Study of care for patients with cleft lip/palate (CLP) in Lao People's Democratic Republic.

Objective: The objectives of the study were to determine basic information, understand health-related problems and examine problem-solving strategies among patients with cleft lip/palate (CLP) residing in Lao People's Democratic Republic (PDR).

Material And Method: This was a cross-sectional, descriptive study. The research team interviewed 24 patients with CLP who underwent surgery at the Khammouan Hospital between October 16-20, 2010 and their caregivers. A questionnaire was developed by the research team to collect information on demographics, health-related problems and problem-solving strategies. Content validity was reviewed by five experts.

Results: Sixty-two percent (15/24) of the patients were boys with an average age of 6.3 years. Fifty percent of the patients had both a cleft lip and cleft palate. Heredity played a major role in causing the CLP among the majority of patients (58%). Most of caregivers resided in either Khammouan (33%) and Bolikhamxai Province (33%). With respect to the caregivers, their average age was 36 years, 50% were fathers and mothers, 87% had a family income lower than one million Kip/month (124 USD); all were satisfied with the treatment provided, 96% had sufficient knowledge for helping or publicizing the proper treatment to other patients and 87% knew of the healthcare resources for patients with CLP (i.e., Khammouan Hospital provides free-of-charge surgery). The caregivers also understood the need for regular, life-long follow-up care of cleft lip. However, 87% of the caregivers did not know the causes of CLP, 75% did not know that the patients with ridges cleft must have a ridges bone graft surgery, while 66% did not know about post operative care, wound care, audiometry and speech therapy.

Conclusion: Although timely receipt of primary cleft surgery is essential to the physical and psychosocial well-being of patients with CLP, those residing in Lao PDR did not receive surgery until the age of 6 years. The main reasons for this are the lack of awareness regarding diagnosis and treatment, limited availability of health services, and insufficient financial resources; therefore, both technical and financial support from external stakeholders is crucial. The establishment of a local medical infrastructure, training local surgeons and free access are also critical for the development of a sustainable and effective multidisciplinary management program for patients with CLP and their families.