Clubfoot in Malawi: treatment-seeking behaviour.

We explore the treatment-seeking behaviour of guardians of patients undergoing treatment for clubfoot at clinics run by the Malawi National Clubfoot Programme (MNCP). Core data was collected and analysed using qualitative methodologies of critical medical anthropology. Sixty detailed case studies were completed, each based on an extended open-ended interview with patient guardians. Two positive drivers in seeking treatment for clubfoot were identified: a desire to correct the impairment; and a direct instruction to do so, usually from a health-care professional. Four main barriers prevented treatment seeking: lack of knowledge about the condition and its treatment; familial resistance; logistical obstacles; and socio-economic pressures. In delivering effective health care, organizations should seek to minimize barriers and their impact, whilst maximizing drivers that lead to positive action.