Filipino Explanatory Models of Cleft Lip with or without Cleft Palate

Abstract

Objective To describe beliefs about the cause, prevention, and treatment of cleft lip with or without cleft palate (CL±P) among working class people and health care workers in the Philippines. Design and Setting The study was a focused ethnography and took place in the province of Negros Occidental, Philippines. Participants Using a stratified purposeful recruitment strategy, 80 individuals were selected for study. They were categorized into three groups: those having a CL±P or a child with a CL±P, those who neither had a CL±P nor child with CL±P, and health care workers. Methods Kleinman's explanatory models of illness theory were used to elicit Filipino explanations for CL±P. Data were collected through guided individual and group informant interviews and analyzed through content analysis. Results Filipinos reported that inheritance, falls, cravings, environmental factors, and God's will were causes for CL±P. Beliefs about prevention of CL±P included limiting the number of children, being careful not to fall, and avoiding environmental factors. It was found that general causal explanations for CL±P were not always congruent with personal causal explanations, and general/personal causal explanations for CL±P were not always congruent with prevention explanations. Conclusion By eliciting patients’ explanations for CL±P and comparing these with their own, clinicians can find commonalities between divergent explanations and use these as a starting point from which to improve health outcomes. Findings from this study will be used to guide the design of health campaigns regarding CL±P in the Philippines.