Mothers’ Perception of Presurgical Waiting Timing for Cleft Lip Surgeries in Kano: A Qualitative Study

Background: The timing of cleft lip repair is guided by the principles of safety for the child such as the “rule of 10’s.” Delays in surgical repair may often be acceptable to medical personnel but may be misunderstood by family members such as the mother of the cleft child. The aim of this study was to identify perception of mothers of children with unilateral cleft lip toward surgical wait times for cleft lip repair and to identify the factors affecting their perception. Methods: Mothers of children with unilateral cleft lip and/or palate awaiting surgery at the Armed Forces Specialist Hospital, Kano were prospectively studied between January 2019 and January 2020. Focus group discussions and in-depth interviews were digitally recorded and transcribed. Grounded theory approach was used for the data collection and analysis. Results: Sixty-six mothers were interviewed during the study period. Four areas of perceived inequity were identified from participants’ accounts: socioeconomic inequity, sociocultural inequity, locational inequity, and inequity related to waitlist prioritization. The waiting period was described as frustrating, stressful, and anxiety provoking. Participants identified the importance of healthcare provider and health support systems during the presurgical period. Conclusions: Mothers of children with unilateral cleft lip frequently experience anxiety and frustration while awaiting surgical repair. The waiting experience can be improved by periodic updates from the surgical team and various other support structures.