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Sharratt et al. Plast Aesthet Res 2020;7:35 Plastic and
DOI: 10.20517/2347-9264.2020.99 Aesthetic Research

Review Open Access

Equality in cleft and craniofacial care

Nicholas D. Sharratt , Jean Calleja Agius , Gareth Davies , Felicity V. Mehendale , Peter Hagell , Martin
5
4
2
3
1
Persson 5
1 Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, UK.
2 Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida MSD2080, Malta.
3 European Cleft Organisation, Rijswijk ZH 2288 EL, The Netherlands.
4 Global Cleft Lip and Palate Research Programme, Global Health Research Centre, Usher Institute, University of Edinburgh,
Edinburgh EH8 9AG, UK.
5 Faculty of Health Sciences, Kristianstad University, Kristianstad SE-291 88, Sweden.
Correspondence to: Prof. Martin Persson, Faculty of Health Sciences, Kristianstad University, Kristianstad SE-291 88, Sweden.
E-mail: martin.j.persson@hkr.se
How to cite this article: Sharratt ND, Calleja Agius J, Davies G, Mehendale FV, Hagell P, Persson M. Equality in cleft and craniofacial
care. Plast Aesthet Res 2020;7:35. http://dx.doi.org/10.20517/2347-9264.2020.99

Received: 29 Apr 2019 First Decision: 12 Jun 2020 Revised: 19 Jun 2020 Accepted: 29 Jun 2020 Published: 12 Jul 2020
Academic Editor: Carroll Ann Trotman Copy Editor: Cai-Hong Wang Production Editor: Tian Zhang

Abstract
This review examines the issue of equality of care amongst those with cleft lip and/or palate in the European Union
(EU) and beyond. Issues of equality both between and within national populations are considered, and it is argued
that those from countries with smaller healthcare expenditure and who are from marginalised groups are at the
greatest risk of, and affected most severely by, healthcare inequalities. The socioeconomic impact of inequality
is also discussed. Having reviewed these topics, the goals and activities of the European Cleft and Craniofacial
Initiative for Equality in Care Action, formed pursuant to an award from the EU’s European Cooperation in Science
and Technology, are introduced. Constituted of an open network of clinicians and researchers committed to
exploring and reducing such inequalities, the ongoing Action is formed of multiple working groups examining these
issues within the EU and has organised training schools, conferences and short-term scientific missions concerned
with these issues. These activities are discussed along with the future directions of the Action, the impact it has
had to date and the benefits of the European Cooperation in Science and Technology award.

Keywords: Cleft, craniofacial, equality, care, healthcare, Europe

INTRODUCTION
The European Union (EU) currently consists of 27 countries with a combined population of 446 million
[1]
inhabitants . There are approximately 637,000-743,000 individuals living with a cleft lip and/or palate (for
convenience referred to hereafter as “cleft”) in Europe and many others with other craniofacial conditions.
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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