‘This is the Test of Our Faith’: An Exploratory Study of the Religio–spiritual and Cultural Construction of Cleft Lip and Palate Among Muslim Parents in Punjab, Pakistan

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Abstract
One of the most common congenital defects affecting the orofacial areas worldwide is cleft lip and/or cleft palate (CL/P), which causes a range of social, psychological, and medical challenges for affected children and their families. Several socio-cultural beliefs and superstitions are attached to this condition, but little is known about how CL/P is framed by Muslim parents. The religious, spiritual, and cultural construction of CL/P is a significant yet often overlooked aspect of the subject covered in this study. It also discusses how parents of children with CL/P use spirituality and religion as coping strategies. Through in-depth, semi-structured interviews, data were gathered from 21 parents of children with CL/P at a cleft care hospital in Lahore, the provincial capital of Punjab, Pakistan. The purposive sampling technique was used to ensure that participants had direct and relevant lived experience. By utilizing thematic analysis technique, four main and nine sub-themes were identified regarding parents' religio-spiritual and cultural construction of CL/P. In addition to understanding their children's condition through religious and cultural beliefs, the study also found that parents utilized religion and spirituality as coping mechanisms and saw CL/P as a ‘test’ from God. Many parents seemed to believe in superstitions embedded in Punjabi culture and associated CL/P with several cultural constructions and rituals. The study concludes that religious, spiritual, and cultural beliefs shape how Muslim parents in Punjab, Pakistan constructed and interpreted CL/P. Further, religious and spiritual belief gave optimism and courage to parents as they prayed to God for the quick recovery of their children.

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