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Taiwo AO, Lehmann U, Scott V, Shafi'u I, Lawal SG, Abdulmajid U, Braimah RO, Ibikunle AA, Abubakar AB, Mujtaba B, Ogbeide ME, Labbo-Jadadi S, Adigun OI, Ile-Ogedengbe BO. Barriers in Cleft Service Access in Sub-Saharan Africa: A Thematic Analysis of Practical Needs of Rural Families. Cleft Palate Craniofac J 2024:10556656241244976. [PMID: 38557293 DOI: 10.1177/10556656241244976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE To explore the experiences and perceptions of barriers of parents and family members of patients with cleft lip and palate in accessing cleft services in remote northwest Nigeria. DESIGN Face-to-face semi-structured audio recorded interviews were used to obtained qualitative textual data. Thematic analysis using interpretative descriptive techniques was employed to understand the participants' lived experiences with barriers and accessibility to cleft services. SETTING Participants were from Sokoto, Kebbi and Zamfara states in remote northwest, Nigeria. PARTICIPANTS Consisted of 22 caregivers (17 parents and 5 extended family members) were purposively sampled between 2017 and 2020. MAIN OUTCOME MEASURES Barriers experienced while accessing cleft services were identified during thematic analysis. RESULT Over three quarter of the respondents had patients with both cleft lip and palate and without any previous family history (n = 20). About two-thirds of the participants (n = 15) were females. Most of the interviews were conducted before the surgeries (n = 15). FIVE THEMES EMERGED lack of information, financial difficulty, misrepresentation from health workers, multiple transportation and previous disappointment. CONCLUSIONS Areas of poor awareness, misinformation from primary health care workers, financial hurdles, multiple transportation logistics and others were identified. Aggressive broadcasting of information through radio, timely treatment and collaboration with influential religious leaders were emphasized. Support, grants and subsidies from government and voluntary agencies are encouraged to mitigate the huge out of pocket cost of cleft care in the region.
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Affiliation(s)
- Abdurrazaq Olanrewaju Taiwo
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
- Resmile Craniofacial Anomaly Foundation Zamfara, Gusau, Zamfara, Nigeria
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Health Science, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Uta Lehmann
- School of Public Health, University of Western Cape, Cape town, South Africa
| | - Vera Scott
- School of Public Health, University of Western Cape, Cape town, South Africa
| | | | - Suleman Gusau Lawal
- Department of Family Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Usamatu Abdulmajid
- Department of Otolaryngology/ENT, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Ramat Oyebummi Braimah
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Health Science, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Adebayo Aremu Ibikunle
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | - Bala Mujtaba
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Health Science, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Mike Eghosa Ogbeide
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Suwaiba Labbo-Jadadi
- Department of Dental and Maxillofacial Surgery, Sir Yahyah Memorial Hospital, Birnin-Kebbi, Kebbi, Nigeria
| | - Olufemi Ibrahim Adigun
- Resmile Craniofacial Anomaly Foundation Zamfara, Gusau, Zamfara, Nigeria
- Department of Dental and Maxillofacial Surgery, Federal Medical Centre, Gusau, Zamfara, Nigeria
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Oladayo AM, Odukoya O, Sule V, Molobe I, Busch T, Akodu B, Adeyemo WL, Gowans LJJ, Eshete M, Alade A, Awotoye W, Adeyemo AA, Mossey PA, Prince AER, Murray JC, Butali A. Perceptions and beliefs of community gatekeepers about genomic risk information in African cleft research. BMC Public Health 2024; 24:507. [PMID: 38365612 PMCID: PMC10873930 DOI: 10.1186/s12889-024-17987-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND A fundamental ethical issue in African genomics research is how socio-cultural factors impact perspectives, acceptance, and utility of genomic information, especially in stigmatizing conditions like orofacial clefts (OFCs). Previous research has shown that gatekeepers (e.g., religious, political, family or community leaders) wield considerable influence on the decision-making capabilities of their members, including health issues. Thus, their perspectives can inform the design of engagement strategies and increase exposure to the benefits of genomics testing/research. This is especially important for Africans underrepresented in genomic research. Our study aims to investigate the perspectives of gatekeepers concerning genomic risk information (GRI) in the presence of OFCs in a sub-Saharan African cohort. METHODS Twenty-five focus