Step-by-step

Step-by-Step improving diabetic foot care in the developing world program
and
Step-by-Step courses.

The International Working Group on the Diabetic Foot together with the Diabetic Foot Society of India (DFSI) and the Muhimbili University College Of Health Sciences Dar es Salaam, Tanzania (MUCHS), have initiated in 2003 a foot care project called “Step-by-Step, improving diabetic foot care in the developing world”. This was financially made possible by the World Diabetes Foundation (WDF). Among others successful projects, programmes in the Caribbean region were financed by Rotary Clubs in several countries (lead by the Rotary Club of Ledbury, UK), Rotary International and IDF.

Step-by-Step programme

The Step-by-Step programme (SbS) is a two year project. Teams consisting of a doctor and a nurse or paramedic, are invited to attend a basic and an advanced course. During the two years data collection is mandatory. The goal is to improve educational skills and the management of diabetic foot problems. By doing so this has created a cascade effect and sustainability in the region/country. An experienced national and international faculty is responsible for teaching and the practical sessions. Medical equipment and educational materials are provided to all participants. Very successfully pilot programmes and studies were held in India and Tanzania in 2004 and 2005. More recent publication(s) have shown that well executed SbS programmes have a significant reduction in amputation rate.

In the following countries Step-by-Step courses were executed:

India
Tanzania
Pakistan
Egypt
Botswana
Democratic Republic of Congo
Guinee
Mali
Kenya
Barbados
St Lucia
St Maarten
St Kitts
Brit. Virgin Islands
The Common Wealth of Dominica
Grenada
Antigua

Education:

References:

Bakker K, Abbas ZG, Pendsey S. Step by Step, improving diabetic foot care in the developing world. A pilot study for India, Bangladesh, Sri Lanka and Tanzania. Practical Diabetes International, 2006;23(8):365-369.

Sharad Pendsey, ZG Abbas. The Step–by–Step Program for reducing diabetic foot problems: A model for the developing world. Current Diabetes Reports, 2007; 7: 425-28

Karel Bakker, Kristien van Acker, Stephan Morbach, Andrew Perry. Promoting foot care education in developing countries: the Caribbean Diabetic Foot Care Programme. Diabetes Voice, 2009, 54, 3: 15-8

Abbas ZG, Lutale JK, Bakker K, Baker N, Archibald LK. The ‘Step by Step’ Diabetic Foot Project in Tanzania: a model for improving patient outcomes in less-developed countries. Int Wound J 2011; 8:169–175

Contacts:

Dr Kristien Van Acker, Belgium: dr.k.van.acker@mac.com
Dr Karel Bakker, Netherlands: karel.bakker@hetnet.nl
Dr Sharad Pendsey, India: sharad_ngp@sancharnet.in
Dr ZG Abbas, Tanzania: zabbas@cats-net.com
Mr Andrew Perry, UK (Rotary Club of Ledbury): aperry9381@aol.com
World Diabetes Foundation
International Diabetes Federation: info@idf.org

Pictures founding of the Step-by-Step project

founding

India

India

 Tanzania

Tanzania

Egypt

Egypt

Caribbean

Caribbean

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