In Vietnam, the prevalence of type 2 diabetes has increased rapidly in both urban and rural areas. The diabetes prevalence in Vietnam is estimated to be 3.2% (IDF, 2011) and diabetes is recognised as a public health problem by the government of Vietnam since 2001. A national strategy for prevention and control of non-communicable diseases was issued in 2002, however the infrastructure for managing diabetes in Vietnam is less than adequate, resulting in incorrect or no treatment at all.Between February 2004 and December 2010, the Ministry of Health (MoH) in Vietnam and the regional office of the World Health Organization for the Western Pacific (WHO/WPRO) successfully implemented a National Diabetes Program (WDF02-013), a project funded by the WDF that improved the quality of diabetes care in Vietnam through a community-based approach for prevention, control, and management of diabetes.Diabetic foot disease is on the rise in Vietnam, and is a major source of morbidity among people with type 2 diabetes. Approximately 50% of all amputations are attributable to diabetes, and up to 85% of those amputations are preventable through proper foot care.This project will utilize the network of clinics and previously trained staff to create and educate foot care teams and establish foot care services in the clinics. This project aims to improve diabetic foot care in 8 provinces in Vietnam by establishing a network of foot care teams, training healthcare professionals (HCPs) on the prevention and treatment of diabetic foot, and providing basic foot care and knowledge to people with diabetes.
This project will be implemented by the National Institute of Diabetes and Metabolic Disorders (NIDIMED) in Vietnam in collaboration with the Clinical and Training Center for Endocrinology and Diabetes, Au Lac International Hospital, and Ha Long International Hospital.A systematic approach to diabetes foot care will be established in 8 Vietnamese provinces through 3 phases of activities:1) Establish a diabetic foot care network2) Training of healthcare professionals3) Screening and education of people with diabetesThis project will establish a diabetes foot care team and a fully-equipped central diabetic foot unit at the National Institute of Diabetic and Metabolic Disorder. NIDIMED will be a centre of excellence and the headquarters for foot care in Vietnam. The faculty will consist of 6-8 experts that will serve as a task force for diabetes related foot care in Vietnam. Educational material will be developed by the faculty for training HCPs and for people with diabetes.Eight provincial diabetes foot care and training units will be set up. The project will provide technical support and train the health units using the diabetes foot care training programme.Thirty diabetic foot care teams, each consisting of 1 doctor and 2-3 nurses or paramedics, will undergo a 3-day basic training course. The foot care teams will learn basic foot care, practical management, and be trained in foot care with basic equipment. After the basic training course, teams will be required to establish foot care clinics in their respective health facilities by introducing regular foot screening among people with diabetes.After 1 year, the foot care teams will attend a 1-week advanced training course. The advanced training course will utilize the Training of Trainers (ToT) model for the dissemination of knowledge to local districts.Both the basic and advanced training course participants will receive a certificate after passing a mandatory exam. Refresher courses will be held 1 year after the advanced course, and repeated every 3 years to update HCPs on new diabetes-related insights. A total of 250 HCPs will be trained within 3 years.The teams trained will carry out diabetes prevention and treatment, and provide foot care. Hospitals in the NIDIMED network will hold free foot screening campaigns for people with diabetes, which will be advertised through local newspapers and television. Within 3 years, an estimated 21,000 people will be screened for diabetes-related foot complications.People with diabetes will be provided with basic knowledge on foot care and wound prevention through videos, , posters, and publications in the diabetes clubs. In addition, the local foot care units will hold monthly foot care education sessions.The results of the interventions will be evaluated using a KAP study to evaluate behavioural change and compare the situation in Vietnam before and after this project.A National Conference on foot care will be held annually to share expertise and conduct clinical studies between the established diabetes foot care units and international experts.
- Central diabetic foot care and training center established- Establishment of a network of diabetes foot care teams - 540 health workers trained on diabetes foot care- Development of training materials: DVD, video, software.- 24,461 people with diabetes screened for diabetic foot - 24 Foot care education sessions held