The Chief Medical Director, National Hospital Abuja (NHA), Dr. Jeff Momoh has called for the inclusion of treatment for cleft lip and palate in the National Health Insurance Scheme (NHIS), to relieve parents/patients who are mostly from poor homes, the difficulties associated with management of the condition.
Dr. Momoh made the call at the National Cleft Stakeholders Forum- North Central Zone, themed; “Planning for Sustainable Comprehensive Cleft Care,’ on Friday in Abuja which was organized by Smile Train, a global cleft charity. He said the care and management of cleft lip palate patients was a long-term journey.
Smile Train has been in Nigeria for more than 10 years, having treated over 25,000 cleft patients using the scalable sustainable approach to cleft care.
Represented by the Head Clinical Services of the Hospital, Dr. Aisha Umar, he insisted that health insurance would be the best way to capture patients and families with cleft lip and palate, considering the four main components associated with its care and management.
He said,” It is a long term care that needs to take care of four main problems that the patient has; it starts with correcting the teeth of the patient which will require a team of doctors as well as psychosocial support by professionals for the family to know that they have not done anything wrong.”
“After that, they have to plan for the surgery usually three months after birth but in between this period the child needs to have support through special feeding and health. When the surgery is done, you still need assessment for hearing by going to ENT, and finally, they need to correct any speech problems. All these components have to be paid for holistically in the NHIS System.”
“I call upon the stakeholders to propose all-encompassing cleft care, where the child will eventually get all the care and follow-up they need until finally discharged. Health insurance will be the best way to capture it.”
On her part, Smile Train Programme Director, West and Central Africa, Mrs. Nkeiruka Obi, said cleft is a congenital anomaly viewed as a medical mystery, as the definitive cause of the anomaly was yet to be ascertained, even though genetic and environmental factors were postulated as possible causes.
While noting that Nigeria has the highest annual incidence of over 6,000 new cleft births in Africa with more prevalence in the North, she said based on the Smile Train data base, an average of about 3,000 to 4,000 cases were addressed every year.
“Children with cleft experience difficulty eating, breathing or even speaking and if left untreated, some children die while those who grow up are often neglected and isolated. Causes of cleft are unknown but associated with risk factors such as environmental, lack of proper nutrition as well as genetics. Once treated, the child can go on to live a normal and productive life. We need to work together to support the families to receive free comprehensive and quality care under the Smile Train Program,” noted Mrs. Obi.
On preventive measures, she advised women to maintain proper care especially during pregnancy, pay close attention to their nutrition, ensure consumption of folic acid, ensure strict compliance to antenatal care for guidance through the pregnancy period and avoid taking drugs not prescribed by doctors.
On his part, The Secretary General, West African College of Surgeons, Prof. Philip Mshelebwala stressed that capturing care and management of cleft in the NHIS would make a huge difference. He commended Smile Train for its many years of support which has made care and management of cleft completely free in the country. He also called for collaboration among stakeholders and the government to prioritize sustainable and comprehensive cleft care in Nigeria.
“Most of the people affected are poor people and if they can enroll in the NHIS, that will make a big difference. It should be discussed at the high level of government to include not just the surgery but the comprehensive care and support; that will go a long way in relieving the difficulties parents face when they give birth to children with cleft.”
Prof. Mshelbwala, added, “If the stakeholders can come together as a team and come up with policies that are sustainable and workable, it will make a whole lot of difference.”
Earlier, prof. Emmanuel Ameh, Smile Train meeting coordinator for North Central zone disclosed that the objective of the meeting was to educate stakeholders on nature and challenges of cleft, provide information on how to access care, promote close interactions and share ideas and experiences on the cleft management amongst other issues.