Table S1: Demographic, Economic, and Health Statics
Country Nepal Rwanda Sierra Leone Uganda
Population 28.17 million 11.34
million 6.315 million 37.78 million
% rural population 81.8% 72.2% 60.4% 84.2%
GDP per capita
(USD) 694.1 638.7 679.0 572.0
Estimated Annual Road Traffic Fatalities
4713 3782 1661 10,280
Government Expenditure on health
40.3% 38.1% 11.1% 24.9%
Doctors per 1,000
people .04 0.6 .02 .08
Nurses &
Midwives per 1,000 people
.3 .67 .18 .72
Table 1 – Demographic, economic, and health statics of the four countries from the World
Health Organization, Institute of Health Metrics, and World Bank (1999 – 2014)
Table S2: Four Country Demographics
Table 2 – Demographic characteristics of Craniofacial disease within surveyed households across the four studied countries
a – Predictors for receiving care adjusted odds-ratio evaluated age, age categories, sex, literacy, occupation, rural living, timing of injury, and disability scale
Craniomaxillofacial
diseases Nepal
179(12.7%) Rwanda
452(31.95%) Sierra Leone
515(36.45%) Uganda
267(18.9%) Total Face / Individual
1,413 / 13,806 (10.2%) P Value OR 95% CI P-Value ORa 95% CI P-Value
Age (mean) 33.8 27.1 27.9 26.1 28.03 <.001 1.01 1.0 – 1.01 <.01 1.01 .99-1.02 .236
Age Groups
Newborn – 5 14(7.82%) 63(13.94%) 55(10.68%) 28(10.49%)
6-14 23(12.87%) 118(26.11%) 97(18.83%) 61(22.85%)
15-64 131(73.2%) 235(51.99%) 336(65.24%) 169(63.3%)
65 or older 11(6.15%) 36(7.96%) 27(5.24%) 9(3.37%) <.001 1.11 1.02-1.21 <.05 1.04 .8-1.35 .80
Female 85(47.49%) 256(56.64) 276(53.69%) 138(51.7%) 755(53.4%)
Male 94(52.51%) 196(43.36) 239(46.41%) 129(48.3%) 658(46.6%) .19 .94 .75-1.2 .556 1.03 .8-1.31 .84
Illiterate 65(36.31%) 230(50.88%) 281(54.78%) 108(41.7%) 684(48.75%)
Literacy 114(63.69%) 222(49.12%) 232(45.22%) 151(58.3%) 719(51.25%) <.001 .56 .45-.71 <.001 .58 .45-.76 <.001
None/Student/H
ome-maker 101(56.74%) 244(53.98%) 234(45.53%) 134(51.74%) 713(50.82%) Employed
outside home 77(43.26%) 208(46.02%) 280(54.47%) 125(48.26%) 690(49.18%)
.017 1.15 .92-1.43 .218 1.09 .83-1.5 .569
Rural 119(66.48%) 423(93.58%) 284(55.15%) 225(84.27%) 1051(74.38%)
Urban 60(33.52%) 29(6.42%) 231(44.85%) 42(15.73%) 362(25.62%) <.001 .92 .71-1.19 .52 1.06 .78-1.39 .78
Table S3: Plastic Surgery Related Diseases & Anatomic Location of the Face
Face Type Nepal Rwanda Sierra Leone Uganda P value
Ear/Nose/Throat 49(27.37%) 114(25.22%) 63(12.23%) 41(15.36%) Dental/Lips/Mouth 28(15.64%) 73(16.15%) 140(27.18%) 77(28.84%)
Neck 34(18.99%) 61(13.50%) 77(14.95%) 47(17.6%)
Head 68(37.99.9%) 204(45.13%) 235(45.63%) 102(38.2%) <.001
Total 179(100%) 452(100%) 515(100%) 267(100%) 1,413
Injury Related
Wound
49(27.37%)
54(11.95%)
73(14.23%) 60(24.69%) Non- Injury
Related Wound 14(7.82%) 46(10.18%) 104(20.27%) 54(22.22%)
Burn 7(3.91%) 11(2.43%) 26(5.07%) 20(8.23%)
Mass/Growth 72(40.22%) 86(19.03%) 86(16.76%) 63(25.93%)
Congenital
Deformity 18(10.06%) 17(3.76%) 63(12.28%) 9(3.7%)
Acquired
