Perceived Barriers to Comprehensive Cleft Care Delivery

Abstract

Introduction We analyzed the perceptions of participants and faculty members in simulation-based comprehensive cleft care workshops regarding comprehensive cleft care delivery in developing countries. Methods Data were collected from participants and faculty members in 2 simulation-based comprehensive cleft care workshops organized by Global Smile Foundation. We collected demographic data and surveyed what they believed was the most significant barrier to comprehensive cleft care delivery and the most important intervention to deliver comprehensive cleft care in developing countries. We also compared participant and faculty responses. Results The total number of participants and faculty members was 313 from 44 countries. The response rate was 57.8%. The majority reported that the most significant barrier facing the delivery of comprehensive cleft care in developing countries was financial (35.0%), followed by the absence of multidisciplinary cleft teams (30.8%). The majority reported that the most important intervention to deliver comprehensive cleft care was creating multidisciplinary cleft teams (32.2%), followed by providing cleft training (22.6%). We found no significant differences in what participants and faculty perceived as the greatest barrier to comprehensive cleft care delivery (P = 0.46), or most important intervention to deliver comprehensive cleft care in developing countries (P = 0.38). Conclusions Our study provides an appraisal of barriers facing comprehensive cleft care delivery and interventions required to overcome these barriers in developing countries. Future studies will be critical to validate or refute our findings, as well as determine country-specific roadmaps for delivering comprehensive cleft care to those who need it the most.

Comprehensive Cleft Care Delivery in Developing Countries: Impact of Geographic and Demographic Factors

“…We have previously evaluated the perceived barriers and limitations to comprehensive cleft care delivery among participants in this educational initiative and faculty. 7 Our analysis showed that the most significant barrier facing comprehensive cleft care delivery was financial limitations, which was concordant among faculty members and attendees. Similarly, the major intervention required to deliver comprehensive cleft care was creating multidisciplinary teams, also concordant between faculty members and attendees.…”

“…Faculty members included 25 (8.0%) surgeons, 5 (1.6%) dentists, 4 (1.3%) speech and language pathologists, and 6 (1.9%) from different specialties. 7 The total response rate was 57.8% (n ¼ 181), with the survey completed by 39 out of 40 faculty members (97.5%) and 142 out of 273 participants (52.0%). The majority of respondents were female (57.1%), 30 years or older (82.6%), and had more than 5 years of experience in their current position (69.5%).…”

“…13 The development of these educational initiatives is a result of strong teamwork and resilient cooperation with other cleft care foundations, healthcare facilities, as well as invested stakeholders from the biomedical industry sector. 7…”

“…7 The majority reported that the most significant barrier was financial, followed by the absence of multidisciplinary cleft teams, while the most significant intervention was creating multidisciplinary cleft teams, with concordance of responses between participants and faculty members. 7 We acknowledge, however, that barriers facing cleft care are not standard across LMICs and may vary between different practitioners based on demographic and geographic factors. In this study, we investigate how these demographic and geographic factors affect perceived barriers facing cleft care in our quest to delineate communityspecific road maps to refine cleft care delivery.…”

“…4,5 Barriers to multidisciplinary cleft care in LMICs are numerous and diverse, ranging from financial and psychosocial to logistical and administrative challenges. [6][7][8][9] The culmination of these challenges in resource-limited countries have resulted in many patients suffering from the consequences of delayed treatment, which has pushed cleft care practitioners worldwide to establish cleft care initiatives targeting LMICs. 4,5 These initiatives have been implemented primarily through the establishment of short-term medical missions to underserved countries by groups of surgeons and multidisciplinary practitioners.…”