congenital deformity among paediatric patients. The outcome of starting clubfoot treatment early is very
promising. Patient retention throughout the treatment programme is challenging in Sarawak. In this study,
we explored the barriers that parents/caregivers face when seeking clubfoot treatment in Sarawak, Northwest
Borneo. A better understanding of the barriers will provide us with the information to formulate effective
programmes for clubfoot treatment in this region.
Methods: We conducted a questionnaire-based quantitative cross-sectional descriptive survey. We adapted
a set of closed-ended questionnaires originally designed by Kazibwe and Struthers in a study done in Uganda
in the year 2006.
Results: A total of 53 parents/caregivers of children with idiopathic clubfoot were recruited in this study, with
16 defaulter cases and 37 non-defaulter cases. We found 2 statistically significant barriers to clubfoot treatment
in Sarawak, with p-value < 0.05, namely the geographical factor (p = 0.019) and logistic factor (p = 0.017).
Conclusion: Barriers to clubfoot treatment that influence the compliance to treatment identified in this study
are long distance travel, logistics limitations, uncooperative patients during treatment, parents/caregivers
having other commitments, unsupportive family members, lack of understanding regarding clubfoot and its
treatment, inadequate specialists in clubfoot, traditional socio-cultural beliefs and practices and economic
constraints. Enhanced understanding in this matter will guide us in devising culturally admissible ways to
increase awareness in parents/caregivers regarding clubfoot and its treatment. A sustainable national clubfoot
program will be very beneficial in providing a holistic approach to tackle barriers to treatment in our country.
This study explores the quality of life, social integration and the effects of perceived stigma of people with mental illness living in the community. Adopting a complimentary mixed method, this study was represented by 165 people with mental illness in Kuching, Sibu and Miri. Findings indicated that the quality of life scale was poor, 49.67% and 78.43% often experienced stigma. Anticipated stigma 43.79%; 16.99% all the time and 4.58% never experienced stigma. Findings also noted that people with mental illness living in the community are still largely depending on and needed continuous support from their family members/carers for financial aid and their living arrangement for a “better” quality of life. Where treatment is concerned, follow up care at home by health care providers continue to play a significant role. In order to “erase” the perceived or stigma experienced, establishing therapeutic relationship, communication and creating awareness on “stigma discrimination paradigm” poses a phenomenal challenge in the current misrepresentations of mental health messages.