Towards Effective Ponseti Clubfoot Care: The Uganda Sustainable Clubfoot Care Project
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Neglected clubfoot is common, disabling, and contributes to poverty in developing nations. The Ponseti clubfoot treatment has high efficacy in correcting the clubfoot deformity in ideal conditions but is demanding on parents and on developing nations’ healthcare systems. Its effectiveness and the best method of care delivery remain unknown in this context. The 6-year Uganda Sustainable Clubfoot Care Project (USCCP) aims to build the Ugandan healthcare system’s capacity to treat children with the Ponseti method and assess its effectiveness. We describe the Project and its achievements to date (March 2008). The Ugandan Ministry of Health has approved the Ponseti method as the preferred treatment for congenital clubfoot in all its hospitals. USCCP has trained 798 healthcare professionals to identify and treat foot deformities at birth. Ponseti clubfoot care is now available in 21 hospitals; in 2006–2007, 872 children with clubfeet were seen. USCCP-designed teaching modules on clubfoot and the Ponseti method are in use at two medical and three paramedical schools. 1152 students in various health disciplines have benefited. USCCP surveys have (1) determined the incidence of clubfoot in Uganda as 1.2 per 1000 live births, (2) gained knowledge surrounding attitudes, beliefs, and practices about clubfoot across different regions, and (3) identified barriers to adherence to Ponseti treatment protocols. USCCP is now following a cohort of treated children to evaluate its effectiveness in the Ugandan context.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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- Towards Effective Ponseti Clubfoot Care: The Uganda Sustainable Clubfoot Care Project
Clinical Orthopaedics and Related Research
Volume 467, Issue 5 , pp 1154-1163
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- 1. Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
- 2. Orthopaedic Surgery, University of British Columbia, 205-245 East Columbia Street, New Westminster, BC, V3L 3W4, Canada
- 3. Department of Orthopaedics, Makerere University Medical School, PO Box 7051, Kampala, Uganda
- 4. School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, V6T 1Z3, Canada
- 5. School of Public Health, Makerere University, PO Box 7072, Kampala, Uganda
- 6. Department of Orthopaedic Surgery, University of British Columbia, PO Box 5007, Victoria, BC, V8R 6N3, Canada
- 7. Clinical Services, Ugandan Ministry of Health, PO Box 7272, Kampala, Uganda
- 8. Comprehensive Rehabilitation Services in Uganda, PO Box 20146, Kampala, Uganda