Barriers to Cleft Lip and Palate Repair Around the World

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMASSENBURG, Benjamin B.
dc.contributor.authorJENNY, Hillary E.
dc.contributor.authorSALUJA, Saurabh
dc.contributor.authorMEARA, John G.
dc.contributor.authorSHRIME, Mark G.
dc.contributor.authorALONSO, Nivaldo
dc.date.accessioned2016-12-20T16:34:39Z
dc.date.available2016-12-20T16:34:39Z
dc.date.issued2016
dc.description.abstractBackground:Cleft lip and/or palate (CLP) is estimated to occur in 1 out of every 700 births, but for many people residing in low- and middle-income countries this deformity may be repaired late in life or not at all. This study aims to analyze worldwide provider-perceived barriers to the surgical repair of CLP in low- and middle-income countries.Methods:From 2011 to 2014, Smile Train distributed a multiple-choice, voluntary survey to healthcare providers to identify areas of need in CLP care worldwide. Data on provider-reported barriers to care were aggregated by year, country, and larger world regions.Results:A total of 1997 surveys were completed by surgeons and healthcare providers (60.7% response rate). The most commonly reported barriers were patient travel costs (60.7%), lack of patient awareness (54.1%), and lack of financial support (52.8%). Patient travel costs was the most commonly reported barrier in sub-Saharan Africa, the Middle East and North Africa, and South and Southeast Asia. Lack of financial support was the most commonly reported barrier in the Americas, Eastern Europe, and East Asia.Conclusions:This is the largest intercontinental study on healthcare provider-identified barriers to care, representing the limitations experienced by healthcare professionals in providing corrective surgery for CLP around the world. Financial risk protection from hidden costs, such as patient travel costs, is essential. Community health workers and nurses are critical for communication and linking CLP care to the rest of the community. Recognition of these barriers can inform future policy decisions, targeted by region, for surgical systems delivering care for patients with CLP worldwide.
dc.description.conferencedateAPR 04-09, 2016
dc.description.conferencelocalAtlanta, GA
dc.description.conferencename73rd Annual Meeting of the American-Cleft-Palate-and-Craniofacial-Association
dc.description.indexMEDLINE
dc.identifier.citationJOURNAL OF CRANIOFACIAL SURGERY, v.27, n.7, p.1741-1745, 2016
dc.identifier.doi10.1097/SCS.0000000000003038
dc.identifier.eissn1536-3732
dc.identifier.issn1049-2275
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/16981
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.relation.ispartofJournal of Craniofacial Surgery
dc.rightsrestrictedAccess
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINS
dc.subjectBarriers to care
dc.subjectcleft lip
dc.subjectcleft palate
dc.subjectglobal surgery
dc.subjectinternational
dc.subjectlow- and middle-income countries
dc.subjectSmile Train
dc.subject.othercommunity-health workers
dc.subject.otherorofacial clefts
dc.subject.othernorth-carolina
dc.subject.othersmile train
dc.subject.otherfollow-up
dc.subject.othercare
dc.subject.otherchildren
dc.subject.othermodel
dc.subject.othercentralization
dc.subject.otherreasons
dc.subject.wosSurgery
dc.titleBarriers to Cleft Lip and Palate Repair Around the World
dc.typearticle
dc.type.categoryarticle; proceedings paper
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.author.externalMASSENBURG, Benjamin B.:Icahn Sch Med Mt Sinai, Dept Med Educ, New York, NY 10029 USA; Harvard Med Sch, Program Global Surg & Social Change, Boston, MA USA; Boston Childrens Hosp, Dept Plast & Oral Surg, Boston, MA USA
hcfmusp.author.externalJENNY, Hillary E.:Icahn Sch Med Mt Sinai, Dept Med Educ, New York, NY 10029 USA; Harvard Med Sch, Program Global Surg & Social Change, Boston, MA USA; Boston Childrens Hosp, Dept Plast & Oral Surg, Boston, MA USA
hcfmusp.author.externalSALUJA, Saurabh:Harvard Med Sch, Program Global Surg & Social Change, Boston, MA USA; Boston Childrens Hosp, Dept Plast & Oral Surg, Boston, MA USA; Weill Cornell Med Coll, Dept Surg, New York, NY USA
hcfmusp.author.externalMEARA, John G.:Harvard Med Sch, Program Global Surg & Social Change, Boston, MA USA; Boston Childrens Hosp, Dept Plast & Oral Surg, Boston, MA USA
hcfmusp.author.externalSHRIME, Mark G.:Harvard Med Sch, Program Global Surg & Social Change, Boston, MA USA; Massachusetts Eye & Ear, Dept Dept Otolaryngol, Boston, MA USA
hcfmusp.citation.scopus75
hcfmusp.contributor.author-fmusphcNIVALDO ALONSO
hcfmusp.description.beginpage1741
hcfmusp.description.endpage1745
hcfmusp.description.issue7
hcfmusp.description.volume27
hcfmusp.origemWOS
hcfmusp.origem.pubmed27763973
hcfmusp.origem.scopus2-s2.0-85019334936
hcfmusp.origem.wosWOS:000386352100085
hcfmusp.publisher.cityPHILADELPHIA
hcfmusp.publisher.countryUSA
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