Task sharing clubfoot treatment in Latin America: a cross-sectional survey of expert opinions

Abstract

While the Ponseti method has quickly become the mainstay of clubfoot treatment in most parts of the world, its dissemination and successful implementation in Latin America has been more limited. The additional shortage of orthopedic surgeons in this region makes task sharing a practical approach to address gaps in service provision. We designed an online survey to assess needs, perceptions, and willingness to task share the delivery of the Ponseti method by Ponseti-method-trained physicians across Latin America. Multiple-response questions were summarized and an applied thematic analysis approach was used to analyze free-response questions. We achieved a 66% response rate (31 of 47 experts responded). Our findings illustrate that most physicians feel the need for disseminating and improving Ponseti training, as well as having additional support for clubfoot treatment. While physicians who treat clubfoot have mixed opinions on the role of nonphysicians treating clubfoot, most report logistical concerns and insufficient training as barriers to their inclusion. Given this and the need for improved, more accessible clubfoot care across Latin America, future clubfoot treatment efforts may benefit from incorporating task sharing between orthopedic surgeons and non-physician personnel.