Deformity 19(10.61%) 238(52.65%) 161(31.38%) 37(15.23%) <.001
Total 179(100%) 452(100%) 513(100%) 243(100%) 1,387
Table S4: Timing of Injury
Face Nepal Rwanda Sierra Leone Uganda Total P value OR 95% CI P-Value ORa 95% CI P-Value
"In the last month" 44(22.58%) 56(12.39%) 115(22.37%) 29(10.86%)
"During the past 12
months" 19(10.61%) 99(21.9%) 125(24.32%) 56(20.97%)
"Longer than 12
months ago" 116(64.8%) 297(65.71%) 274(53.31%) 182(68.16%)
Total 179(100%) 452(100%) 514(100%) 267(100%) <.001 .58 .5-.67 <.001 .48 .41-.56 <.001
Current Condition
No 69(38.5%) 371(82.1%) 145(28.2%) 118(44.2%) 703 (49.8)
Yes 110(61.5%) 81(17.9%) 370(71.8%) 149(55.8%) 710 (50.2%) <.001 *
Prevalence 4.1% 2.5% 10.0% 3.5% 5.1%
*no association
Table 4 – Report of Craniofacial disease timing relative to the date of interview across the four countries
a – Predictors of care received adjusted odds-ratio evaluated age, age categories, sex, literacy,
occupation, rural living, timing of injury, and disability scale
Table S5: Reason for not receiving care
Face Nepal Rwanda Sierra
Leone Uganda P
value
"No Money For
Healthcare" 22(17.6%) 61(14.81%) 187(46.52%) 32(37.65%)
"No Money For
Transportation" 1(0.8%) 1(0.24%) 2(0.5%) 1(1.18%)
"No Time " 2(1.6%) 9(2.18%) 12(2.99%) 3(3.53%)
"No Trust In
Health Facility " 15(12%) 44(10.68%) 19(4.73%) 8(9.41%)
"No Skilled Physicians/Nurses Available”
24(19.2%) 270(65.53%) 30(7.46%) 14(16.47%)
“No Need” 61(48.8%) 27(6.55%) 152(37.81%) 27(31.76%) <.001 Total 125(100%) 412(100%) 402(100%) 85(100%) 1,024
Table 5 – Description of reasons for why care was not sought for craniofacial conditions across
the four surveyed countries
Table S6: Disability
Disability
Scale Nepal Rwanda Sierra Leone Uganda P value OR 95% CI P-Value ORa 95% CI P-Value
"No Disability" 142(79.33%) 254(56.32%) 279(56.79%) 144(57.37%)
"Feel Ashamed" 10(5.59%) 19(4.21%) 69(14.2%) 33(13.15%)
"Not Able to
Work" 21(12.29%) 146(32.37%) 122(25.1%) 49(19.52%)
"Need help with
transportation" 1(0.56%) 4(0.89%) 3(0.62%) 5(1.99%)
"Need help with daily life"
Total
4(2.23%) 179(100%)
28(6.21%) 451(100%)
16(3.29%) 486(100%)
20(7.97%) 251(100%)
<.001
1,367
1.32 1.2-1.45 <.001 1.31 1.18-1.46 <.001
Table 6 – Responses for SOSAS disability scale from craniofacial diseases across the four surveyed countries
a – Predictors of care received adjusted odds-ratio evaluated age, age categories, sex, literacy,
occupation, rural living, timing of injury, and disability scale
Table S7: Care Seeking and Care Met
Care
Sought Nepal Rwanda Sierra Leone Uganda P value OR 95% CI P-Value ORa 95% CI P-Value
Yes 117(65.36%) 405(89.6%) 309(60%) 227(85.02%)
No 62(34.64%) 47(10.4%) 206(40%) 40(14.98%) <.001
Total 179(100%) 452(100%) 515(100%) 267(100%) 1,413
Care Met
Yes 99(55.31%) 378(83.63%) 246(47.77%) 202(75.66%)
No Total 80(44.69%)
179(100%) 74(16.37%)
451(100%) 223(52.23%)
515(100%) 65(24.34%)
267(100%) <.001
1,413 .97 .92-1.01 .158 1.07 .94-1.22 .326
