THET Africa Grants Programme 2020 – Delayed Presenting Clubfoot
Development of training for treatment and surgical care for walking children with delayed presenting clubfoot in Ethiopia.
© CURE International
Above: before and after treatment for delayed presenting clubfoot.
Funder: Tropical Health Education Trust (THET) Africa Mother & Child Grants Programme, funded by Johnson & Johnson Foundation Scotland
Project duration: 21 months Project dates: 1 August 2020 – 31 March 2022
- UK Partner: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford (NDORMS). Prof Chris Lavy (project director) and Grace Drury (project manager)
- LMIC Partner: CURE Ethiopia Children’s Hospital. Dr Tim Nunn (project director)
In addition we are delighted to be working with:
- Global Clubfoot Initiative,
- Black Lion Hospital, University Teaching Hospital, Addis Ababa
- CBM (Christian Blind Mission)
- Hope Walks
- Colleagues from orthopaedic training institutions in Ethiopia including St Paul’s Hospital Millennium Medical College, University of Gondar Teaching Hospital and Bahir Dar University, Tebebe Ghio Specialised Teaching Hospital.
- CURE International UK
- A wider project stakeholders group including MiracleFeet.
Background & need
There are thousands of children who await clubfoot treatment in Ethiopia; including long waiting lists at CURE Ethiopia, the leading elective children’s orthopaedics centre in the country. CURE Ethiopia conducted a training needs analysis that identified potential partner institutions where there could be opportunity to scale up services providing clubfoot treatment to older children. Since an earlier project developing training materials for children 0-2years with clubfoot, we have received many requests from trainers in the sub-Saharan Africa region requesting more resources to treat older children with clubfoot who did not receive treatment as babies. We have been working with CURE Ethiopia on research studies developing the evidence base on management of older children with clubfoot.
Increase the capacity of health workers (surgeons, physios, clinical officers) in surgical management of delayed presenting clubfoot in walking children, an underserved population. To do this, the project will develop and pilot a one-day training course and materials, train and mentor new trainers, and then roll-out the training course. The project aims to strengthen the workforce, improve surgical capacity, and improve both national and regional surgical training capacity for children with clubfoot and with clubfoot care for older children.
We will develop a 1-day surgical training course on management of delayed presenting clubfoot. This will include
- A survey of the community of practice
- Consultation with an expert panel
- Gathering a multidisciplinary technical advisory group
- Creating technical teaching videos to cover surgical techniques and rehabilitation
- Applying lessons learned and teaching approach from Africa Clubfoot Training project
- Piloting the course in Addis Ababa
- Translation of materials to Amharic
- Mentoring of course participants and future trainers
- Support for roll-out of training nationally
- Making the course available to others in CURE and GCI network who wish to pilot in other settings.
- Monitoring and evaluation of project activities, and sharing of results and lessons learned.
Our training course will focus on management of children (aged 2-10years) with delayed presenting clubfoot who have received no prior treatment. The course will be designed primarily use in Ethiopia, with potential for piloting and roll-out in other settings in Africa and by other GCI partners where DCP is commonly seen.
Sustainability after the project
We will support for health workers after pilot course training through onsite mentoring support and advocacy for service uplift in these units to support roll-out. We will work with training partners for roll-out of training in Addis Ababa and nationally, with potential for piloting in other settings too.
- THET AGP 2020 page: https://www.thet.org/our-work/grants/africa-grants-programme/
- Read more about treating older children with clubfoot at CURE Ethiopia in this article by our project director, Dr Tim Nunn
- We presented an abstract on: 'Health partnership solidarity and adapting to challenges in AMCGP management of delayed presenting clubfoot project' at the THET Annual Conference, October 2021.