The impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate

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dc.contributor.advisorNorman, Vivienne
dc.contributor.advisorMorrow, Brenda
dc.contributor.authorKhoza, Nonhlanhla
dc.date.accessioned2026-07-03T09:44:35Z
dc.date.available2026-07-03T09:44:35Z
dc.date.issued2026
dc.date.updated2026-07-03T09:11:50Z
dc.description.abstractBackground: Cleft lip and/or palate (CL/P) is one of the most common craniofacial birth defects worldwide, with a global prevalence of approximately 1 in 700 live births. Infants and children with CL/P and their families require intervention and support from a multidisciplinary cleft team. Initial intervention focuses on information counselling, facilitation of feeding, surgical repair, and psychosocial support. These interventions are considered time sensitive to reduce potentially negative consequences. However, the COVID-19 pandemic in 2020 disrupted the typical timeline for CL/P interventions globally, and in South Africa, due to restrictions and regulations resulting in the suspension and cancellation of many healthcare services, including cleft services. Aim: To describe the impact of COVID-19 related restrictions on the caregivers of infants and young children (6 months to 3 years) born with CL/P, through exploring caregivers' perceptions of access to CL/P health services, difficulties related to feeding, and caregiver support. Methodology: A qualitative, narrative research design was employed. Semi-structured interviews were conducted with eight caregivers of children born with CL/P (6 months to 3 years at the time of data collection) attending the multidisciplinary cleft clinic at Chris Hani Baragwanath Academic Hospital. The interviews were transcribed, and data were thematically analysed. Results: One main theme and five subthemes emerged from the caregivers' perceptions of the impact of the COVID-19 related restrictions on their experience. The main theme, ‘a difficult journey', was further described through subthemes, which included: ‘limited/no access to cleft services', ‘delays, cancellations and poor communication', ‘feeding difficulties and experiences', ‘a roller-coaster of emotions' and ‘we just need support'. Every aspect of care was impacted and there was a ripple effect, for such as limited access to the cleft clinic and delays affected other areas, such as feeding and emotional support, which compounded the caregivers' difficult journey. Conclusion: Caregivers faced significant challenges during the pandemic. The main challenges were related to difficulties accessing the multidisciplinary cleft team, particularly the speech-language therapist; delays and cancellation of cleft repair surgeries; poor communication with the healthcare facility; difficulties related to feeding their child with CL/P; and psychosocial challenges and the need for professional and informal support. The findings also highlighted broader systemic issues within the healthcare system.
dc.identifier.apacitationKhoza, N. (2026). <i>The impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate</i>. (). University of Cape Town ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders. Retrieved from http://hdl.handle.net/11427/43462en_ZA
dc.identifier.chicagocitationKhoza, Nonhlanhla. <i>"The impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate."</i> ., University of Cape Town ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders, 2026. http://hdl.handle.net/11427/43462en_ZA
dc.identifier.citationKhoza, N. 2026. The impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate. . University of Cape Town ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders. http://hdl.handle.net/11427/43462en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Khoza, Nonhlanhla AB - Background: Cleft lip and/or palate (CL/P) is one of the most common craniofacial birth defects worldwide, with a global prevalence of approximately 1 in 700 live births. Infants and children with CL/P and their families require intervention and support from a multidisciplinary cleft team. Initial intervention focuses on information counselling, facilitation of feeding, surgical repair, and psychosocial support. These interventions are considered time sensitive to reduce potentially negative consequences. However, the COVID-19 pandemic in 2020 disrupted the typical timeline for CL/P interventions globally, and in South Africa, due to restrictions and regulations resulting in the suspension and cancellation of many healthcare services, including cleft services. Aim: To describe the impact of COVID-19 related restrictions on the caregivers of infants and young children (6 months to 3 years) born with CL/P, through exploring caregivers' perceptions of access to CL/P health services, difficulties related to feeding, and caregiver support. Methodology: A qualitative, narrative research design was employed. Semi-structured interviews were conducted with eight caregivers of children born with CL/P (6 months to 3 years at the time of data collection) attending the multidisciplinary cleft clinic at Chris Hani Baragwanath Academic Hospital. The interviews were transcribed, and data were thematically analysed. Results: One main theme and five subthemes emerged from the caregivers' perceptions of the impact of the COVID-19 related restrictions on their experience. The main theme, ‘a difficult journey', was further described through subthemes, which included: ‘limited/no access to cleft services', ‘delays, cancellations and poor communication', ‘feeding difficulties and experiences', ‘a roller-coaster of emotions' and ‘we just need support'. Every aspect of care was impacted and there was a ripple effect, for such as limited access to the cleft clinic and delays affected other areas, such as feeding and emotional support, which compounded the caregivers' difficult journey. Conclusion: Caregivers faced significant challenges during the pandemic. The main challenges were related to difficulties accessing the multidisciplinary cleft team, particularly the speech-language therapist; delays and cancellation of cleft repair surgeries; poor communication with the healthcare facility; difficulties related to feeding their child with CL/P; and psychosocial challenges and the need for professional and informal support. The findings also highlighted broader systemic issues within the healthcare system. DA - 2026 DB - OpenUCT DP - University of Cape Town KW - Cleft lip and/or palate KW - COVID-19 KW - feeding and swallowing KW - speech-language therapy KW - psychosocial support LK - https://open.uct.ac.za PB - University of Cape Town PY - 2026 T1 - The impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate TI - The impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate UR - http://hdl.handle.net/11427/43462 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/43462
dc.identifier.vancouvercitationKhoza N. The impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate. []. University of Cape Town ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders, 2026 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/43462en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDivision of Communication Sciences and Disorders
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectCleft lip and/or palate
dc.subjectCOVID-19
dc.subjectfeeding and swallowing
dc.subjectspeech-language therapy
dc.subjectpsychosocial support
dc.titleThe impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMSc
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