{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T14:41:01Z","timestamp":1781275261225,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,11,9]],"date-time":"2013-11-09T00:00:00Z","timestamp":1383955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Clubfoot occurs in nearly 1\u00a0in every 1,000 live births worldwide, representing a significant burden of disease. In high\u2010income countries, an evidence\u2010based treatment protocol utilizing sequential casting was pioneered by Ponseti and has resulted in excellent outcomes among children treated for this condition. However, treatment methods and results of treatment vary greatly across low\u2010 and middle\u2010income countries (LMICs). Our goal was to create a framework for understanding how effective programs that treat clubfoot in LMICs choose and organize their activities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature review was conducted using the keywords \u201cdeveloping countries\u201d and \u201cclubfoot.\u201d A public health analysis model known as the Care Delivery Value Chain (CDVC) was applied to discover public health practices that would optimize value over the entire course of a patient\u2019s life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The literature review yielded 32 unique results, seven of which met our inclusion and exclusion criteria. Review of the bibliographies yielded two additional papers for a total of nine papers. We identified seven vital steps in the clubfoot cycle of care and constructed a CDVC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The analysis of this CDVC model suggests six best practices that are essential to successfully scaling up clubfoot treatment programs and ensuring excellent clinical outcomes: (1) diagnosing clubfoot early; (2) organizing high\u2010volume Ponseti casting centers; (3) using nonphysician health workers; (4) engaging families in care; (5) addressing barriers to access; (6) providing follow\u2010up in the patient\u2019s community. These practices must be adapted to each context. Applying them will optimize outcomes when designing public health programs that deliver clubfoot care in LMICs.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2318-9","type":"journal-article","created":{"date-parts":[[2013,11,8]],"date-time":"2013-11-08T18:01:26Z","timestamp":1383933686000},"page":"839-848","source":"Crossref","is-referenced-by-count":22,"title":["Clubfoot Care in Low\u2010Income and Middle\u2010Income Countries: From Clinical Innovation to a Public Health Program"],"prefix":"10.1002","volume":"38","author":[{"given":"Luke","family":"Harmer","sequence":"first","affiliation":[{"name":"Section of Orthopedic Surgery University of Calgary 3330 Hospital Drive NW T2N 4N1 Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Rhatigan","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Harvard School of Public Health 651 Huntington Avenue, 7th floor 02115 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,9]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010009\u20100734\u20109"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0468"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.89B3.18313"},{"key":"e_1_2_6_5_2","first-page":"59","article-title":"Treatment of idiopathic clubfoot: an historical review","volume":"20","author":"Dobbs MB","year":"2000","journal-title":"Iowa Orthop J"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010009\u20100720\u20102"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010009\u20100754\u20105"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.01621"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1258\/td.2008.080178"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010008\u20100600\u20101"},{"key":"e_1_2_6_11_2","first-page":"33","volume-title":"competitive advantage","author":"Porter ME","year":"1985"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.10.1103"},{"key":"e_1_2_6_13_2","volume-title":"Redefining Health Care: creating value\u2010based competition on results","author":"Porter ME","year":"2006"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31818a43af"},{"key":"e_1_2_6_15_2","unstructured":"RhatiganJ JainS MukherjeeJS et al (2009)Applying the care delivery value chain: HIV\/AIDS care in resource poor settings. 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