A.A. Adekunle, A.A. Adamson, O. James, W.L Adeyemo, M.O. Ogunlewe
Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital/ college of Medicine, University of Lagos, Idi- araba, Lagos.
Abstract
Objective: To evaluate the effectiveness of our awareness campaign strategies and identify the most effective strategy for our environment.
Design: This was a cross-sectional descriptive study using a 15-item interviewer administered questionnaire.
Setting: The orofacial cleft clinic of a tertiary health institution in Lagos, Nigeria
Participants: The sample population was all consenting parents and adult patients attending the orofacial cleft clinic within the study period.
Main outcome measures: The primary outcome measures was the percentage contribution of the various outreach modalities to the source of referral to the clinic.
Results: A total of 107 respondents were recorded in this study. Forty-six percent of the respondents received information about the availability of treatment and referrals from the maternity centers where the child was delivered (45.8%, n = 49), while the media campaign contributed 13.1% to our patient referrals. Seventy percent (n = 75) of the participants lived within the state of Lagos. Eighty-five percent (n=91) utilized public transport for clinic visits. The median approximate distance travelled from their home to the clinic was 23 (IQR 11– 42) km, with a range of 1.5–988 km. The median approximate cost of public transportation to the clinic from their homes was 2000 (IQR 1500–4375) Naira (~ 4 USD), with a range of 200–120,000 Naira (~ 0.4–250 USD) per visit.
Conclusion: The results of this study show that campaigns focused on maternity homes and peripheral hospitals appear to be the most effective strategy and the single largest source of referrals to our cleft care programme.
Keywords: Community awareness; Health campaign; Health promotion; Orofacial cleft
Correspondence:
Dr. A.A Adekunle
Dept. of Oral and Maxillo Surgery, Lagos University Teaching Hospital. Idi – Araba, Lagos. Nigeria.
Email: aadeadekunle01@gmail.com
Submission Date: 10th June, 2024
Date of Acceptance: 5th July, 2024
Publication Date: 30th Aug., 2024
Introduction
Studies have identified lack of awareness of availability of treatment services as one of the most important barriers to cleft care in low- and middle-income countries. These studies have shown this to be one of the major factors responsible for late presentation1,2. The prevalence of cleft lip and palate in Nigeria is estimated to be about 0.5 per 1000 live births3and the incidence rate of orofacial clefts in individuals of sub-Saharan Africa origin ranges from 0.18 to 1.67 per 1,000 worldwide.4 Butali et al.3,5 has done substantial work to quantify the burden of orofacial cleft in Nigeria and Africa, however the problem of under ascertainment remains a significant challenge. This is because childbirth, especially in suburban and rural areas still occurs largely out of the formal hospital setting, in addition, the stigma associated with having a child with a birth deformity also hampers reporting6. Adebola et al.7, in their work on the impact of community mobilization and awareness campaigns on orofacial cleft, argued that due to the anticipated disease burden of over 3000 infants born yearly with orofacial cleft in Nigeria, organizations involved in cleft care provision in Nigeria must take community mobilization and awareness seriously if the largely unmet needs of orofacial cleft patients in Nigeria are to be adequately addressed.
To tackle this issue of awareness, as a cleft care team situated in a metropolitan city, we conduct quarterly outreaches to suburban communities, primary and secondary level health facilities, and engage with community health extension officers at local government level within the state, along with social media campaigns and use of traditional media such as billboards, radio, and television to generate awareness about cleft lip and palate (CLP) and availability of comprehensive management at our center. These campaigns have been majorly within the last 5 years.
The aim of this study was to evaluate the effectiveness of our awareness campaign strategies with the specific objectives of identifying the medium by which information was obtained about availability of cleft care at our centre, we also sought to identify the regions within and outside the state from which patients travel to the clinic, the approximate distance travelled and the approximate cost of travel per patients visit to the clinic.