The Quality of Cleft Care Services at a Tertiary Cleft Care Center in Addis Ababa

Abstract

This study explores the quality of cleft care provided at Yekatit 12 Hospital Medical College, the only government hospital in Ethiopia offering comprehensive cleft care through a multidisciplinary team.  Although reconstructive surgery addresses feeding and aesthetic issues, functional issues such as speech difficulties, dental problems, hearing loss, and psychosocial problems can still persist without ongoing care, particularly speech and language therapy. The study aims to investigate participants' opinions concerning the quality of care in children with speech and language disability. Employing a qualitative case study methodology, the study collected data from two plastic surgeons, two speech and language therapists, and three parents of children being treated, using semi-structured interview guide. The results show that the hospital delivers cleft care services comprehensively, following proper timelines for initial assessment, surgery, and speech therapy. Nevertheless, delays in primary lip surgeries were observed, mainly on the grounds of weight eligibility criteria. Several challenges were also observed, such as a lack of proper resources, shortages of manpower, particularly in speech therapy and nutrition, poor documentation, and language barriers. Despite these challenges, participants commended the hospital's commitment to providing holistic cleft care with the aid of non-governmental charities. Suggestions for improving the quality of care are enhanced diagnostic equipment, adding more professionals to staff, expanding hospital capacity, and creating stronger local support networks. Addressing these could improve Yekatit 12 Hospital's response to the diverse needs of children with clefts, enhance the effectiveness of care, and improve long-term results. These Enhancements would help to improve the hospital's capacity to continue its critical activity in cleft care and rehabilitation.