In Kenya, 3-6% of the population suffers from diabetes. Due to inadequate treatment, many of them are at high risk of diabetes related complications such as diabetic foot problems which may lead to lower limb amputations.The majority of those who suffer from diabetes, belong to the poorest segments of society in Kenya. Oftentimes they are the sole breadwinners for their families and thus losing a limb may have devastating effects on the livelihood of the whole family.Nonetheless, diabetic foot care is sparse and inaccessible to many; hence the need to improve this access is critical.The project seeks to improve diabetic foot care and education throughout Kenya.
The "Step-by-Step" method for prevention of diabetic foot complications was initially developed in Tanzania and India under the WDF funded project WDF03-056. Subsequently the model has been adapted to various contexts including Pakistan (WDF07-261) and Mali (WDF07-251).This current project intends to introduce an adapted version of the model to a Kenyan setting in order to improve diabetic foot care and prevention in the country.The implementing partner is the Kenya Diabetes Management and Information (DMI) Centre, a medical charity aiming at improving the understanding of diabetes and creating more public awareness on diagnosis, care and predisposing factors of diabetes. The project is in line with the national health strategy and the Kenyan Ministry of Health is a close collaborating partner.Initially, 10 doctors who will serve as provincial coordinators will undergo training in basic foot care based on "Step-by-Step". This will be followed by an advanced training programme six months later.The provincial coordinators will be in charge of a diabetic foot care centre at each provincial hospital. These diabetic foot care centres will be established within the already established diabetes clinics at the provincial hospitals, established under WDF04-085 and also implemented by DMI. This will provide a comprehensive prevention and management programme of diabetic foot problems.Upon establishment of the 10 provincial foot care clinics, the 10 provincial coordinators will each train 100 primary health care professionals from their province. As a result of this training, a further 52 foot care centres will be established, also located in health facilities with on-going diabetes clinics.The primary health care professionals will be trained in clinical examination of feet and in giving information related to foot care to people with diabetes. During the training, the aspect of patient self-management and care will also be emphasised. The primary health care professionals are expected to promote this through patient education sessions at the health facilities and during individual consultations.In addition, a mobile diabetic foot clinic will be launched in order to provide prevention, care and education on diabetic foot problems in remote, rural areas. Moreover, the mobile diabetic foot clinic will conduct mass screening camps to detect diabetic foot problems in these remote areas.The vehicle to be used as mobile clinic is donated by the Safaricom Foundation. The mobile clinic will be manned by trained health care professional and it will operate on a rotating basis throughout Kenya, on average conducting screening and care 4-5 days every 4 months in each province.In general, it is pursued that all people with diabetes receive at least one annual foot examination either at the diabetic foot clinics or at the mobile clinic. Likewise, patients should receive education on how to prevent diabetic foot problems including training on self-care.Finally, the referral systems will be strengthened. This will be done through better evaluation, instructions and coordination. In addition, it will also be included in the training of the primary health care professionals when to refer diabetic foot problems to the next level of care.
- 10 provincial coordinators trained- 51 clinics established & equipped - 1090 health care providers’ trained- The mobile foot clinic has been present in all the community awareness and screening camps- 39,288 patients treated