Syllabus: Issues related to the Health Sector.
Context and Scale of the Problem
- Over 7.5 lakh cleft surgeries conducted in India by Smile Train in 25 years.
- Annual average of 30,000 surgeries, highest by any single organisation nationally.
- India records one cleft birth per 700 children, the highest globally.
- Estimated 36,000 babies born annually with cleft lip and/or palate deformities.
- Persistent annual backlog of 7,000 corrective surgeries remains unresolved.
Role of NGOs and Existing Coverage
- Smile Train India partners with surgeons to provide free cleft surgeries and care.
- Collectively, NGOs like Mission Smile and Operation Smile benefited 15 lakh children.
- Despite NGO efforts, 17.5 lakh children still live with unrepaired clefts.
- India lacks national epidemiological data on cleft lip and palate prevalence.
Medical and Nutritional Dimensions
- Cleft deformity occurs due to genetic factors or maternal nutritional deficiencies.
- Affects feeding, speech, hearing, breathing, and overall child development.
- 68% of affected children rely on government hospitals for initial diagnosis.
- Lancet Surgery Commission estimated 18.7% untreated orofacial clefts in India.
- Children with clefts are 1.5 times more prone to severe malnutrition.
- One-third of cleft-related malnutrition deaths preventable through timely surgery.
Systemic Gaps in Public Health Response
- Weak documentation of birth anomalies and inadequate parental counselling persist.
- High surgical costs deter families, especially in rural and low-income settings.
- Government hospitals lack specialised infrastructure and trained personnel.
- Cleft care data remains fragmented, as craniofacial anomalies are not notifiable diseases.
Social Impact and Stigma
- Uncorrected clefts cause school bullying, communication barriers, and social exclusion.
- Long-term consequences include employment difficulties, marriage challenges, and trauma.
- Superstitions and ignorance reinforce stigma, deepening the rural–urban divide.
Policy Initiatives and Global Recognition
- WHO recognises craniofacial anomalies under the Global Burden of Disease initiative.
- National Birth Defect Awareness Month 2024 focused on inclusive cleft support.
- NITI Aayog initiated discussions on birth defects and early intervention.
Way Forward: Strengthening Public Health Systems
- 68.8% rural population requires aggressive outreach and early screening mechanisms.
- Collaboration with Rashtriya Bal Swasthya Karyakram and ASHA workers is essential.
- Incentives covering travel, surgery, hospital stay, and speech therapy are needed.
- 1.35 crore births occur annually in government hospitals, enabling early intervention.
- Policymakers must recognise clefts as a core health issue, not cosmetic deformities.
- Upgrading government hospitals can ensure timely, functional, and stigma-free outcomes.