Cultural Beliefs on Cleft lip and/or Cleft Palate and Their Implications on Management: A Systematic Review

OBJECTIVE

This article examines and summarizes the published epidemiological literature on cross-cultural variations. Particular emphasis was put on addressing cross-cultural beliefs on the causes, management, and attitude toward cleft lip and/or cleft palate. A healthcare provider's awareness of these cross-cultural attitudes and beliefs is vital for promoting effective collaboration with patients' families and ensuring a favorable medical outcome.

DESIGN

Systematic review.

SETTING

Not applicable.

PARTICIPANTS

Patients with cleft lip and/or cleft palate, their families, their communities, and healthcare providers.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Not applicable.

RESULTS

All relevant and eligible studies were identified using PubMed and Google Scholar databases. The cultural belief was categorized and measured using Murdock's Theories of Illness. The study was reported in compliance with PRISMA guidelines. The quality of the selected studies was evaluated in accordance with the Critical Appraisal Skills Programme criteria (CASP). Fourteen articles covering thirteen countries on four continents met the inclusion criteria. In diverse communities, cleft lip and/or cleft palate was attributed to natural (infection, medication, improper diet, smoke, or radiation) or supernatural (God, eclipse, ancestral spirit, and curse) causes. Reported consequences include stigmatization, inappropriate treatments, leaving patients untreated, and infanticide.

CONCLUSION

Cultural beliefs are the main cause of misconceptions surrounding a cleft lip and/or cleft palate. There is also a need for public health care providers' intervention to educate society about the natural causes and ease of management, thereby increasing opportunities for patients substantially.

Approaches of South African Traditional Healers regarding the Treatment of Cleft Lip and Palate

Objective

Due to the large number of Black South Africans known to consult with traditional healers and the influential role they play in the developing world, this study investigated the approaches of a group of 15 traditional healers toward the treatment of cleft lip and palate.

Design

An exploratory-descriptive, qualitative research design was employed, which involved the use of standardized, semistructured interviews, conducted with the assistance of an interpreter who was fluent in several African languages.

Setting

Interviews were conducted outdoors in places in which traditional healers usually consult with their patients. These areas were in the fields close to the traditional healers’ homes or under a highway bridge in the Johannesburg inner city.

Participants

Individual interviews were conducted with 15 African traditional healers who had been practicing in their callings for at least 1 year.

Results

Traditional healers interviewed had treated one to six persons with a cleft lip, cleft palate, or both. Most informants believed that clefts were caused by the ancestors, spirits, and witchcraft. A variety of plant and animal products were used to treat these conditions and were augmented by spiritual resources from the ancestors. All except one healer had undergone formal training, although they had received no specific training relative to cleft lip and palate. Most participants reported referring patients to Western health care practitioners who were referred to as modern doctors but did not receive reciprocal referrals from these professionals. Patients generally consulted with traditional healers because this approach was part of their culture.

Conclusions

These findings have important implications for health care professionals as well as traditional healers in terms of cross-cultural consultation, collaboration, and information sharing with regard to cleft lip and palate; the potential use of traditional healers in primary health care and education; and further research.

Mexican-American and Anglo-American mothers' beliefs and values about child rearing, education, and language impairment

This study investigated the cross-cultural and intra cultural diversity of mothers' beliefs and values regarding child rearing, education, and the causes of language impairment. Thirty Mexican-American and 30 Anglo-American mothers of children with language impairments completed 2 questionnaires, and 10 randomly selected mothers from each group participated in an interview. In addition, the Mexican-American mothers completed an acculturation rating scale. Results indicated that Mexican-American mothers held more strongly traditional, authoritarian, and conforming educational and child rearing beliefs and values than Anglo-American mothers. Mexican-American mothers cited extrinsic attributes as the cause of their children's language impairment, whereas Anglo-American mothers cited intrinsic attributes. Mexican-American mothers exhibited differences in their beliefs that were related to their level of acculturation to the mainstream culture.