The aim of the project is to increase awareness and improve care for diabetic foot patients through the Step-by-Step model.
Expected impact
30 doctors and 30 nurses trained in diabetic foot care
30,000 people with diabetes reached each year
Results to date
29 diabetic foot teams (consisting of 1 nurse and 1 doctor) have been trained, equipped and have set up 30 diabetic foot clinics.
11,207 people with diabetes have been screened for diabetic foot complications.
Educational material including DVDs, posters and books have been produced in Arabic and distributed to the clinics.
The project has received publicity in various newspapers and TV channels.
Project details
One of the most common and feared complications of diabetes is diabetic foot, which far too often results in an amputation of the limb.
In Egypt, the prevalence of diabetic foot ulcers has been found to be high. The reasons commonly stated for this prevalence includes inappropriate footwear and the lack of knowledge regarding diabetic foot problems.
The latter is very pertinent to Egypt since more than 90% of the people having diabetes do not receive education on diabetic foot problems.
Yet, studies have shown that with proper provision including regular follow-up and education of the patient, the rate of diabetic foot problems resulting in amputation may be reduced.
Approach
This project applies the "Step by Step" model in an Egyptian context. The "Step by Step" model was initially developed by a coalition of WDF, the Int. Working Group on the Diabetic Foot and some diabetes/foot care specialists under the WDF funded project WDF03-056 covering India and Tanzania. Since then, the model has been widely applied, a.o. in Pakistan, Mali, Kenya and the Democratic Republic of Congo.
The Mansoura University in the Delta region will lead the implementation of the project. The university's faculty of medicine runs a diabetes clinic, which is the only clinic in the country that provides integrated, multidisciplinary foot care services to people with diabetes.
As a key part of the "Step by Step" model, training of medical teams consisting of a doctor and a nurse will be conducted. In total, 30 teams - each representing a district or a state - will be trained. The doctors and nurses will be selected from medical centres with a high attendance of people with diabetes.
The training will be executed during two courses - a basic and an advanced.
The basic course will consist of a 3-day practical training programme at which the participants will be taught to perform physical examinations, screen for neuropathy and ischaemia, classify and stage the foot, and organise appropriate foot care and education. Emphasis will also be put on acquiring teaching skills to enable the participants to educate their patients and passing on the gained knowledge to their colleagues in their home region and thereby creating a spin-off effect.
After one year, the trained teams will be called for an advanced course during which the elements from the basic course will be examined at a higher level. The advanced course has an emphasis on interactive sessions focusing on sharing of experience among the trained teams. The teams present and discuss cases experienced in their respective clinics over the past year.
Appropriate education materials will be given to the teams to be used in the education of patients and colleagues. The various materials will be tailored to the target group e.g. by taking into account the group's level of literacy.
The trained teams and the education materials will greatly upgrade the level of service provided at the country's already existing diabetes clinics since the personnel now will be able to screen for diabetic foot and provide preventive measures.
It is expected that as a result of the project, 30,000 people with diabetes will benefit from improved foot care each year.
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