A cleft care workshop for speech and language pathologists in resource-limited countries: The participants' experiences about cleft care in Uganda and satisfaction with the training effect

Alighieri, Cassandra; Kissel, Imke; D’haeseleer, Evelien; Bruneel, Laura; Bettens, Kim; Sseremba, Daniel; Pype, Peter; Lierde, Kristiane Van

doi:10.1016/j.ijporl.2020.110052

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…To address the lack of availability of SLPs, training other professionals in cleft speech therapy has been successful 16–19 . In some countries, such as Uganda, for example, speech and language services have been traditionally provided by international healthcare professionals 20 . In Sri Lanka, individuals with a health or education background participated in a 16-week cleft speech and habilitation training program that was directed by British therapists, which included observation and practical experience in cleft speech therapy.…”

Section: Discussionmentioning

confidence: 99%

“…30 Implementation of international workshops to educate local SLPs on cleft palate speech therapy has also been developed to improve services and increase sustainability of cleft palate care in LMICs. Alighieri et al 20 reported on a 2-day free workshop conducted in Uganda for a group of 17 local SLPs. The contents of the workshop included anatomy and physiology, perceptual assessment of cleft palate speech, and multidisciplinary care to address the needs of this population.…”

Section: Access To Local Speech Providersmentioning

confidence: 99%

“…[16][17][18][19] In some countries, such as Uganda, for example, speech and language services have been traditionally provided by international healthcare professionals. 20 In Sri Lanka, individuals with a health or education background participated in a 16-week cleft speech and habilitation training program that was directed by British therapists, which included observation and practical experience in cleft speech therapy. Upon completion of the training program, trainees were judged to be skilled in providing speech therapy to individuals with CLP.…”

Section: Access To Local Speech Providersmentioning

confidence: 99%

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Barriers and Resources to Cleft Lip and Palate Speech Services Globally: A Descriptive Study

Baigorri

Crowley

Sommer

et al. 2021

Journal of Craniofacial Surgery

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Background: Although a number of international cleft organizations and cleft professionals in low- and middle-income countries (LMICs) have built and supported comprehensive cleft care and speech therapy models to address the shortage of speech services in LMICs, the specific speech needs of individuals with cleft lip and palate (CLP) in such countries remain unknown. The objective of this study was to evaluate the barriers to accessing speech services for patients with CLP as well as the resources and models of speech services that are currently available for individuals with CLP in LMICs, with the goal of better understanding the needs of this population. Methods: Qualitative and quantitative methods consisted of Smile Train partner surveys that were distributed June 25th to July 31st, 2018 worldwide. Surveys were distributed through Smile Train's online medical database, Smile Train Express, which every Smile Train partner uses to report their Smile Train sponsored treatment outcomes. A total of 658 Smile Train partners responded to the surveys. Respondents included surgeons, speech therapists, orthodontists, administrators and nurses who represented non-governmental organizations, hospitals (private or public), hospital groups, and private clinics. Results: Results indicated that lack of resources, including access to local speech providers and language materials, as well as financial constraints such as patient travel and speech treatment costs, are the most commonly reported barriers to accessing speech services across all geographic regions surveyed. Conclusions: Improving access to CLP speech services in LMICs may require strategies that address lack of speech providers, language materials, and financial constraints.

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Section: Discussionmentioning

confidence: 99%

Section: Access To Local Speech Providersmentioning

confidence: 99%

Section: Access To Local Speech Providersmentioning

confidence: 99%

See 1 more Smart Citation

Barriers and Resources to Cleft Lip and Palate Speech Services Globally: A Descriptive Study

Baigorri

Crowley

Sommer

et al. 2021

Journal of Craniofacial Surgery

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“…Short, intensive interventions to train local SLPs to provide care to patients with CLP have been successful on a small scale. 22,27,28 In the long run, this type of capacity-building effort will ultimately provide the greatest, most sustainable benefit. However, capacity building is a costly, time-consuming endeavor, and any tool that can expand the reach of currently practicing SLPs should be encouraged, yet properly vetted, to improve current cleft care in under-resourced countries.…”

Section: Discussionmentioning

confidence: 99%

The Feasibility of Cross-Linguistic Speech Evaluation in the Care of International Cleft Palate Patients

