Diabetes Africa Foot Initiative (DAFI)

Partnership objectives

  1. Develop a sustainable initiative that will contribute to preventing foot amputation in people with diabetes and improving diabetes care in Sub-Saharan Africa.
  2. Develop a comprehensive risk stratification model combined with an early intervention strategy.

The objective is to prevent foot amputation in people with diabetes and improve diabetes care in Sub-Saharan Africa. The objective is to prevent foot amputation in people with diabetes and improve diabetes care in Sub-Saharan Africa. Copyright Sanofi

What are the health needs and challenges?

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. Diabetes care in Africa has only recently assumed a quality priority. 


Description of partnership activities and how they address needs and challenges

The Diabetes Africa Foot Initiative (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 (2012-2014) aimed to 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 were trained on diabetes foot care through e-diabetes in collaboration with UNFM and a few of them followed a more specialized training developed by the University of Johannesburg and University Senghor to be certified as Diabetes Foot Care Assistants. In collaboration with health authorities and local communities, IDF member associations started information activities for people with diabetes.

During the first phase:

  • 10 centers were selected and 30 health workers (each center identified one doctor and two nurses) were trained and certified.
  • Risk stratification and intervention tools and related protocol were developed and are ongoing ethical committees’ clearance.
  • A distance learning program about foot care was established.

In the second phase of the initiative (2015-2017), the ten participating centres are expected to become accredited reference centres to train peripheral centres about diabetes foot care and roll-out the program 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.

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Diabetes Africa Foot Initiative

Partnership information

Company(ies) Sanofi

Partner(s) International Diabetes Federation (IDF), Université Senghor, University of Johannesburg, World Francophone Digital University (UNFM-WFDU)

Type of Partner(s) Academia / Hospitals, NGOs

Therapeutic Focus Non-Communicable Diseases

Disease(s) Diabetes

Program Type(s) Health System Infrastructure - Development of Physical Infrastructure, Health System Infrastructure - mHealth, Health System Infrastructure - Training, Prevention Programs - Awareness & Outreach

Targeted Population(s) Health professionals, Men, Patients in needs of treatment, People with low income, Women

Region(s) Sub-Saharan Africa

Number of Countries 10

Country(ies) Cameroon, Congo, Ghana, Guinea, Kenya, Madagascar, Rwanda, Senegal, Tanzania, Uganda

Start Date 2012

More information DAFI, International Diabetes Federation DAFI objectives

Completed date 2015

« DAFI recognizes the cultural and socio-economic diversity of the Africa Region and is designed to accommodate other existing foot care projects within the region, without duplication. »