Impact of India’s Rashtriya Bal Swasthya Karyakram and Smile Train’s rural outreach on timely cleft lip and palate treatment in Uttar Pradesh: A retrospective analysis (2007–2025)

Timely surgical repair of cleft lip and palate is critical for achieving optimal functional outcomes and improving psychosocial well-being; however, delayed intervention remains prevalent in resource-limited regions of India. To address these challenges, the Rashtriya Bal Swasthya Karyakram and initiatives by Smile Train have focused on early detection, improved access to care, and increased community awareness. This retrospective analysis evaluates the long-term impact of these programs on the age distribution of primary cleft surgeries in Uttar Pradesh. Data from the Smile Train database at a high-volume plastic surgery center in Lucknow were reviewed, including 13,153 patients treated between 2007 and 2025, of whom 11,032 primary cases under these initiatives were analyzed. Over the study period, a total of 11,032 primary cleft lip and palate repairs were performed, with the highest surgical volume recorded during 2021–2025 (3952; 35.8%). The proportion of primary lip repairs performed within the recommended age of 3–6 months increased from 2.5% in 2007–2010 to 12.9% (895/6,935) in 2021–2025, while timely primary palate repairs (9–12 months) rose from 3.1% to 16.8% (205/1221). Age distribution trends demonstrated a clear shift toward earlier intervention, with a substantial increase in surgeries performed before 5 years of age and a corresponding decline in delayed presentations. These findings indicate that the combined efforts of RBSK and Smile Train’s rural outreach programs have significantly improved timely access to cleft care, enabling earlier surgical intervention and enhancing awareness in Uttar Pradesh.