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ePaper created 2016-12-19, 09:18:41 | version 1.38.0
By DTI LOS ANGELES, USA: Charitable or- ganisations perform more than 80 per cent of cleft lip and cleft palate surgeries in Vietnam, a new study by US researchers has found. According to the scientists, this reflects the complex and per- sistent barriers to surgical care in low- to middle-income countries (LMICs) and shows that charitable missions remain a critical source of access to surgical care for these states. Cleft lip and palate are the most common craniofacial birth defects, occurring in between one in 500 to one in 2,500 infants worldwide. “The defect not only results in physical obstacles to feeding and language develop- ment, but patients are often sub- jectedtosignificantsocialstigma,” the researchers stated. They surveyed approximately 450 Vietnamese families seeking cleft lip and/or palate repair sur- gery for their affected child. Some of the children had already under- gone surgery for their condition previously (54 per cent) and 46 per cent of them were seeking surgical care for the first time. The families were seen at four medical mis- sions sponsored by the interna- tional charity Operation Smile. Parents were asked in-depth ques- tions about their perceptions of the barriers to surgical and medi- cal care for their child’s condition. Facing structural, financial and cultural barriers to cleft lip and palate surgery, patients in LMICs rely on charitable care outside the centralised health care sys- tem, the study report pointed out. “As a result, surgical treatment of cleft lip and palate is delayed be- yond the standard optimal win- dow compared to more developed countries,” the researchers wrote. At the time of initial cleft sur- gery, the children’s average age was 3.25 years. By comparison, in developed countries, the recom- mended age for cleft lip and palate repair surgery is between 3 and 18 months of age. Nearly three-quarters of the families had health insurance coverage. Nevertheless, 83 per cent had their surgery performed by a charitable organisation out- side of the national health care system. While most parents had a local hospital that was more accessible than the charitable mis- sion was, many said that they could not obtain cleft treatment there, mainly owing to cost. About 40 per cent stated that, without thecharitablemission,theywould not have had access to any surgi- cal or medical treatment for their child’s condition. The survey found a wide range of structural, financial and cul- tural barriers to cleft care. Struc- tural barriers included lack of trained medical staff, equipment and medicine. Financial barriers were identified as not only the cost of the surgery, but also the cost of travel to obtain care. Cultural barriers included family members’ opinions and permis- sion, as well as lack of trust in the medical system and staff. According to the researchers, these barriers need to be better understood in order to design more effective programmes for both missions-based and locally sustainable surgical care in LMICs. On the basis of their findings, they proposed a new surgical LMIC modelthataccountsfortheunique barriers and specific challenges to accessing surgery in resource-poor countries—especially for conditions that require multiple operations, such as cleft lip and palate. Improving access to surgical care has become a major global health priority, the researchers said. However, the current knowl- edge gap on providing surgery in LMICs—including the need for specialised facilities, physicians and follow-up care—has only begun to be studied. Thus, even in coun- tries with near-universal health insurance, charitable missions re- main a critical source of access to surgical care, they concluded. The study, titled “Barriers to reconstructive surgery in low- and middle-income countries: A cross-sectional study of 453 cleft lip and cleft palate patients in Vietnam”, was conducted by scien- tists from the University of South- ern California in Los Angeles. It was published in the November issue of Plastic and Reconstructive Surgery, the journal of the Ameri- can Society of Plastic Surgeons. 02 Dental Tribune Asia Pacific Edition | 12/2016 ASIA PACIFIC NEWS IMPRINT PUBLISHER: Torsten OEMUS GROUP EDITOR/MANAGING EDITOR DT AP & UK: Daniel ZIMMERMANN newsroom@dental-tribune.com CLINICAL EDITOR: Magda WOJTKIEWICZ ONLINE EDITOR: Claudia DUSCHEK EDITOR: Anne FAULMANN ASSISTENT EDITOR: Kristin HÜBNER COPY EDITORS: Sabrina RAAFF, Hans MOTSCHMANN PRESIDENT/CEO: Torsten OEMUS CFO/COO: Dan WUNDERLICH MEDIA SALES MANAGERS: Matthias DIESSNER Peter WITTECZEK Maria KAISER Melissa BROWN Weridiana MAGESWKI Hélène CARPENTIER Antje KAHNT INTERNATIONAL PR & PROJECT MANAGER: Marc CHALUPSKY MARKETING & SALES SERVICES: Nicole ANDRAE ACCOUNTING: Karen HAMATSCHEK BUSINESS DEVELOPMENT: Claudia SALWICZEK-MAJONEK EXECUTIVE PRODUCER: Gernot MEYER AD PRODUCTION: Marius MEZGER DESIGNER: Franziska DACHSEL INTERNATIONAL EDITORIAL BOARD: Dr Nasser Barghi, Ceramics, USA Dr Karl Behr, Endodontics, Germany Dr George Freedman, Esthetics, Canada Dr Howard Glazer, Cariology, USA Prof. Dr I. Krejci, Conservative Dentistry, Switzerland Dr Edward Lynch, Restorative, Ireland Dr Ziv Mazor, Implantology, Israel Prof. Dr Georg Meyer, Restorative, Germany Prof. Dr Rudolph Slavicek, Function, Austria Dr Marius Steigmann, Implantology, Germany Published by DT Asia Pacific Ltd. DENTAL TRIBUNE INTERNATIONAL Holbeinstr. 29, 04229, Leipzig, Germany Tel.: +49 341 48474-302 Fax: +49 341 48474-173 info@dental-tribune.com www.dental-tribune.com Regional Offices: DT ASIA PACIFIC LTD. c/o Yonto Risio Communications Ltd, Room 1406, Rightful Centre, 12 Tak Hing Street, Jordan, Kowloon, Hong Kong Tel.: +852 3113 6177 Fax: +852 3113 6199 UNITED KINGDOM 535, Stillwater Drive 5 Manchester M11 4TF Tel.: +44 161 223 1830 www.dental-tribune.co.uk DENTAL TRIBUNE AMERICA, LLC 116 West 23rd Street, Suite 500, New York, NY 10001, USA Tel.: +1 212 244 7181 Fax: +1 212 224 7185 © 2016, Dental Tribune International GmbH All rights reserved. Dental Tribune makes every effort to report clinical information and manufacturer’s product news accurately, but cannot assume respon- sibility for the validity of product claims, or for typo- graphical errors. The publishers also do not assume responsibility for product names or claims, or state- ments made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune International. Scan this code to subscribe our weekly Dental Tribune AP e-newsletter. DENTAL TRIBUNE The World’s Dental Newspaper · United Kingdom Edition Barriers to cleft lip and palate surgery persist in Vietnam “...patients are often subjected to significant social stigma...” ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providersof continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Join the largest educational network in dentistry! www.DTStudyClub.com – education everywhere and anytime – live and interactive webinars – more than 1,000 archived courses – a focused discussion forum – free membership – no travel costs – no time away from the practice – interaction with colleagues and experts across the globe – a growing database of scientific articles and case reports – ADA CERP-recognized credit administration register for FREE Dental Tribune Study Club AD © Operation Smile For their child affected by cleft lip and/or palate, more than 80 per cent of Vietnamese families surveyed in a study sought surgical care in a charitable mission—although 73 per cent of them had health insurance. Tel.: +4934148474-302 Fax: +4934148474-173 Tel.: +85231136177 Fax: +85231136199 Tel.: +441612231830 Tel.: +12122447181 Fax: +12122247185