Reasons for late presentation of cleft deformity in Nepal.
OBJECTIVE
To determine the causes of late presentation of patients with cleft lip and palate in Nepal.


METHODS
Cross-sectional survey using interviews of patients' parents.


METHODS
The study was carried out between April 1999 and September 1999 in Western Regional Hospital (WRH), Pokhara, Nepal, a secondary care center.


METHODS
All patients with cleft lip and palate coming to WRH outpatient department or coming for surgery were included in the study. Those without parents were excluded. A total of 53 patients were included.


RESULTS
Forty-two (79%) presented after 3 months. The most common reasons were lack of knowledge of availability of repair (31%), lack of accessibility of care (29%), and lack of finances (24%).


CONCLUSIONS
In Nepal, the majority of patients with cleft present late, mainly because of a lack of awareness of cleft services, the remoteness of available services, or a lack of finances. These obstacles can be largely surmounted through itinerant services.
Schwarz
Richard
R
Western Regional Hospital, Pokhara, Nepal. Rschwarz@inf.org.np
Bhai Khadka
Sanu
S
D002675:Child, Preschool; D002971:Cleft Lip / Q000191:economics / Q000523:psychology; D002972:Cleft Palate / Q000191:economics / Q000523:psychology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D009390:Nepal; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care; D011203:Poverty; D012923:Social Class