scholarly journals Adapting cleft care protocols in low- and middle-income countries during and after COVID-19: a process-driven review with recommendations

2021 ◽  
Author(s):  
Matthew John Fell ◽  
Michael Goldwasser ◽  
BS Jayanth ◽  
Rui Manuel Rodrigues Pereira ◽  
Christian Tshisuz Nawej ◽  
...  
Keyword(s):  
Working Group ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Care Providers ◽  
Resource Constrained ◽  
Middle Income ◽  
Middle Income Countries ◽  
International Working Group ◽  
Consensus Recommendations ◽  
Low And Middle Income

Objective: A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptions to cleft care protocols during and after COVID 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 adaptions to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organisations 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 scrutinised and COVID adaptions, specifically in the pre and peri-operative periods, were highlighted. Second, surgical operations and access to services were prioritized according to their relationship to functional outcomes and time-sensitivity. The operations assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft services assigned the highest priority were new-born assessments, paediatric 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.

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

2022 ◽  
pp. 105566562110698
Author(s):  
Matthew Fell ◽  
Michael Goldwasser ◽  
B.S. Jayanth ◽  
Rui Manuel Rodrigues Pereira ◽  
Christian Tshisuz Nawej ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Working Group ◽  
Care Providers ◽  
Resource Constrained ◽  
Middle Income ◽  
Middle Income Countries ◽  
International Working Group ◽  
Consensus Recommendations ◽  
Care Services ◽  
Low And Middle Income

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. 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. 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. 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.

Efficacy of Facilitated Capacity Building in Providing Cleft Lip and Palate Care in Low- and Middle-Income Countries

2017 ◽  
Vol 28 (7) ◽  
pp. 1737-1741 ◽  
Author(s):  
Hillary E. Jenny ◽  
Benjamin B. Massenburg ◽  
Saurabh Saluja ◽  
John G. Meara ◽  
Mark G. Shrime ◽  
...  
Keyword(s):  
Capacity Building ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

A Model of the Unmet Need for Cleft Lip and Palate Surgery in Low- and Middle-Income Countries

2016 ◽  
Vol 40 (12) ◽  
pp. 2857-2867 ◽  
Author(s):  
Lucas C. Carlson ◽  
Barclay T. Stewart ◽  
Kristin W. Hatcher ◽  
Charles Kabetu ◽  
Richard VanderBurg ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Unmet Need ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

A Framework for Adapted Nutritional Therapy for Children With Cancer in Low- and Middle-Income Countries: A Report From the SIOP PODC Nutrition Working Group

2016 ◽  
Vol 63 (8) ◽  
pp. 1339-1348 ◽  
Author(s):  
Elena J. Ladas ◽  
Brijesh Arora ◽  
Scott C. Howard ◽  
Paul C. Rogers ◽  
Terezie T. Mosby ◽  
...  
Keyword(s):  
Working Group ◽  
Nutritional Therapy ◽  
Children With Cancer ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Remote Digital Preoperative Assessments for Cleft Lip and Palate May Improve Clinical and Economic Impact in Global Plastic Surgery

2017 ◽  
Vol 54 (5) ◽  
pp. 535-539 ◽  
Author(s):  
Christopher Hughes ◽  
Jacob Campbell ◽  
Swagoto Mukhopadhyay ◽  
Susan Mccormack ◽  
Richard Silverman ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Plastic Surgery ◽  
Cleft Lip ◽  
Digital Video ◽  
Cleft Lip And Palate ◽  
Surgical Care ◽  
Short Term ◽  
Middle Income ◽  
Alveolar Cleft ◽  
Middle Income Countries

Objective Reconstructive surgical care can play a vital role in the resource-poor settings of low- and middle-income countries. Telemedicine platforms can improve the efficiency and effectiveness of surgical care. The purpose of this study is to determine whether remote digital video evaluations are reliable in the context of a short-term plastic surgical intervention. Setting The setting for this study was a district hospital located in Latacunga, Ecuador. Patients Participants were 27 consecutive patients who presented for operative repair of cleft lip and palate. Main Outcome Measures We calculated kappa coefficients for reliability between in-person and remote digital video assessments for the classification of cleft lip and palate between two separate craniofacial surgeons. We hypothesized that the technology would be a reliable method of preoperative assessment for cleft disease. Results Of the 27 (81.4%) participants, 22 received operative treatment for their cleft disorder. Mean age was 11.1 ± 8.3 years. Patients presented with a spectrum of disorders, including cleft lip (24 of 27, 88.9%), cleft palate (19 of 27, 70.4%), and alveolar cleft (19 of 27, 70.4%). We found a 95.7% agreement between observers for cleft lip with substantial reliability (κ = .78, P .01). There was an 82.6% agreement between observers for cleft palate, with a moderate interrater reliability (κ = .55, P = .01). We found only a 47.8% agreement between observers for alveolar cleft with a nonsignificant, weak kappa agreement (κ = .06, P .74). Conclusions Remote digital assessments are a reliable way to preoperatively diagnose cleft lip and palate in the context of short-term plastic surgical interventions in low- and middle-income countries. Future work will evaluate the potential for real-time, telemedicine assessments to reduce cost and improve clinical effectiveness in global plastic surgery.

scholarly journals COVID-19 preparedness—a survey among neonatal care providers in low- and middle-income countries

2021 ◽  
Author(s):  
Claus Klingenberg ◽  
◽  
Sahil K. Tembulkar ◽  
Anna Lavizzari ◽  
Charles C. Roehr ◽  
...  
Keyword(s):  
Low Income ◽  
Care Delivery ◽  
Neonatal Care ◽  
Sub Saharan Africa ◽  
World Health ◽  
Care Providers ◽  
Clinical Practices ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Objective To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents. Study design Cross-sectional, web-based survey administered between May and June, 2020. Results Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infected infants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making. Conclusions Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.

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