DESIGN, IMPLEMENTATION, AND EVALUATION OF IMPLEMENTATION OUTCOMES OF INDIGENOUS KNOWLEDGE HEALERS SCREENING FOR DIABETES FOOT INFECTION IN RURAL SOUTH AFRICA kathryn_chu@yahoo.com

195-01

DESIGN, IMPLEMENTATION, AND EVALUATION OF IMPLEMENTATION OUTCOMES OF INDIGENOUS KNOWLEDGE HEALERS SCREENING FOR DIABETES FOOT INFECTION IN RURAL SOUTH AFRICA

8

 

 

 

 

South Africa

Oral only

South Africa (SA) has the highest diabetes mellitus (DM) prevalence in Africa. Untreated DM may lead to significant morbidity including foot infections, however, half of persons living with DM remain undiagnosed. Community strategies to improve DM detection using Indigenous Knowledge Healers (IKHs) are underexplored. This study aimed to design, implement, and evaluate the implementation outcomes of a DM detection intervention using IKHs in rural SA.

We designed, implemented, and evaluated an intervention for IKHs to screen and refer clients with suspected DM to formal healthcare facilities. The formative research phase included stakeholder discussions and a DM knowledge survey. DM education and training were followed by the intervention of IKHs screening and referring DM clients, and the implementation outcome evaluations.

There was acceptability and strong support for collaboration for IKHs to get involved in DM screening and referral processes. IKH's baseline knowledge of DM aetiology, symptoms, and prevention were low. Evaluation of the implementation outcomes showed appropriateness was rated high, whereas fidelity, adoption, and penetration (reach) were more limited, highlighting barriers such as unclear screening or referral pathways and limited resources.

Our study demonstrated that community-based screening by IKHs and diagnosis of DM is acceptable and feasible, especially in rural areas of SA where clinics are located far from the community. This intervention may address missed opportunities in preventative care, as many community members do not routinely seek DM check-ups at primary health clinics. IKHs may serve as trusted intermediaries to fill this gap and help improve DM management strategies.