Psychosocial Care From the Cleft Provider Perspective in Low Resource Settings

Abstract

Objective

In low resource settings, there are several barriers to achieving a multidisciplinary approach covering all aspects of cleft including psychosocial services. The study aim was to gain insight into current psychosocial practices in these settings.

Design

Cross-sectional study.

Setting

Comprehensive Cleft Care Workshop in October 2024.

Participants

Workshop Attendees.

Interventions

A 20-item survey including quantitative and qualitative questions about psychosocial practices in participants’ workplaces was distributed.

Main Outcome Measures

The main outcomes were to assess cleft psychosocial practices, and the challenges faced when integrating psychosocial care in low resource settings.

Results

Seventy-six respondents were working in low-resource settings in Africa or Asia, with 67.2% working in plastic or oral/maxillofacial surgery department and 68.4% working in an academic hospital. Almost 90% of respondents work in a multidisciplinary team. Of those who responded that psychosocial care was available in their setting (n = 44), 47.7% reported that either psychologists or psychiatrists were responsible for providing this care. Twenty-five (56.8%) of these respondents reported that although psychosocial support is available, this service is not provided by a cleft specialist. Most respondents reported a lack of resources/tools (68.4%) as a challenge to referring patients to psychosocial care and mentioned a need for: (1) more cleft-specialized psychosocial personnel; (2) dedicated financial budgets; (3) increased awareness; and (4) protocols to integrate multidisciplinary discussions.

Conclusions

Availability, accessibility and knowledge of the importance and recommended delivery of psychosocial services in cleft remains limited in low resource settings. Further research into psychosocial needs and ways of improving delivery is required.