Preventing Foot Amputation in Diabetics in Sub-Saharan Africa

The Diabetes Africa Foot Initiative (DAFI) is a multi-stakeholder partnership led by the International Diabetes Federation (IDF) that aims to develop a comprehensive, affordable and sustainable foot-screening programme in sub-Saharan Africa. The primary objective of the project is to prevent lower extremity amputation in people with diabetes.

Diabetes Africa Foot Initiative (DAFI)

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 (October 2012-October 2013) 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.

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.

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 diabetes foot care was established.


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Key Information

LocationEastern Africa, Uganda, Tanzania, Senegal, Rwanda, Madagascar, Kenya, Guinea, Ghana, Congo, The Democratic Republic of, Cameroon, West Africa
  • Start Date 2012