Related Experiment Video
Updated: May 8, 2026
Laparoscopic Non-Mesh Cerclage Pectopexy with Uterine Preservation for Pelvic Organ Prolapse
Published on: October 25, 2024
Barriers to the Ponseti method in Peru: a two-year follow-up
Melissa Palma1, Thomas Cook, Julio Segura
1department of Orthopaedic Surgery and Rehabilitation Carver College of Medicine University of Iowa.
Insights
Idiopathic clubfoot treatment in Peru faces challenges. Key obstacles to the Ponseti method include insufficient trained physicians, patient travel burdens, and limited parental awareness, hindering treatment completion rates.
Area of Science:
- Orthopedics
- Pediatric disability
- Global health
Background:
- Idiopathic clubfoot is a leading cause of childhood disability worldwide, affecting 100,000 children annually.
- The Ponseti method offers a highly effective, non-surgical treatment for clubfoot, with over 95% success rates when properly implemented.
- Developing countries like Peru require low-cost treatment alternatives, yet face significant challenges in patient adherence.
Purpose of the Study:
- To identify obstacles to the successful implementation of the Ponseti method in Peru.
- To understand physician perspectives on barriers to clubfoot treatment completion in the Peruvian context.
- To inform strategies for improving Ponseti method adherence in underserved regions.
Main Methods:
- Semi-structured interviews were conducted with 25 physicians practicing the Ponseti method in Peru.
- Physicians were asked to discuss challenges and barriers encountered in treating idiopathic clubfoot.
- Qualitative data were analyzed to identify recurring themes and obstacles.
Main Results:
- The primary obstacles reported by physicians include a shortage of trained Ponseti method practitioners nationwide.
- Significant barriers involve patient transportation difficulties and long distances to treatment centers.
- Lack of adequate parental knowledge regarding the Ponseti method was also a frequently cited issue.
Conclusions:
- Addressing the scarcity of trained physicians, particularly in provincial areas, is crucial for improving treatment access.
- Reducing the financial and travel burdens for parents can enhance compliance with the Ponseti method.
- Targeted interventions to increase parental awareness are necessary to support successful clubfoot treatment outcomes in Peru.
Abstract:
Idiopathic clubfoot affects approximately 100,000 children each year and is one of the leading causes of disability worldwide. The Ponseti method is an inexpensive, non-surgical treatment that, when executed correctly, is more than 95% effective; however, in Peru, a developing country where a low-cost alternative is greatly needed, physicians report up to 30% of patients do not complete treatment. This study involved semi-structured interviews with 25 physicians who practice the Ponseti Method in Peru to discuss obstacles for the method in their country. The most frequent obstacles to the Ponseti method in Peru reported by physicians included lack of physicians trained in the Ponseti method in the country, patient transportation and distance to treatment centers, and lack of parental knowledge of the Ponseti method. These data suggest the need to train more physicians in Peru, particularly in the provinces. Increasing access to trained physicians in provincial areas may reduce the financial and travel burden of parents to help increase compliance with treatment.
