Working together for better diabetes care and reduced amputations
The Sheila Kitzinger Programme at Green Templeton is supporting a project on co-designing a diabetes foot screening pathway in South Africa.
Jemma Houghton (DPhil Primary Care, 2022) reports on progress
Building on a broader DPhil project on strengthening diabetes care in South Africa, a full-day participatory workshop was held on 10 November 2025 at the Groote Schuur Hospital Diabetes Clinic in Cape Town. The workshop brought together people living with diabetes, community advocates, nurses, podiatrists, and other healthcare providers to collaboratively examine and improve current diabetes foot screening practices in support of World Diabetes Day 2025.
The workshop followed a structured, evidence-based agenda that combined lived experience, professional insight, and hands-on clinical demonstration. Activities included storytelling and group reflection, breakout discussions, and a practical demonstration of a focused, three-component foot screening approach – including monofilament testing, pedal pulse assessment, and visual inspection. Participants explored what currently works, what does not, and what patients and providers respectively think, feel, and need when it comes to foot care. These exercises were guided by a dedicated question framework designed to reveal barriers, enablers, and emotional dimensions of foot screening from both perspectives.
Mixed-group co-design sessions allowed participants to jointly identify the biggest gaps in service delivery, envision what ‘better’ diabetes foot screening should look like, and propose both immediate and longer-term changes. Key themes included the need for greater provider training, clearer workflows, improved communication, reduced stigma around exposing feet in clinic settings, and structural support for more equitable routine screening across the health system. Outputs were synthesised in real-time and validated collectively during the final plenary discussion.
The event concluded with shared reflections, commitments to action, and the distribution of certificates recognising each attendee as a co-designer in shaping an evidence-informed foot screening pathway for South Africa. The workshop successfully created a collaborative, trusted space in which diverse stakeholders could contribute meaningfully to practical, context-grounded solutions. These insights now form a central component of the project’s recommendations for improving diabetes-related foot care policy, practice, and patient experience across South Africa.
In parallel with the workshop, we undertook an advocacy and dissemination film initiative in collaboration with participatory research videographer Dr Sarah van Borek. Funded by the Sheila Kitzinger Programme, this initiative produced three separate videos: an advocacy film highlighting patient and healthcare provider testimonies; a short instructional guide to support clinicians in performing the three-component diabetes foot screening; and an educational video to help patients carry out foot care safely at home. All three videos were filmed during the same week as the workshop and released in support of World Diabetes Day on 14 November 2025. The full set of videos is publicly accessible via the Division of Endocrinology, Groote Schuur Hospital’s YouTube channel.
