By Fru Rita Ngum
Staff of the Cameroon Clubfoot Care Project (CCCP) has undertaken the first phase of the 2017 Monitoring and Evaluation (M&E) visit to seven CCCP partner clinics in the North, Far North and Center Regions of Cameroon. The maiden M&E visit since 2016 when CCCP partnered with these clinics to facilitate the treatment of clubfoot that took place from October 9-13, 2017 comprising CCCP Project Officer, Tina Ashiyo, Physiotherapist at Banso Baptist Hospital Mr. Nkwenti Alfred, CCCP Monitoring and Evaluation Officer, Ndzi Grace and the CCCP Communication Officer, Fru Rita Ngum.
For 5 days, the team visited Centre Fondation Bethleém Mouda, Maroua, Centre Ndoukoua Yves in Mokolo, Garoua Regional Hospital, PIAP Office in Garoua, PROMHANDICAM in Yaounde, Etugebe Baptist Hospital Yaounde, Centre Handicapé in Yaounde and Centre de Sante Catholique Bikop in Mbalmayo.
In each clinic, the CCCP Project Officer noted that the objective of the visit was to assess quality of services provided at treatment sites, understand the challenges clinic staff are facing in the provision of services, get their recommendations and support project staff on handling financial expectations. On behalf of the team, the Project Officer, Tina Ashiyo applauded the clinic management and staff for their hard work in ensuring that children with clubfoot who access their facilities are treated.
During the discussions led by Tina Ashiyo, the clinic staff revealed that management is facilitating the provision of clubfoot services in their clinics. They noted that they carry out awareness raising on clubfoot in their health facilities, in the media and in maternities. In the different clinics, the staff appreciated CCCP for the provision of treatment consumables which is facilitating the treatment of most children in terms of cost. They also expressed gratitude for the training they have received on the ponseti method. Tina explained to them some issues on costing clubfoot treatment to ensure sustainability of running the clubfoot clinics.
The Physiotherapist in the team, Mr. Nkwenti Alfred who represented the CCCP Clinical Supervisor took lead in clinical discussions during which he had a careful look at the patient assessment forms. He noted some lapses on the forms such as duration of manipulation and casting, some parents not respecting appointments and some clinic staff not filling the assessment forms appropriately.
In clinics in the Northern regions, the staff explained that most parents do not come for treatment because of poverty, long distances, and cultural beliefs that it is the sole responsibility of the mothers in taking the children for treatment. Responding to these challenges, Mr. Nkwenti encouraged them to always call the parents for follow up so that they can come for their appointments. Mr. Nkwenti also recommended that much time should be taken at the beginning of the treatment to counsel the clients to know how long and what effort it will take for treatment to yield results.
The physiotherapist called on clinic staff to also encourage the mothers to talk to their husbands on the need for them to be involved in the treatment of their children with clubfoot. As a strategy to encourage other parents uptake treatment, Mr Nkwenti said they should always show them pictures of other children who have successfully gone through treatment and as well encourage the parents to come for each session of the treatment with any little amount so that it will enable them finish the treatment fees.
For her part, CCCP Monitoring and Evaluation Officer, Ndzi Grace laid emphasis on meeting up with reporting deadline and how to fill the forms appropriately so that all the clubfoot cases treated will be reported. She also appreciated them for the efforts in meeting up with deadlines despite their busy work in the clinics.
Speaking on taking consent for pictures and commitment to treatment, the CCCP Communication Officer, Fru Rita Ngum explained the importance of getting the consent of parents before taking their pictures so that the pictures can be used when need be. She also encouraged the staff to always get the parents sign the commitment form in other to prevent and reduce default.
At the end of each discussion in the clinics, the staff had different recommendations such as further trainings on the ponseti technique, and tenotomy for some doctors, provision of some clinic equipment for clubfoot treatment and the need to discuss with management for more space to be provided for clubfoot treatment in some centres.
The CCCP team also had the opportunity to meet with some Hospital Administrators such as the Director of Garoua Regional Hospital and the CMO of Centre de Santé Catholique de Bikop who were elated to receive the team and pledged their continues support to the project. The team left each centre by encouraging them to ensure that any child who comes to their facility with clubfoot should be treated given that the project provides subsidies to very needy cases.