ArticleBMJ global health2016
Cost-effectiveness of club-foot treatment in low-income and middle-income countries by the Ponseti method.
Article in BMJ global health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- The role of clubfoot training programmes in low- and middle-income countries: a systematic review.Tropical doctor · 2020Pooled it
- Interventions for congenital talipes equinovarus (clubfoot).The Cochrane database of systematic reviews · 2020Pooled it
- Bridging the Gap in Clubfoot Care: A Framework for Sustainable Rehabilitation in Low-Resource Settings.Cureus · 2026Article
- Finite Element Simulation of Clubfoot Correction: A Feasibility Study Toward Patient-Specific Casting.Children (Basel, Switzerland) · 2025Article
- Global clubfoot treatment in 2023: an overview of advances and outcomes.BMJ global health · 2025Observational
- Factors responsible for dropout in the Ponseti method of clubfoot treatment: A cross-sectional study.Qatar medical journal · 2024Review
- Using a health observance event to raise awareness: An assessment of World Birth Defects Day.Birth defects research · 2023Article
- Assess perception, practice and lived experiences on use of corrective braces among parents of children diagnosed with clubfoot: A mixed method study.Journal of education and health promotion · 2023Article
- Should disability-inclusive health be a priority in low-income countries? A case-study from Zimbabwe.Global health action · 2022Article
- Can Below-Knee Casts be Effective for Clubfoot Management in Walking-Age Children? A Prospective Cohort Study.Indian journal of orthopaedics · 2022Article
- Ending Neglected Surgical Diseases (NSDs): Definitions, Strategies, and Goals for the Next Decade.International journal of health policy and management · 2022Article
- The impact of socio-economic factors on parental non-adherence to the Ponseti protocol for clubfoot treatment in low- and middle-income countries: A scoping review.EClinicalMedicine · 2022Review
- Impact of COVID-19 pandemic on clubfoot program at tertiary care institute.Journal of clinical orthopaedics and trauma · 2022Article
- A Focus Group Study to Understand the Perspectives of Physiotherapists on Barriers and Facilitators to Advancing Rehabilitation in Low-Resource and Conflict Settings.International journal of environmental research and public health · 2021Article
- The Health Determinants of Accessibility to Clubfoot Treatment in LMICs: A Global Exploration of Barriers and Solutions.International journal of MCH and AIDS · 2021Article
- Improving musculoskeletal health for children and young people - A 'call to action'.Best practice & research. Clinical rheumatology · 2020Review
- Global prevalence estimates of three chronic musculoskeletal conditions: club foot, juvenile idiopathic arthritis and juvenile systemic lupus erythematosus.Pediatric rheumatology online journal · 2020Article
- Early management of clubfoot by the Ponseti method with complete percutaneous tenotomy of tendoachillis.Journal of family medicine and primary care · 2019Article
- Development and validation of a delayed presenting clubfoot score to predict the response to Ponseti casting for children aged 2-10.Strategies in trauma and limb reconstruction · 2018Article
- The development of a training course for clubfoot treatment in Africa: learning points for course development.BMC medical education · 2018Article
Corrections and comments
- Erratum issuedCorrection:2018
Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClub foot is a common congenital deformity affecting 150 000-200 000 children every year. Untreated patients end up walking on the side or back of the affected foot, with severe social and economic consequences. Club foot is highly treatable by the Ponseti method, a non-invasive technique that has been described as highly suitable for use in resource-limited settings. To date, there has been no evaluation of its cost-effectiveness ratio, defined as the cost of averting one disability-adjusted life year (DALY), a composite measure of the impact of premature death and disability. In this study, we aimed to calculate the average cost-effectiveness ratio of the Ponseti method for correcting club foot in sub-Saharan Africa.
methodsUsing data from 12 sub-Saharan African countries provided by the international non-profit organisation CURE Clubfoot, which implements several Ponseti treatment programmes around the world, we estimated the average cost of the point-of-care treatment for club foot in these countries. We divided the cost of treatment with the average number of DALYs that can be averted by the Ponseti treatment, assuming treatment is successful in 90% of patients.
resultsWe found the average cost of the Ponseti treatment to be US$167 per patient. The average number of DALYs averted was 7.42, yielding a cost-effectiveness ratio of US$22.46 per DALY averted. To test the robustness of our calculation different variables were used and these yielded a cost range of US$5.28-29.75. This is less than a tenth of the cost of many other treatment modalities used in resource-poor settings today.
conclusionsThe Ponseti method for the treatment of club foot is cost-effective and practical in a low-income country setting. These findings could be used to raise the priority for implementing Ponseti treatment in areas where patients are still lacking access to the life-changing intervention.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.