Our Summary

This research paper looks at why people in low- and middle-income countries, specifically Vietnam, struggle to access specialized healthcare, such as plastic and reconstructive surgery. The study was conducted at five different sites across the country.

The researchers found that 453 households faced major obstacles in accessing surgical care for conditions like cleft lip and/or cleft palate. These barriers included the high cost of surgery, a lack of trust in medical professionals, and a shortage of necessary supplies and trained doctors at local hospitals.

Interestingly, the study found no significant difference in income or hospital access between households who had received cleft surgery in the past and those who hadn’t. However, fewer of the households that had received surgery were enrolled in health insurance.

The study also found that 83% of households who had accessed surgery in the past did so through a charity, suggesting that many people rely on charitable care rather than the centralized healthcare system. This leads to delays in treatment, as surgical treatment of conditions like cleft lip and palate are often carried out later than is considered optimal in more developed countries.

Based on these findings, the authors suggest a more evidence-based approach to understanding health behaviors and perceptions about reconstructive surgical care in underprivileged countries.

FAQs

  1. What are the major obstacles faced by households in Vietnam in accessing surgical care for conditions like cleft lip and/or cleft palate?
  2. Is there a difference in the income or hospital access between households who had received cleft surgery and those who hadn’t?
  3. What percentage of households in the study accessed surgery through a charity and what impact does this have on the timing of treatment?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft palate surgery is to follow all pre-operative and post-operative instructions carefully. This can include avoiding certain foods or medications before surgery, maintaining good oral hygiene, and attending all follow-up appointments to ensure proper healing and optimal results. It is also important to communicate any concerns or complications with your healthcare provider promptly.

Suitable For

Typically, patients with cleft lip and/or cleft palate are recommended cleft palate surgery. These patients may face challenges in accessing specialized healthcare due to factors such as cost, lack of trust in medical professionals, and limited availability of trained doctors and necessary supplies. Charity care is often relied upon for accessing surgical treatment in low- and middle-income countries, leading to delays in treatment compared to more developed countries. A more evidence-based approach is needed to address barriers to accessing reconstructive surgical care in underprivileged countries.

Timeline

  • Before cleft palate surgery:
  1. Patient is born with cleft lip and/or cleft palate, which can impact feeding, speech, and overall quality of life.
  2. Patient and their family may face stigma and discrimination due to the visible difference in appearance.
  3. Patient may struggle to access specialized healthcare, such as plastic and reconstructive surgery, due to barriers such as high cost, lack of trust in medical professionals, and shortage of necessary supplies and trained doctors at local hospitals.
  4. Patient may rely on charitable care for surgical treatment, leading to delays in treatment.
  • After cleft palate surgery:
  1. Patient undergoes surgical procedure to repair the cleft lip and/or palate, improving their appearance and overall function.
  2. Patient may experience a period of recovery, including pain management and follow-up appointments with healthcare providers.
  3. Patient may undergo speech therapy and other interventions to address any lingering issues related to the cleft palate.
  4. Patient and their family may experience improved quality of life and reduced stigma following successful surgery and rehabilitation.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cleft palate surgery may include:

  1. What are the potential risks and complications associated with cleft palate surgery?
  2. How long is the recovery period, and what can I expect during the recovery process?
  3. Will there be scarring after the surgery, and if so, how noticeable will it be?
  4. What type of anesthesia will be used during the surgery, and are there any potential side effects?
  5. How many surgeries may be required to fully correct the cleft palate, and what is the timeline for these procedures?
  6. Will there be any dietary restrictions or special care instructions following the surgery?
  7. What are the long-term outcomes and potential challenges that may arise after cleft palate surgery?
  8. Are there any alternative treatment options or complementary therapies that can help improve the results of the surgery?
  9. How experienced is the surgical team in performing cleft palate surgeries, and what is their success rate?
  10. What is the cost of the surgery, and are there any financial assistance programs or insurance coverage options available?

Reference

Authors: Yao CA, Swanson J, Chanson D, Taro TB, Gura B, Figueiredo JC, Wipfli H, Hatcher K, Vanderburg R, Magee WP 3rd. Journal: Plast Reconstr Surg. 2016 Nov;138(5):887e-895e. doi: 10.1097/PRS.0000000000002656. PMID: 27783003