement relies on consistent communication between medical departments. To illustrate, nursing staff play a pivotal role in monitoring protocol adherence and hygiene. Likewise, dietitians ensure that nutritional goals are met through the enteral route. By integrating these specialties, healthcare facilities in LMICs can create a robust safety net for vulnerable patients. Finally, research suggests that structured follow-up programs can identify mechanical issues early. As a result, serious morbidity and unplanned hospital readmissions are effectively minimized.

Frequently Asked Questions

What are common gastrostomy complications in LMICs?

Common complications include peristomal infections, skin irritation, tube leakage, and accidental dislodgement. Pediatric patients often experience higher complication rates, which highlights the need for robust monitoring systems and standardized care protocols.

Why is caregiver training essential for gastrostomy care?

Caregivers are responsible for daily device maintenance at home. Therefore, comprehensive training ensures they can manage the tube safely, recognize early warning signs of infection, and prevent mechanical failures, ultimately improving the patient's quality of life.

Disclaimer: This content is for informational and educational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Marrero Morales LS et al. The current landscape and opportunities in gastrostomy care quality improvement in low- and middle-income countries: a scoping review. Int Health. 2026 May 09. doi: undefined. PMID: 42104811.

Kehar M et al. Percutaneous Endoscopic Gastrostomy in Children: Experience from Single Center of a Developing Country. J Nepal Paediatr Soc. 2014;34(2):125-131.

Juviler P et al. Reduction of Pediatric Gastrostomy Tube Healthcare Utilization and Socioeconomic Disparities: Longitudinal Benefits of Quality Improvement. J Pediatr Surg. 2024. doi: 10.1016/j.jpedsurg.2024.161964.