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. 2019 Oct 28;7(10):e2487.
doi: 10.1097/GOX.0000000000002487. eCollection 2019 Oct.

The Impact of Social Stigma for Children with Cleft Lip and/or Palate in Low-resource Areas: A Systematic Review

Karen Y Chung  1 , Kimia Sorouri  2 , Lily Wang  2 , Tanishq Suryavanshi  3 , David Fisher  4
Affiliations

The Impact of Social Stigma for Children with Cleft Lip and/or Palate in Low-resource Areas: A Systematic Review

Karen Y Chung et al. Plast Reconstr Surg Glob Open. .

Abstract

There are still children with cleft lip and/or palate (CLP) in low-resource areas who face social rejection. This stigma disadvantages children in education, employment, marriage, and community, and is exacerbated by barriers to care. Our study objective was to conduct a systematic review of the impact of social stigma of CLP for children in low-resource areas. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A systematic search was conducted of 3 databases: Ovid Embase, Ovid Medline, and the African Journal Online from 2000 to October 5 2018. Common themes were identified using a grounded theory approach and quantitatively summarized. The Joanna Briggs Institute criteria were used to evaluate the risk-of-bias assessments. Four hundred seventy-seven articles were screened; 15 articles were included that focused on the impact of social stigma on CLP in low-resource areas. This was limited to English articles. The majority of studies originated in Nigeria or India. Themes were reported as follows: societal beliefs (n = 9; 60%), social impact (n = 7; 46%), marriage (n = 7; 46%), education (n = 6; 40%), employment (n = 5; 33%), and psychological distress (n = 3; 20%). Causes include the effect of "God's will," supernatural forces, evil spirits or ancestral spirits, exposure to an eclipse, black magic, or a contagion. Further, children with CLP may not be worth a full name or considered human and killed. Awareness of the impact of social stigma for children with CLP in low-resource areas generates support toward national education and awareness in low-resource areas.

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Figures

Fig. 1.
Fig. 1.
Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram for the screening process.
Fig. 2.
Fig. 2.
Infographic of the themes in the results.
Fig. 3.
Fig. 3.
JBI criteria for qualitative research.
Fig. 4.
Fig. 4.
JBI criteria for cohort studies.
Fig. 5.
Fig. 5.
JBI criteria for cross-sectional studies.
See this image and copyright information in PMC

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