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. 2012:12:15.
Epub 2012 May 30.

Africa has unique and urgent barriers to cleft care: lessons from practitioners at the Pan-African Congress on Cleft Lip and Palate

Oluwaseun Adetayo  1 , Rachel Ford, Mark Martin
Affiliations

Africa has unique and urgent barriers to cleft care: lessons from practitioners at the Pan-African Congress on Cleft Lip and Palate

Oluwaseun Adetayo et al. Pan Afr Med J. 2012.

Abstract

Background: The goals of this study were to delineate the protocols employed for managing patients with cleft lip and palate deformities, delineate the challenges facing practitioners and patients, and to determine the patient and physician barriers to cleft care delivery in the region.

Methods: Survey questionnaires were administered to practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP), which took place in Ibadan, Nigeria, West Africa from February 4-7, 2007. The conference included 225 participants, representing 17 African countries

Results: Protocols for repair of cleft lip and palate deformities were varied, with Millard's and von Langenbeck's techniques being the preferred approach for the management of cleft lip and palate deformities, respectively. A large proportion of providers have limited access to core cleft care supporting teams, especially speech language pathologists, orthodontists, and audiologists. Several challenging barriers to cleft care were also identified at both the institutional and individual levels and are reported.

Conclusion: Geographic separation in Africa presents a similar challenge due to isolationism as it does to surgeons in Europe. Specific to Africa are the increased barriers to care, and economic and financial hardship at various levels. A focus on funding, team building, infrastructural support, and patient education appear to be crucial in improving the care and lives of children with facial clefts in Africa.

Keywords: Africa; Cleft care; Nigeria; cleft Palate; cleft lip; craniofacial cleft.

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Figures

Figure 1
Figure 1
Percentage of patients with cleft lip and palate and ages at presentation
Figure 2
Figure 2
Protocols for repair of complete unilateral cleft lip and palate seen during the neonatal period for: A. cleft lip B. cleft nasal deformity C. alveolar deformity D. hard palate
Figure 3
Figure 3
Protocols for repair of complete unilateral cleft lip and palate presenting at age 6 or greater for: A. cleft lip B. cleft nasal deformity C. alveolar deformity D. hard palate
Figure 4
Figure 4
Practitioner's repair of isolated cleft palate presenting in the neonatal period A. Practitioners’ preferred technique B. Preferred age of repair
Figure 5
Figure 5
Practitioners’ evaluation of: A. Priority of access to cleft care services B. Ease of access to cleft care services
Figure 6
Figure 6
Practitioners’ evaluation of: A. Treatment challenges facing cleft care practitioners B. System-based challenges facing cleft care practitioners
See this image and copyright information in PMC

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