Washington: India has more than 72,000 children and adults with unrepaired cleft lip or cleft palate, says a new study significantly highlighting the unmet need for cleft lip and/or palate (CL/P) care in India. The findings showed that there are 72,637 cases of unrepaired CL/P in India. The percentage of individuals with unrepaired CL/P who were older than the respective target age group of 1-2 ranged from 37.0 per cent in Goa to 65.8 per cent in Bihar. Also, infants in low and middle-income countries face significant barriers to treatment, leading to prolonged disfigurement, social stigma, speech impairment as well as trouble of feeding food that can result in malnutrition and death. Safe, timely and effective surgery can result in successful outcomes, the researchers noted, in the paper published online by JAMA Facial Plastic Surgery. However, poor states like Bihar, with less health care infrastructure were found to have with exceptionally high rates for the surgery. The rate of unrepaired CL/Ps ranged from less than 3.5 per 100,000 population in Kerala and Goa to 10.9 per 100,000 population in Bihar. “The results describes the prevalent unmet need for cleft surgery in India by each state and includes patients older than the surgery target ages of 1 and 2 years for cleft lip and cleft palate repair, respectively,” said Barclay T. Stewart from the University of Washington. Substandard nutrition and a lack of prenatal care are known to be the likely reasons for these congenital disorders. "Significant efforts must be made to relieve the prevalent unmet need and strengthen health care services to meet the demand of new cases so that the surgical backlog does not grow," Stewart added. For the study, the data were used from patients who received care at Operation Smile programmes -- a non-government supported campaign to provide surgical care to affected babies, indicators of surgical care capacity, wealth, and infrastructure across different states -- in 12 low-and middle-income countries from June 1, 2013, to May 31, 2014. Using state-level economic and health system indicators, the total number of unrepaired CL/P cases in each state was estimated.