Background: Oral clefts occur in approximately one out of 700 births worldwide
and can affect the lip, the palate, or both. In developing countries, lack of awareness
of cleft treatment options, scarcity of surgical services, and poverty create barriers
to corrective surgeries. To reduce global cleft care disparities, many
nongovernmental organizations have developed short-term missions that provide
surgical treatment. Few of these organizations have evaluated the impacts of their
programs for the children and their families.
Aim: To evaluate the activities of the surgical outreach organization Faces of Hope
(FOH) for the years 2005 through 2009.
Conceptual Framework: The Center for Disease Control Framework for Program
Development in Public Health was used to initiate the evaluation of FOH. Research
questions evaluated patient eligibility to receive services, and the outputs and
outcomes of the services provided.
Design: A cross sectional design utilizing five consecutive years of data collected for
Methods: Medical record review data provided the independent, dependent and
Sample: A sample of 706 medical records documented the clinical encounters of
Guatemalan families seeking surgical services from the organization FOH for 2005
Results: There is no evidence that surgical repair of primary orofacial clefts
occurred sooner over the years of FOH activities. Surgical complications compared
by years suggest that a statistically significant difference exists between surgical
complications in 2006 and 2009. There were no complications in 2009 compared to
2006 in which there was an 11.3% complication rate. Anesthetic complications did
not have an association by year. Diagnosis, illness and wt/age- in- month Z scores
were statistically significant predictors of complications.
Eligibility (receiving surgical treatment) was predicted by previous surgery, illness
and diagnosis. Pre-operative vital signs and blood hemoglobin level did not predict
eligibility. Returning in subsequent years to seek additional services was predicted
by diagnosis, wt/age-in-month Z scores and documented futures needs.
Significance: Evaluation of short-term surgical missions is crucial as these
organizations continue to participate in the provision of surgical care for children
who may otherwise not receive treatment.