From cutting to casting: impact and initial barriers to the Ponseti method of clubfoot treatment in China.

From cutting to casting: impact and initial barriers to the Ponseti method of clubfoot treatment in China.

JournalThe Iowa orthopaedic journal
Publication date – Jun – 2010
Authors – Lu, N; Zhao, L; Du, Q; Liu, Y; Oprescu, FI; Morcuende, JA
KeywordsAchilles Tendon surgery, barriers to treatment, Braces, Clubfoot, interview, Ponsetti
Open access – Yes
SpecialityPaediatric surgery, Trauma and orthopaedic surgery
World region Eastern Asia
Country: China
Language – English
Submitted to the One Surgery Index on July 18, 2018 at 12:00 am

In 2005, a nationwide clubfoot treatment program focused on the Ponseti method -an effective, affordable and minimally-invasive method- was initiated in China. The purpose of this study was to evaluate and identify barriers to the program. A qualitative study (rapid ethnographic study) was conducted using semi-structured interviews of 44 physicians who attended four of the 10 Ponseti training workshops, focus groups with parents of children with clubfoot, and observation. Several barriers to the Ponseti method are quite unique due to China’s size, socio-economics, culture, politics, and healthcare systems. The barriers were classified into seven themes: (i) physician education, (ii) caregiver compliance, (iii) culture, (iv) public awareness, (v) poverty, (vi) financial constraints for physicians/hospitals, and (vii) challenges of the treatment process. A number of suggestions that could be helpful in reducing or eliminating the effects of these barriers were also identified: (i) pamphlets explaining clubfoot and treatment for caregivers, (ii) directories of Ponseti providers, (iii) funding/financial support, and (iv) improving public awareness. The information from this study provides healthcare planners with knowledge to assist in meeting the needs of the population and continued implementation of effective and culturally appropriate awareness and treatment programs for clubfoot throughout China.

OSI Number – 10099
PMID – 21045964

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