The project seeks to train multidisciplinary teams of health care professionals on preventive and primary foot care, and thereby improve the health care delivery to people with diabetes.
Expected impact
A total of 240 health care professionals trained on preventive and primary foot care.
Results at project completion
4 foot and wound care training courses conducted. A total of 252 health care professionals from 81 health facilities trained. 36 provinces covered.
The admission due to infected diabetic wounds at the Udonthani Provincial Hospital has been reduced from 0.45% in 2006 to 0.27% in 2008. This also brought about a reduction of the health care expenditure.
Project details
The number of people with diabetes in Thailand is growing at an alarming rate. A survey from 2004 found that over 3 million people aged 15 or above had diabetes, and more than half are not aware that they have the disease.
Moreover, in Thailand it is estimated that 50% of lower extremity amputations, excluding accidents, are due to diabetes. The majority of these amputations are preventable.
Local practice such as bare-foot walking often results in non-healing wounds and ulcers on the feet of people with diabetes.
In addition, poverty often leads to late presentation of patients with diabetic wounds at the health facilities. Lack of knowledge and experience of the health care professionals prevent them from delivering proper primary wound care and conduct timely referrals as well as passing on appropriate information on prevention of diabetes and diabetic wounds.
Last but not least, with non-healing ulcers there tends to be a blind referral for amputation rather than investing the time and effort in making the ulcer heal and thus save the limb.
Approach
The two major partners in this project are the Theptarin Hospital and the Foundation for the Development of Diabetes Care.
The Theptarin Hospital was the first diabetes centre in Thailand and also the first to establish a multidisciplinary foot and wound care team - a concept they wish to proliferate throughout the country.
The Foundation for the Development of Diabetes Care is a foundation aiming at training medical personnel in health care delivery to people with diabetes.
The project has 4 main goals:
To create more awareness of diabetic foot problems in Thailand
To provide basic training to health care professionals in management of diabetic foot and wound care
To bring together health professionals, currently working with diabetic foot problems to promote multidisciplinary team work and network in diabetic foot and wound care
To pass on basic knowledge on foot care and wound prevention to people with diabetes and empower them to perform self-care and detect problems at an early stage.
The primary activity of the project will be 4 training sessions. Each session has a 2-day duration and can accommodate 60 participants. Hence, a total of 240 health care professionals will be trained. A training session will be held every third month and the training includes lectures, workshops and case discussion.
The training is designed to enable participants to understand the broad picture of foot and wound care problems and to teach the participants basic primary care procedures and risk assessment techniques.
It is expected that the participants upon return to their local health facility will share the obtained knowledge and skills with their colleagues as well as community leaders, patients and their families, and eventually the general population.
