title: Cleft lip and palate: Parental experiences of stigma, discrimination, and social/structural inequalities.
abstract: BACKGROUND
  Cleft lip and palate (CLP) are the most common craniofacial birth impairment and one of the most common congenital impairments in humans. Anecdotal evidence suggests that stigmatization, discrimination, and sociocultural inequalities are common "phenomenon" experienced by families of children with CLP in Nigeria. This study aimed to explore the stigmatization, discrimination, and sociocultural inequalities experiences of families with children born with CLP.
  
  
  METHODS
  The study was carried out at the surgical outpatient cleft clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. This was a cross-sectional descriptive study among mothers of children born with CLP, using both interviewer-administered questionnaire and a semi-structured interview.
  
  
  RESULTS
  A total of 51 mothers of children with cleft lip and/or palate participated in the study. 35.3% of respondents believed cleft was an "act of God," whereas others believed it was either due to "evil spirit" (5.9%), "wicked people" (9.8%). Seventy-three percent of the mothers were ashamed of having a child with orofacial cleft. Two of the respondents wanted to abandon the baby in the hospital. About a quarter of the respondent wished the child was never born and 59% of the fathers were ashamed of the facial cleft. Fifty-one percent admitted that their relatives were ashamed of the orofacial cleft, and 65% admitted that their friends were ashamed of the cleft. In addition, 22% of the respondents admitted that they have been treated like an outcast by neighbors, relatives, and friends because of the cleft of their children. When asked about refusal to carry the affected children by friends, relatives, and neighbors, 20% of respondents said "Yes."
  
  
  CONCLUSIONS
  Myths surrounding the etiology of orofacial cleft are prevalent in Nigeria. Parents and individuals with CLP experience stigma as well as social and structural inequalities due to societal perceptions and misconception about CLP. Public and health-care professionals must be equipped with necessary knowledge to combat stigma, discrimination, social and structural inequalities, and misconceptions associated with orofacial cleft. CLP should be considered a facial difference rather than a disability.
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria.
authors.forename: Wasiu Lanre
authors.initials: WL
authors.lastname: Adeyemo
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria.
authors.forename: Olutayo
authors.initials: O
authors.lastname: James
authors.affiliation: Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
authors.forename: Azeez
authors.initials: A
authors.lastname: Butali
keywords: Discrimination; inequalities; orofacial cleft; stigma