Diabetes Africa Foot Initiative (DAFI)

In July 2012 the International Diabetes Federation (IDF) and the IDF Africa Region, in collaboration with the University of Johannesburg, Université Senghor, Université Numérique Francophone Mondiale (UNFM) and Sanofi Diabetes launched the Diabetes Africa Foot Initiative (DAFI). This four-year initiative aims at preventing lower-extremity amputations in Sub-Saharan Africa, through a comprehensive, affordable and sustainable foot-screening programme involving health authorities, IDF Member Associations and local communities.

Diabetes care in Africa assumed a quality priority only recently. This important change of focus in diabetes care in Sub-Saharan Africa followed the African Declaration in 2006 in Cape Town and later the UN Resolution 61/225 in December of the same year. The African Diabetes Declaration calls on governments of African countries and all partners and stakeholders in diabetes to prevent diabetes and related chronic diseases, and to improve quality of life and reduce morbidity and premature mortality from diabetes. The UN Summit on non-communicable diseases in September 2011 marked a new era of political commitment in confronting the global diabetes epidemic and offered a new window of opportunity to develop sustainable diabetes care programmes.

The African region has the fastest growth of diabetes, which will double in the next 20 years, the highest rate of undiagnosed diabetes and the highest mortality rate due to diabetes. The main problems are the late diagnosis, the severe complications due to diabetes, the high mortality rate and the poor quality of life of people with diabetes. The diabetic foot is a complication of diabetes that carries a high morbidity and mortality rate in Africa, and is increasing as the burden of diabetes continues to rise. Amputations remain high, despite intensive training of health workers in traditional preventive methods. DAFI aims to address the lack of a common, regionally accepted, sustainable and comprehensive approach for diabetic foot care in the region.

DAFI is a two-phase initiative that will be implemented in ten countries: Cameroon, Ghana, Guinea, Kenya, Madagascar, Republic of Congo, Rwanda, Senegal, Tanzania and Uganda.

The first phase (October 2012-October 2013) will develop and implement a Risk Stratification and Intervention Tool and its associated protocol in ten diabetes centres in the selected countries. Health workers from these institutions will be trained on diabetes foot care through e-diabetes in collaboration with UNFM and a few of them will follow a more specialized training developed by the University of Johannesburg and Université Senghor to be certified as Diabetes Foot Care Assistants. In collaboration with health authorities and local communities, IDF member associations will start information activities for people with diabetes.

In the second phase of the initiative (36 months), the ten participating centres are expected to become accredited reference centres to train peripheral centres about diabetes foot care and roll-out the programme in the selected countries. The impact of the risk stratification and intervention tool will be measured. Community activities led by IDF member associations will be strengthened in collaboration with health authorities.

The objective is to develop a sustainable Diabetes Africa Foot Initiative that will contribute to preventing foot amputation in people with diabetes and improving diabetes care in Sub-Saharan Africa.

Read an interview with the DAFI Programme Chair and Vice Chair.

Diabetes Africa Foot Initiative Technical Committee:

  • Chair: Dr. Silver Bahendeka, IDF Africa Region
  • Vice Chair: Dr.Evariste Bouenizabila, IDF Africa Region
  • Maïmouna  Mbaye: Secretary & Africa Diabetes Foot Care Coordinator
  • Dr.Kaushik Ramaiya, IDF Africa Region
  • Dr. Line Kleinebreil, UNFM e-education
  • Dr Z Abbas, International Working Group on Diabetes Foot, Expert Advisor
  • Prof George Ramahandridona, Expert Advisor
  • Prof. Andrew Boulton, Expert Advisor
  • Ms Fatima Cassim, University of Johannesburg
  • Dr. Christian Mesenge, Université Senghor, Alexandria

Participating Centres

Cameroon Hôpital Central de Yaoundé, Service d'Endocrinologie Diabétologie Centre National d'Obésité
Ghana Lekma Hospital
Guinea Centre Hospitalier et Universitaire de Donka-Conakry, Service d’Endocrinologie Diabétologie
Kenya Kenyatta National Hospital
Madagascar Clinique du Diabète et Centre de Formation A.MA.DIA
Republic of Congo Institut Maison Bleue du Diabète
Rwanda Kigali University Teaching Hospital (CHUK)
Senegal Centre National du Diabète Marc Sankalé
Tanzania Shree Hindu Mandal Hospital
Uganda St. Francis Nsambya Hospital

For more information about the Programme, please contact Dr Maïmouna N. Mbaye, Africa Diabetes Foot Care Coordinator.