Analysis of the effectiveness of a non-governmental organization in supporting clubfoot clinic at a tertiary care center

Abstract

Background: Since December 2011, a non-governmental organization (NGO) has been associated with our clubfoot clinic. Debates related to the effectiveness of NGOs in clinical milieu have raged on for a long time. The aim of this study was to analyze the effectiveness of an NGO in supporting the running of a clubfoot clinic in a tertiary care center. Methods: A descriptive, observational study was conducted from October to December 2014. The three main conceptualizations of effectiveness namely goals, resources and reputation were evaluated for this study, and to analyze them, we compared our treatment data with other published reports, and devised a ten-point questionnaire looking into the working of the NGO. This questionnaire was given to all parents (49) of children with clubfoot attending the clinic and also to an independent observer who was present at the time of patients’ interactions with the counselor. The significance of patients’ and observers’ response was tested by Wilcoxon matched-pairs signed-rank test. Results: 138 cases with 228 feet were registered in the clubfoot clinic till the end of our study. The average number of visits by the patients was 6.67 and 69.47% of cases required tenotomy during the course of treatment. Of the 49 patients, 33 (67.35%) graded the role of the NGO as excellent, while the rest showed a good response; 28 observers (57.14%) responded as excellent. The average score of parents towards role of the NGO was significantly higher than the observer’s score. Conclusions: The NGO associated with our clubfoot clinic successfully supported formal health care professionals.

Attendee Profile of a Clubfoot Patient: Experiences from an Indian Ponseti Clubfoot Clinic

“…Another Indian study conducted in 2014 showed that 42% clubfoot patients were under 6 weeks of age when first enrolled for treatment. 6 This clearly does not match with international recommendation of introducing Ponseti treatment soon after birth. The male-female ratio in our study was similar to that reported in world literature.…”

Interobserver Reliability of Pirani Clubfoot Severity Scoring between an Orthopedic Surgeon, a Resident Doctor, and a Nonmedical Counsellor at a Clubfoot Clinic

“…Several studies 6 7 20 21 22 23 24 25 26 27 28 have been undertaken to study the validity and interobserver reliability of Pirani scoring system among trained health personnel [ Table 6 ]. Cosma andVasilescu 24 in a study to determine the reproducibility of Pirani and Dimeglio classification systems found a high Pearson's coefficient correlation (>0.85) for both the systems.…”

“…Counsellors form an essential part of the clubfoot treatment program. 28 These are nonmedical personnel usually associated with an NGO who lend their support to the working of a clubfoot clinic. Their efficiency in effective and accurate Pirani scoring can be of great advantage to the clubfoot team.…”