UCSF

Abstract

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

clinical purposes.

Methods: Medical record review data provided the independent, dependent and

covariate variables.

Sample: A sample of 706 medical records documented the clinical encounters of

Guatemalan families seeking surgical services from the organization FOH for 2005

to 2009.

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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.