Stoehr

Park²,

Reddy³

et al. 2022

Journal of Craniofacial Surgery

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Many patients with cleft palate in developing countries never receive postoperative speech assessment or therapy. The use of audiovisual recordings could improve access to postrepair speech care. The present study evaluated whether English-speaking speech-language pathologists (SLPs) could assess cleft palate patients speaking an unfamiliar language (Tamil) using recorded media. Recordings obtained from Tamil-speaking participants were rated by 1 Tamil-speaking SLP and 3 English-speaking SLPs. Ratings were analyzed for inter-rater reliability and scored for percent correct. Accuracy of the English SLPs was compared with independent t tests and Analysis of Variance. Sixteen participants (mean age 14.5 years, standard deviation [SD] 7.4 years; mean age of surgery of 2.7 years, SD 3.7 years; time since surgery: 10.8 years, SD 5.7 years) were evaluated. Across the 4 SLPs, 5 speech elements were found to have moderate agreement, and the mean kappa was 0.145 (slight agreement). Amongst the English-speaking SLPs, 10 speech elements were found to have substantial or moderate agreement, and the mean kappa was 0.333 (fair agreement). Speech measures with the highest inter-rater reliability were hypernasality and consonant production errors. The average percent correct of the English SLPs was 60.7% (SD 20.2%).English SLPs were more accurate if the participant was female, under eighteen, bilingual, or had speech therapy. The results demonstrate that English SLPs without training in a specific language (Tamil) have limited potential to assess speech elements accurately. This research could guide training interventions to augment the ability of SLPs to conduct cross-linguistic evaluations and improve international cleft care by global health teams.

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“…Local initiatives led by universities and regional professional bodies such as the College of Surgeons of East, Central and Southern Africa (COSECSA) have increased the number of resources and workshops for the health workforce. COSECSA, through collaboration with international NGOs and university hospitals, has established traveling scholarships to fund fellowships for surgical trainees [61][62][63]. Across surgical training programs, the shift from timebased to competency-based outcome measures for trainees has shown improvement in procedure-specific competency scores in a shorter time compared with traditional time-based training [64].…”

Section: The Cleft Surgical Workforcementioning

confidence: 99%

Perspectives on the state of cleft lip and cleft palate patient care in Africa

Liu,

Manana,

Tollefson

et al. 2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review As the most common congenital craniofacial defect, patients with cleft lip -palate (CLP) experience morbidity and social stigma, particularly in low-income and middle-income countries (LMICs) such as those of sub-Saharan Africa (SSA). Delays in treatment secondary either to lack of awareness, skills, equipment and consumables; poor health infrastructure, limited resources or a combination of them, has led to SSA having the highest rates of death and second highest rates of disability-adjusted life years in patients with CLP globally. Here we review current perspectives on the state of comprehensive cleft lip and palate repair in Africa. Recent findings To bridge gaps in government health services, nongovernmental organizations (NGOs) have emerged to provide care through short-term surgical interventions (STSIs). These groups can effect change through direct provision of care, whereas others strengthen internal system. However, sustainability is lacking as there continue to be barriers to achieving comprehensive and longitudinal cleft care in SSA, including a lack of awareness of CLP as a treatable condition, prohibitive costs, poor follow-up, and insufficient surgical infrastructure. With dedicated local champions, a comprehensive approach, and reliable partners, establishing sustainable CLP services is possible in countries with limited resources. Summary The replacement of CLP ‘missions’ with locally initiated, internationally supported capacity building initiatives, integrated into local healthcare systems will prove sustainable in the long-term.

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A cleft care workshop for speech and language pathologists in resource-limited countries: The participants' experiences about cleft care in Uganda and satisfaction with the training effect

Cited by 7 publications

References 29 publications

Barriers and Resources to Cleft Lip and Palate Speech Services Globally: A Descriptive Study

Barriers and Resources to Cleft Lip and Palate Speech Services Globally: A Descriptive Study

The Feasibility of Cross-Linguistic Speech Evaluation in the Care of International Cleft Palate Patients

Perspectives on the state of cleft lip and cleft palate patient care in Africa

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