Ghanaian families with children requiring cleft care spend at least 25% of their annual income on related expenses. This expenditure covers transportation, feeding, and other miscellaneous activities, according to a yet-to-be-published study from the National Cleft Care Centre (NCCC).
This significant financial burden is described as 'catastrophic expenditure' by the NCCC. It threatens to push many families into severe poverty and prevents them from accessing critical holistic care for their children. The high costs pose a barrier to comprehensive, long-term treatment.
This recent study adds urgency to long-standing calls for the government to include cleft care in the National Health Insurance Scheme (NHIS). Such a move would significantly reduce financial strain on families and complement existing support from international organisations. Integrating cleft care into the NHIS aligns with Ghana’s broader efforts to achieve universal health coverage and reduce out-of-pocket health expenditures. Data from the Ghana Statistical Service frequently highlights healthcare costs as a major cause of poverty.
Professor Solomon Obiri-Yeboah, Director of the National Cleft Care Centre, stated that families bear substantial costs. He said, “families spend at least 25 per cent of their annual income on transportation and feeding whenever they visit the care facility.” Professor Obiri-Yeboah warned that this financial strain forces families to skip essential hospital reviews, which is detrimental to children's long-term health outcomes.
The inclusion of cleft care in the NHIS would have immediate and profound implications for thousands of Ghanaian families. Decision-makers are expected to review this data and consider the economic impact on vulnerable populations. Stakeholders will closely monitor policy discussions around health insurance reforms and healthcare accessibility for congenital conditions in Ghana.
Orofacial clefts, which occur when a baby’s lips or mouth do not form properly, affect approximately 1 in every 770 children in Ghana. This makes it one of the country's most common congenital anomalies. An estimated 406 children are born with clefts each year in Ghana. Globally, 1 in 700 babies are born with a cleft lip and/or palate.
Comprehensive cleft care typically spans at least 18 years, involving a multidisciplinary approach. This includes surgery, medical treatment, dental care, speech therapy, nutritional support, and psychosocial assistance. The surgical component alone costs a minimum of GHS 5,000, depending on the specific procedure required. These combined costs are often prohibitive for many families.
Dr Robert Lamy Larmie, a Maxillofacial surgeon at the NCCC, emphasised the life-saving nature of these interventions. He noted that lack of financial support could push families and children into severe social stigma and misconceptions. Dr Larmie stressed that accessible surgeries not only provide physical repair but also prevent abandonment and fatal outcomes for infants. The absence of treatment perpetuates myths and endangers children's lives.
The current system relies heavily on support from non-profit organisations like Smile Train, which absorbs costs for many patients. However, this fragmented support is not a sustainable long-term solution for a national health challenge. Integrating cleft care into the NHIS would provide a stable funding mechanism and ensure equitable access for all affected children. This policy change would reduce the likelihood of children missing crucial appointments due to financial constraints.