Barriers to Clubfoot Treatment and Impact of COVID-19 Pandemic on Clubfoot Program with Quantitative Analysis

Abstract Background and Aim: The Ponseti method for congenital talipes equinovarus has proven highly effective, but its success in countries like India is hampered by numerous barriers, which have been exacerbated by the COVID-19 pandemic. The need for this study is to plan awareness program to educate mothers, to strengthen and monitor the training protocols for family members and community doctors, to analyze the prevalence of neglected and untreated clubfoot cases during the COVID-19 pandemic, and to identify the barriers to effective treatment in the Indian context. Materials and Methods: This observational study included 206 patients with untreated and neglected clubfoot during the COVID-19 pandemic. The data were collected on demographic characteristics, economic status, parental knowledge, cultural beliefs, and the impact of the pandemic on treatment accessibility. Results: The majority of patients (60.68%) were in between 2 and 5 years old, and a significant proportion (46.12%) of parents lacked knowledge about clubfoot. Economic constraints were a major barrier, with many families losing daily wages to attend clinic visits. Cultural beliefs also played a significant role, with 43.72% of families holding beliefs that hindered treatment adherence. 63.11% of patients were not motivated for the completion of treatment. The COVID-19 pandemic further exacerbated these issues, leading to delays in treatment and increased dropout rates. Conclusion: Addressing the barriers to clubfoot treatment in India requires a multifaceted approach, including enhanced parental education, financial support, and the use of telemedicine. Early intervention and strict adherence to the Ponseti method are crucial for improving outcomes and reducing long-term disability.