Challenges of congenital malformations: an African perspective

Abstract

Background: Congenital malformations are defects of morphogenesis of organs or body regions identifiable during the intrauterine life or after birth. The etiological factors proposed have varied in history based on prevailing understanding, culture, and religion. Worldwide historically, the role of the supernatural had been in the forefront of etiological considerations but has changed with advances in embryology and teratology. It has, however, remained a part of many societies and cultures especially in Africa.

Purpose: The aim of this review article is to highlight the psychosocial and economic impact, as well as the ethical and management challenges, posed by congenital malformations in the African setting.

Materials and methods: A literature search was done using PubMed, African Journals Online, HINARI, and Google Scholar, regarding issues and challenges faced by parents who have children with congenital malformations, the affected children, and the healthcare workers who manage them. Focus was on the peculiarities of the African society.

Result: Superstitious beliefs about congenital malformations bred negative attitudes toward these children and their parents. Chronic illness, long-term disabilities, and overall poor quality of life were associated with congenital malformations. These problems in a background of negative sociocultural beliefs created enormous psychosocial challenges for the parents and children. This was further complicated by economic challenges posed by the absence of health support systems in most African settings. Furthermore, the healthcare teams caring for these children were faced with challenges of difficult ethical and medicolegal considerations, as well as paucity of appropriately skilled manpower and facilities.

Conclusion: The role of the supernatural in the etiology of congenital malformations still has a stronghold in the many African settings and poses an enormous psychosocial challenge for the affected. It is hoped that this review can
influence policy formulations to support affected parents and improve outcomes of affected children.

Keywords: African, challenges, congenital malformations, psychosocial, superstitious beliefs