Barriers to implementation

Strategies for addressing implementation barriers

Inadequate health workers

An increased supply and distribution of health care workers that are trained on foot care.

Available staff should be provided with financial rewards, career development, continuing education, improved hospital infrastructure, resource availability, better hospital management and improved recognition of health professionals, help reduce on “brain-drain”.

Emphasis on pre-school training on diabetes and foot care so that every provider should be knowledgeable

Revision of existing diabetes guidelines to include management of diabetic foot ulcers to prevent complications

Limited financial resources to increase screening and treatment of diabetic foot complications

Increased funding support for EHP services

Integrating diabetic foot care into already existing well-funded programme or EHP services provided in all health delivery points

Inadequate trained health workers to provide integrated diabetic foot care

In service (CPD) training and mentorship for health care workers on foot care, screening and management

Integrated regular supervision, audit and feedback of diabetes and foot care in all existing programmes

Loss to follow up

All diabetic patients should receive comprehensive health education on foot care and sugar level control to prevent complications

Emphasise on peer support programmes, proper foot ware, prevention of injuries