group discussions (FGDs) consisting of 214 gatekeepers (religious, community, ethnic leaders, and traditional birth attendants) in Lagos, Nigeria, explored the opinions of participants on genomic risk information (GRI), OFC experience, and the possibility of involvement in collaborative decision-making in Lagos, Nigeria. Transcripts generated from audio recordings were coded and analyzed in NVivo using thematic analysis. RESULTS Three main themes-knowledge, beliefs, and willingness to act-emerged from exploring the perspective of gatekeepers about GRI in this group. We observed mixed opinions regarding the acceptance of GRI. Many participants believed their role is to guide and support members when they receive results; this is based on the level of trust their members have in them. However, participants felt they would need to be trained by medical experts to do this. Also, religious and cultural beliefs were crucial to determining participants' understanding of OFCs and the acceptance and utilization of GRI. CONCLUSIONS Incorporating cultural sensitivity into public engagement could help develop appropriate strategies to manage conflicting ideologies surrounding genomic information in African communities. This will allow for more widespread access to the advances in genomics research in underrepresented populations. We also recommend a synergistic relationship between community health specialists/scientists, and community leaders, including spiritual providers to better understand and utilize GRI.
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Affiliation(s)
- Abimbola M Oladayo
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Veronica Sule
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Ikenna Molobe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tamara Busch
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Babatunde Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - Lord J J Gowans
- Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mekonen Eshete
- School of Medicine, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Azeez Alade
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Waheed Awotoye
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | | | - Peter A Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | | | - Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
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James O, Sabo VY, Adamson OO, Otoghile B, Adekunle AA, Adeyemo WL, Ladeinde AL, Ogunlewe MO. Presentation and Management of Atypical Orofacial Clefts: A Single-Institution Experience for 13 Year Period. Cleft Palate Craniofac J 2023; 60:133-141. [PMID: 34787018 DOI: 10.1177/10556656211055012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This study reviews the craniofacial clefts that presented at a Nigerian tertiary health facility, highlighting our experience with the pattern of presentation and surgical care of these patients. A retrospective review of the smile train database and medical records of all individuals who had been diagnosed with any of the Tessier craniofacial clefts and managed between 1st January 2007 and 31st December 2020 was done. The data were presented as numbers and percentages of cases. The cleft clinic of a tertiary health facility and a major cleft referral center in South-West Nigeria. Forty-five patients with craniofacial clefts were managed over the study period. 15.6% had associated syndromes, 2.2% had a family history of similar craniofacial cleft and 11% had a history of a possible teratogen. There were 21 (46.7%) middle clefts, 14(31.1%) lateral clefts and 10(22.2%) oblique clefts. The most common type of cleft was Tessier 0 while the Tessier 6 was the least common type. The median age at surgery was 10 months for male and 5months for female subjects, 15.3% complication rate was found in this study. Four patients had revision surgeries to correct residual deformities in this study. The diverse presentations and occurrence of the rare craniofacial clefts present complex aesthetic and functional problems that require individualized often multidisciplinary care. The execution of a properly planned treatment will reduce complications and the need for revision surgeries.
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Affiliation(s)
- O James
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
| | - V Y Sabo
- Department of Surgery, 291366University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - O O Adamson
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
| | - B Otoghile
- Department of Otorhinolaryngology-Head and Neck Surgery, Federal Medical Centre Yenegoa, Yenegoa, Nigeria
| | - A A Adekunle
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
| | - W L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
| | - A L Ladeinde
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
| | - M O Ogunlewe
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
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