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From Cutting to Casting: Impact and Initial Barriers to the Ponseti Method of Clubfoot Treatment in China
Conference poster

From Cutting to Casting: Impact and Initial Barriers to the Ponseti Method of Clubfoot Treatment in China

N Lu, Li Zhao, Q Du, Y Liu, Florin I Oprescu and J A Morcuende
2010 Consortium of Universities for Global Health Annual Meeting: Program Book, p.121
Consortium of Universities for Global Health (CUGH) Annual Meeting: Transforming Global Health: The Interdisciplinary Power of Universities, 2010 (Seattle, United States, 19-Sep-2010–21-Sep-2010)
Consortium of Universities for Global Health (CUGH)
2010
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http://www.cugh.org/View
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Abstract

Nursing clubfoot Ponseti Method China
Objective: The purpose of this study is to evaluate and identify barriers to the program. Understanding these barriers is essential for successful and culturally appropriate approaches for the continuation of the program. Background: Congenital clubfoot has a worldwide incidence of 1-6.8/1000 live births. In China, where the birthrate is more than 18.2 million births per year, 18,000 - 123,000 children are born each year with clubfoot. Neglected clubfeet result in physical, social, psychological, and financial burdens for individuals and their families. The Ponseti method has been demonstrated to be an effective, affordable, and minimallyinvasive method of correcting congenital clubfoot. In 2005, a nationwide clubfoot treatment program focused on the Ponseti method was initiated in China. Methods: A qualitative study (rapid ethnographic study), using semi-structured interviews, focus groups, and observation was conducted. Phone interviews were conducted with practitioners trained in the Ponseti method who are currently treating clubfoot patients, and focus groups were conducted with parents of children with clubfoot in order to determine their opinions on the potential barriers. The data was collected in Chinese (Mandarin) and recorded in English over a period of 10 weeks. It was then coded manually and sorted into themes. Results: Since 2005, at least 9 Ponseti training workshops have taken place. Contact information for 164 participants from 4 of these workshops were obtained. 44 physicians who treat clubfoot in 12 provinces were interviewed, though 5 of the physicians were not trained in the Ponseti method, and thus not included in the study. Some of the barriers to the Ponseti method in China are quite unique due to China's size, socioeconomics, culture, politics, and healthcare systems. The barriers were classified into 7 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 awareness. Conclusion: Our study highlights the impact of and barriers to the Ponseti method of clubfoot treatment in China. In addition, we have identified suggestions that could be helpful for overcoming these barriers. This information provides healthcare planners with knowledge to assist in meeting the needs of the population and implementing effective and appropriate awareness and treatment programs for clubfoot in China.

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