The impact and cost-effectiveness of the Amref Health Africa-Smile Train Cleft Lip and Palate Surgical Repair Programme in Eastern and Central Africa

Cleft lip and palate (CLP) cause significant disability in low- and middle-income countries, prompting Amref Health Africa and Smile Train to provide corrective surgeries in eastern and central Africa since 2006. An analysis of 37,274 patients operated on between 2006 and 2014 revealed a median surgery age of 5.4 years, with 207,879 Disability-Adjusted Life Years (DALYs) averted at a cost of $13 million—averaging $62.8 per DALY. Despite a delayed burden of 36,352 DALYs due to late surgeries, the intervention yielded substantial economic benefits: $292 million using the human capital approach and $2.4 billion via the Value of Statistical Life method. These findings underscore cleft surgery as a highly cost-effective strategy for improving health and economic outcomes in the region.

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