Challenges of cleft care in Africa.

Professionals involved in the care of patients with clefts in Africa face unique challenges when compared with what obtained in western countries. It is the purpose of this paper to review some of the challenges of cleft care in Africa. A computerized literature search using electronic databases; Ovid MEDLINE, EMBASE and AJOL databases was conducted for published articles from 1965 to 2006. Mesh phrases used in the search were: Cleft lip, Cleft palate, Cleft care, Management, Challenges and Africa. The search produced 46 articles. A critical evaluation of the 46 articles using the inclusion and exclusion criteria led to selection of 20 articles for the review. The findings were: (1) No reliable data on incidence of cleft; (2) Strong traditional beliefs system exist regarding etiology of cleft; (3) Health problems attributed to clefts common at presentation; (4) Patients with cleft commonly present late; (5) Lack of multidisciplinary approach to care. The chance that a child born with a cleft tomorrow in Africa will receive the best care possible can not yet be guaranteed. The need to formulate basic strategies to improve the standard of cleft care in Africa and the rest of the developing world is overdue. We hope that the findings in this review will provoke solutions that might ultimately improve the standard of cleft care in Africa and the rest of the developing world.