Abstract

Background: Cleft lip and/or palate (CL/P) requires timely, multidisciplinary care to optimize health outcomes. In Bahrain, no prior data describe access to such services. This study aimed to establish a hospital-based registry and assess baseline patterns of attendance across specialty clinics at Bahrain Defense Force - Royal Medical Services before the implementation of a national cleft care pathway.

Methods: In this retrospective cohort study, all patients with CL/P who attended cleft-related clinics between June 2017 and September 2020 were identified. Electronic records were reviewed to collect demographics, cleft type, and age at first visit to Pediatrics, Ear, Nose, and Throat (ENT), Speech and Language Therapy (SLT), Pedodontics, Orthodontics, and Psychology.

Results: Among 51 children (57% female, 43% male), cleft palate alone was most common (37.3%), followed by unilateral cleft lip ± palate (UCLP, 35.3%), cleft lip (17.7%), and bilateral cleft lip ± palate (BCLP, 3.9%). The mean age at first visit was 29 days for Pediatrics, 5.5 months for ENT, and 7.5 years for Orthodontics. Substantial delays were observed for SLT (mean: 8.3 years) and Pedodontics (2.2 years), and no patient had attended a Psychology clinic.

Conclusion: Timely access to core services such as Pediatrics, ENT, and Orthodontics was observed. However, substantial delays in Speech and Language Therapy, Pedodontics, and Psychology highlight gaps in referral pathways, coordination of care, and caregiver awareness. This hospital-based registry offers essential baseline data to guide and measure future improvements in Bahrain’s national multidisciplinary cleft care program.

Keywords: Cleft lip, Cleft palate, Multidisciplinary care, Healthcare access, Bahrain