Families ignore cleft treatment due to non-medical expenses -Research

A study by the National Cleft Care Centre (NCCC) at the Komfo Anokye Teaching Hospital (KATH) has revealed that the headache of parents of children born with cleft lip and palate in Ghana is not about the cost of surgery.

What actually put these families in difficult situations are the non-medical expenses that come in the form of transportation, feeding and temporary accommodation while seeking comprehensive care for such children after surgery.

According to the study, these families spend at least 25 per cent of their annual income on the non-medical expenses required to ensure a comprehensive post- surgery care.

Consequently, the Director of NCCC, Prof. Solomon Obiri-Yeboah, has underscored the need for a comprehensive cleft management which requires a multidisciplinary approach, integrating plastic surgery, dental care, speech therapy, nutritional support, and psychosocial counseling.

Additionally, he has urged the National Health Insurance Scheme (NHIS) to absorb surgical costs so that donor resources can be redirected toward travel and welfare support.

Marking this year’s cleft awareness campaign, Prof. Obiri-Yeboah stated that the core surgical procedure alone costs a minimum of GH₵5,000.

According to the research, that burden has forced many families to miss or abandon the multiple hospital visits required for successful treatment, putting children at risk of complications that could otherwise be prevented.

It explained that although corrective surgeries were offered free through support from international partners, the cost of travelling repeatedly to specialist centres, feeding and accommodation remains beyond the reach of these families.

The research cautioned that until these financial barriers were addressed, more children would continue to shun essential reviews and follow-up care, undermining the success of treatment.

Health professionals have argued that cleft care inclusion on the NHIS would not only reduce the financial burden on families but also improve treatment outcomes and advance Ghana’s commitment to achieving universal health coverage.

Dr Robert Larmie, a Maxillofacial Surgeon at the NCCC, warned that failing to provide financial relief leaves children vulnerable to harmful myths.

“If these mothers cannot afford the journey for care, children are pushed back into misconceptions.

To expand treatment capacity, Smile Train has collaborated with KATH and the Ghana Cleft Foundation to build over $2-million, six-storey National Cleft Care Centre at KATH.

The facility has an outpatient department, consulting rooms, four specialised operating theaters, pre- and post-operative wards, clinical laboratories, lecture halls, a library, and research units.

Prof. Peter Donkor, President of the Ghana Cleft Foundation and First Vice-President of the West African College of Surgeons, noted that the centre provides free treatment regardless of a patient’s age.

Cleft lip and palate occur during pregnancy when a baby’s lip or the roof of the mouth fails to fuse properly. The condition may range from a small notch in the lip to a wide opening extending into the nose.

Without timely treatment, affected children often experience serious challenges with feeding, breathing, hearing and speech development, while many also endure social stigma and discrimination.

Globally, one in every 700 babies is born with a cleft, leaving an estimated 4.6 million people living with untreated or inadequately treated conditions, particularly in low and middle income countries.

In Ghana, about one in every 770 babies is born with a cleft, resulting in more than 400 new cases each year, in addition to a backlog of children still awaiting treatment.

By Kingsley E. Hope, Kumasi