Knowledge and cultural beliefs about the etiology and management of orofacial clefts in Nigeria's major ethnic groups

Objective: To determine the knowledge and cultural beliefs about the etiology and management of orofacial clefts in Nigeria's major ethnic groups. Design: Questionnaires designed to elicit respondents' knowledge and cultural beliefs about the etiology and management of orofacial clefts. Setting: Northern and southern Nigerian communities where the major ethnic groups reside. Participants: Consenting, randomly selected individuals. Results: There were 650 respondents (350 women and 300 men) from 34 of Nigeria's 36 states; 65.5% were aged 21 to 40 years and 52.5% were married. There were Yoruba (33.7%), Igbo/Bini/Urhobo (40.5%), and Hausa/Fulani (25.8%), with most having attained primary and secondary education. Of those responding, 75% had seen an individual with an orofacial cleft. A significant level of ignorance about the cultural beliefs was found. The Hausa/Fulani considered it mostly an act of God; whereas, the Igbo/Bini/Urhobo and Yoruba groups displayed a greater variety of cultural beliefs. The latter groups implicated witchcraft, evil spirit or devil, the mother, and occasionally the child. Of respondents, 40% knew that surgery was a possible solution, and 22% would recommend a visit to the hospital. Respondents with higher educational attainment produced significantly more scientifically related etiologic factors and accurate treatment options. Conclusion: Of respondents, 75% were aware of the existence of orofacial clefts, and a fair knowledge of treatment of orofacial clefts was elicited. Diverse cultural beliefs often may present an obstacle to treatment. Improved awareness about the etiology and management of orofacial clefts is required.