Filipino explanatory models of cleft lip with or without cleft palate

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.