Barriers to the treatment of clubfoot in low- and middle-income countries: A guide to improve compliance

Abstract

The Ponseti method of clubfoot treatment is ideal for low- and middle-income countries since it is minimally invasive and easily implementable through non-surgeon providers. However, variables related to the socioeconomic status of the community, patient-related factors, treatment provider-related factors, and health system-related factors may influence the outcome of this deformity. These barriers need a two-pronged approach, a top-down (involvement at the policy level) as well as a bottom-up method (involvement at an individual level). Improving the knowledge level of the caregiver as well as the provider and addressing the issues regarding financial constraints will help in eliminating various barriers to the treatment of clubfoot. Furthermore, regular audits help in identifying the efficacy of various solutions employed as well as identifying new barriers to treatment. Integration at the policy level with the involvement of governmental as well as non-governmental organisations helps to remove health system-level bottlenecks.