Population: 34.6 million
Number of babies born with clubfoot each year: 1972
(Incidence estimated using CIA factbook statistics and clubfoot incidence of 1.2/1000 live births)
Uganda was the first low/middle income country to set up a comprehensive national programme for the identification and treatment of clubfoot using the Ponseti method. As such, it has been a model for many other national programmes and for those wishing to adopt a public health approach to the management of clubfoot.
The Uganda Sustainable Clubfoot Care Project (USCCP) was started in 1999 and is a partnership between Ministry of Health, academic institutions and national and international NGO’s. The first years of the programme were funded by donations from Rotary International, CBM International and the University of British Columbia with the aim that the programme would be sustainable in the long run.
The work of USCCP has contributed greatly to what is now known about implementing programmes for clubfoot in low and middle income countries. Particularly notable developments to come out of USCCP are:
- The idea of a national programme with clinics disseminated throughout the country to allow accessibility for as many as possible.
- The Pirani score, developed by Dr Shafique Pirani, now used by practitioners worldwide to measure the extent of clubfoot deformity.
- The Steenbeek Foot Abduction Brace (SFAB), developed by Michiel Steenbeek using locally available, low cost materials which is now used all over the world and produced for as little as $10.00
- Work by Dr Norgrove Penny on management of neglected clubfoot.
- (Pirani scoring sheet, information on SFAB construction and neglected clubfoot are all available on our resources page.)
|Number of Ponseti clinics in the country||Number of babies enrolled||Number of feet treated||Number of tenotomies|
Clinic locations (as of 2011):
The clinics are scattered through the country. 11 clinics are located in the central region near Kampala with the furthest distance from the capital city being 123Km; Four in the Mid-eastern region in the districts of Jinja, Iganga, Kamuli and Mayuge; Eastern region has 5 clinics located at Mbale, Tororo, Kumi, Kapchorwa and Soroti. North-eastern has 2 clinics at Moroto and Kabong. Northern region has 4 clinics at Lira, Apac, Lacor and Gulu (Gulu district has 2 clinics). West Nile region has 2 clinics at Arua and Nebbi. Mid-western has 2 clinics at Masindi and Hoima; the western region has 6 clinics at Fort-portal, Kagando (Kasese district), Mbarara, Kitagata (Bushenyi district), and Itojo (Ntungamo district) and Ishaka (Bushenyi district): South-western region has 4 clinics at Kisiizi and North Kigezi Diocese (Rukungiri district), Kabale, and Kisoro.
|Number of orthopaedic students taught||Number of PG-orthopaedic students||Number of PG-general surgeons taught||Under graduate medical students taught||Nurses taught screening & identification of clubfoot|
Visit the Uganda Sustainable Clubfoot Care Project website: http://ponseti.info/uganda/index.php?option=com_frontpage&Itemid=1
Research and Publications:
Kazibwe H, Struthers P (2009) Barriers experienced by parents of children with clubfoot deformity attending specialised clinics in Uganda. Tropical Doctor 39 (1): 15-18
McElroy T, Konde-Lule J, Neema S, Gitta S (2007) Understanding the barriers to clubfoot treatment adherence in Uganda: a rapid ethnographic study. Disability and Rehabilitation 29 (11-12) 845-855
Pirani S, Hodges D & Sekeramayi F (2003) A reliable and valid method of assessing the amount of deformity in the congenital clubfoot deformity (The Canadian Orthopaedic Research Society and the Canadian Orthopaedic Association conference proceeding) in The Journal of Bone and Joint Surgery 90 (B) SUPP_1, 53
Pirani S, Maddumba E, Mathias R, Konde-Lule J, Penny N, Beyeza T, Mbonye B, Amoni J, Franceschi F (2009) Towards effective Ponseti clubfoot care: the Uganda Sustainable Clubfoot Care Project. Clinical Orthopaedics and Related Research 467: 1154-1163