Afkar Awad Morgan Mohamad* and Elfatih Mohamed Malik
IBackground: Diabetes mellitus is emerging as a public health problem worldwide. Diabetic septic foot (DSF) is one of the many complications of diabetes. Thus, becoming a socioeconomic burden on the community and health system. Due to scarcity of resources and inadequate training, services provided to DSF patients are suboptimal, especially in developing countries.
Objective: This study was designed to assess services provided to DSF patients attending referred family health centers for wound dressing in the Omdurman locality, from April to May 2016. Specific objectives include assessing infrastructure of service, investigating the process in delivering the service to the patients and of course patient satisfaction with the service provided.
Methodology: An observational cross-sectional facility-based study was carried out in all referred family health centers in Omdurman. Check lists and structured questionnaires were formulated by observing the practice of health care providers’ as well as providing a face to face approach when interviewing patients. Statistical analysis was done for the results using SPSS.
Results: The necessary tools, equipment and instruments were found available in all the 19 centers, yet are reports of the lack of monofilament light source, tuning forks and a doppler ultrasound. Guidelines and protocols for foot care were lacking in all centers. While only 2 doctors were trained, not a single nurse from the workforce was found to be formally trained. Most of the centers provide general laboratory investigations but failed to equip the HbA1C test. The study reported that 141 (90.3%) of patients were not assessed for neuropathy or vascularity, about 258 patients 96.3% received referral to other hospitals for further care, and about 192 patients 61.6% were not advised in regards to suitable footwear, in 167 patients 63.1% nurses performed poor debridement of their wounds and about 163 patients 60.8% received poor foot care education by nurses. Almost all the patients (a staggering 99%) were prescribed antibiotics without conducting culture and sensitivity test. Despite this, 97% of patients reported very satisfactory results of the services.
Conclusion: Services provided to diabetic septic foot patients in family health centers are suboptimal. Efforts to improve the situation are highly recommended. This can be obtained by providing the necessary tests, equipment and instruments for work up, by developing and distributing protocols and guidelines to HCPs, by training HCPs and finally by providing education on foot care to all patients at risk.
