Advanced foot care, Thailand

Objectives

After the successful training of 240 health care providers in basic foot care under the WDF funded project WDF07-279 the need for foot care is receiving increased attention in Thailand.

Hence, basic foot care training is now included in the routine follow-up training of diabetes educators by the Thai Association of Diabetes Educators.

However, with more than 3 million people with diabetes in Thailand, local practices such as bare-foot walking which increases risk of injury and wounds and half of all lower extremity amputations (excluding accidents) being due to diabetes the need is evident.

To further enhance diabetes-related foot care available to the Thai population WDF has granted support to this project.

The project seeks to improve foot care delivery by providing advanced training for health care staff.

Approach

The partners on this project are the same as on the basic foot care project WDF07-279, namely the Foundation for the Development of Diabetes Care and Theptarin Hospital in Bangkok.

On the WDF07-279 project 240 health care providers received basic training in foot care during a 2-day course. These health care providers were followed after their initial training and though most of them have commenced work on foot care in their facilities, it has also become apparent that many of them still lack knowledge, wound care management skills and tool kits to provide care to people with foot ulcers.

Therefore, it was decided that 180 of these health care providers should have the opportunity to receive more advanced training. In total, 3 sessions with 60 participants in each will be conducted to upgrade their knowledge and skills. Training will include lectures, workshops and case discussion; moreover, basic working toolkits and education promotion toolkits will be designed and distributed to ease the implementation process.

Only 180 out of the 240 originally trained health care providers will be offered the opportunity to participate in this advanced course. The reason for this is that not all of the 240 have successfully initiated foot care services in their facilities and not all are equally active in moving forward to the next step. When selecting participants for the advanced course, the support from administrators will also be assessed as it is the target to select those who have the best potential to become a role model and a trainer in the future.

In addition to the training session, a 2-day knowledge sharing session will also be arranged for the participants. Here they will get the opportunity to form networks and share their knowledge and experiences with the rest of the group, and in turn learn from the experiences of their peer groups. All the success stories will be collected and compiled into a book, which subsequently will be distributed.

Field visits to selected facilities will also be carried out. The facilities visited will be those with teams that have attended the advanced trainings, have excelled in foot care services and have a high potential to benefit from additional guidance of foot care experts. The rest of the participants will be followed with the use of e-mail, phone calls and similar methods. It is expected that at least 15,000 diabetes patients will receive proper foot care as a result of the training of health care providers.

Finally, a grant competition for organising basic foot care trainings will be arranged. The purpose is to give incentive and financial support for those who have received basic and advanced training to become trainers and thereby share their gained knowledge and skills in their local areas. There will be 3 grants of 200,000 Baht each available and to receive a grant one must train at least 100 people.

Results at completion

• 194 health care providers trained in advanced foot care
• 45,615 people with diabetes received foot screening and foot risk classification.