Adapting Elements of Cleft Care Protocols in Low- and Middle-income Countries During and After COVID-19: A Process-driven Review With Recommendations

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  • Fell, M.
    • Other Affiliation: University of Bristol
  • Goldwasser, M.
    • Affiliation: School of Dentistry
  • Jayanth, B.S.
    • Other Affiliation: ABMSS
  • Pereira, R.M.R.
    • Other Affiliation: Faculdade de Medicina da Universidade de Sao Paulo
  • Nawej, C.T.
    • Other Affiliation: Cliniques Universitaires de Lubumbashi
  • Winer, R.
    • Other Affiliation: Transforming Faces
  • Daftari, N.
    • Other Affiliation: Transforming Faces
  • Brewster, H.
    • Other Affiliation: Transforming Faces
  • Goldschmied, K.
    • Affiliation: School of Dentistry
  • Almas, C.F.
  • Eshete, M.
    • Other Affiliation: Yekatit 12 Hospital Medical College
  • Galiwango, G.W.
    • Other Affiliation: CORSU Rehabilitation Hospital
  • Hollier, L.H., Jr.
    • Other Affiliation: Baylor College of Medicine
  • Hussain, A.
    • Other Affiliation: Yenepoya Dental College
  • Lo, L.-J.
    • Other Affiliation: Chang Gung Memorial Hospital
  • Salins, P.
    • Other Affiliation: Mazumdar Shaw Medical Centre
  • Sell, D.
    • Other Affiliation: Great Ormond Street Hospital for Children
  • Tafase, A.
  • Zuker, R.M.
    • Other Affiliation: University of Toronto
Abstract
  • Objective A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. Design A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care. Results Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinized and COVID-19 adaptations, specifically in the pre- and perioperative periods, were highlighted. Second, surgical procedures and cleft care services were prioritized according to their relationship to functional outcomes and time-sensitivity. The surgical procedures assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft care services assigned the highest priority were new-born assessments, pediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. Conclusions A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.
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  • Article
Rights statement
  • In Copyright
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  • Attribution 4.0 International
Journal title
  • The Cleft Palate Craniofacial Journal
Language
  • English
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  • The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: MF is supported by the VTCT Foundation for a research fellowship with the Cleft Collective at the University of Bristol.
ISSN
  • 1055-6656
Publisher
  • SAGE Publications Ltd

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