Barriers experienced by parents of children with clubfoot deformity attending specialised clinics in Uganda

Abstract

Clubfoot is a congenital structural impairment that, if untreated or inadequately treated, leads to deformity. Effective management is dependent on the compliance of parents to the treatment for clubfoot. A cross-sectional descriptive survey using a questionnaire identified the barriers parents encounter in bringing their children for treatment during the plaster-casting stage of managing clubfoot at the Talipes Clinics at Mbarara Regional Hospital and Mulago Hospital in Uganda. A total of 167 parents participated in the study. Ninety percent of the parents had attended weekly clinics with 67% indicating that they did not know about clubfoot and its treatment. The study found a significant association between compliance and transport costs (P = 0.014); distance travelled (P = 0.005); and family support (P = 0.028). Other barriers highlighted include the need to improve the communication skills between clinicians offering treatment to children with clubfoot and their parents. Informed parents could assist with compliance to treatment.

Perceptions Regarding Medical Management of Clubfoot in Kenya

“…The feminine gender dominance in this study concurs with the observation made in a study conducted in Uganda on parents/caregivers who took their children at an outpatient treatment clinic for clubfoot management (Kazibwe, 2006). A similar study by Kadzin and Wassell (1999) in USA found that out of 200 parents/caregivers, who took part in a study on barriers to treatment participation reported that majority of them were mothers or female relatives.…”

Reasons for low uptake of referrals to ear and hearing services for children in Malawi

“…[ 9 ] Even when treatment and rehabilitation services are available, there is evidence from LMIC settings that uptake of referrals to these services can be low among children with different impairments. [ 10 – 14 ] However empirical evidence on the uptake of and barriers to referrals for ear and hearing services among children is lacking.…”

What factors affect patient access and engagement with clubfoot treatment in low‐ and middle‐income countries? Meta‐synthesis of existing qualitative studies using a social ecological model

“…However, a number of factors have been identified that act as barriers to service delivery including financial constraints of the service , a related lack of resources and a lack of training for physicians . The majority of patients with clubfoot in LMICs may not come forward for treatment, and many of those who do start treatment do not continue with it . Understanding factors that affect access and adherence to clubfoot treatment may help to inform ways of encouraging uptake and engagement with services that have the potential to improve a child's well‐being and ability to participate in a range of everyday activities.…”

“…Once these are understood, services can be developed to meet their needs most appropriately. Qualitative studies are particularly adept at providing information about experiences of health and healthcare, and a number of qualitative studies have identified factors that affect patient access to clubfoot treatment in LMICs and suggested community‐level interventions to address them . Increasingly, it is thought that synthesis of previous qualitative work can deliver results that are of relevance to multiple contexts .…”