Kenya is characterised by a fragile health system with inadequate infrastructure, lack of human resources and distribution inequalities in services utilisation.
Currently, Kenya experiences a governance transition with health care systems being decentralised from the national level to devolved county governments. Due to this decentralisation, persistent challenges have arisen.
Diabetes is emerging as a chronic non-communicable disease (NCD) of public health concern. Diabetic foot is now the leading cause of prolonged hospitalisation and amputation. This results in a major economic burden to families, society and the health sector.
In Nairobi, there are only two trained podiatrists and three diabetic foot care nurses. Despite the great gains made in the WDF-funded project WDF07-302, treatment and rehabilitation of specific diabetic foot complications continues to be scarce in some parts of the country. Currently, a few public health facilities are served by health care providers who have had basic training on foot care. There is an urgency to train primary health orthopaedic technologists on simple innovative diabetic foot techniques for preventive and rehabilitative solutions.
The aim is to improve diabetic foot awareness and care in Kenya.
This project will build upon the structures laid out by the WDF- funded projects WDF07-302 and WDF09-436.
As the health care services become decentralised there is a need to strengthen three advanced clinics to serve as regional centres of excellence. They will serve as mentors and training hubs for best practices on diabetic foot. The centres will act as central coordinating units to streamline the referral mechanisms among the local health facilities, diabetic foot clinics and community health workers.
The monitoring and evaluation of the centres will be integrated with the national diabetes strategy (developed during the WDF09-436 project) to create synergies for planning and policy development. This will foster the sustainability of the project.
A training curriculum will be developed to facilitate the training of primary health orthopaedic technologists in diabetic foot care. Health care professionals will receive training in forming, formalising and strengthening community diabetes support groups. This will provide a vital platform for interacting and sharing experiences on diabetes foot self-management and prevention of complications. Previously developed educational materials will be revised, translated into Kiswahili and disseminated.
The existing 35 basic foot care clinics (established during the WDF 07-302 project) will be strengthened to an advanced level by equipping them with foot care equipment and tools to increase their preventive diagnostic and treatment capacities. The mobile foot clinic will continue to provide care and education to patients from various counties.
Through community awareness activities, free screening camps and local media, it is envisioned that over 5 million people will be reached with information on simple measures to prevent diabetes foot complications.
- 3 advanced clinics to become centres of excellence
- 30 health orthopaedic technologists trained
- 300 community health care workers and peer educators trained
- 460 health care providers trained
- 3,000 posters disseminated
- 15,000 patient education brochures disseminated
- 35 basic clinics to become advanced clinic
- 3 advanced clinics become centres of excellence
- 65 health orthopaedic technologists trained
- 267 community health care workers and peer educators trained
- 400 health care providers trained
- 30 basic clinics established and 16 advanced clinics established
- More than 50,000 patients screened for diabetes foot complications