Equitable access for diabetic foot care

Diabetic foot care saves lives and limbs. Ensuring services are equitable supports all people to access the education, resources and treatment they need. This project will form a strong foundation to improving equitable access across the Solomon Islands.

Illustration of a woman checking her foot with the Solomon Islands flag in the background.

Setting the scene

At the National Referral Hospital (NRH), Solomon Islands, at least 60% of inpatients on the general surgery ward have severe diabetic foot wounds.1. People with diabetic foot wounds often present to hospital so late that amputation is needed to save their life. While life-saving, amputation can increase the risk of further complications, challenges and costs. If people with diabetic foot wounds were identified early, amputation could be prevented.

More women than men experience disability in the Solomon Islands. Yet, women in the Solomon Islands struggle to access appropriate health care because of workloads at home, lack of transport and cultural requirements for family permission2. Better understanding of specific barriers (what makes it harder) and facilitators (what makes it easier) experienced by women and men needing to access diabetic foot care services is an important step towards designing equitable services.

The outside of the National Referral Hospital.

Taking action

To increase understanding of how services can improve equitable access for all people, local project officers and our partners in the Solomon Islands will:

  • Talk with people who use diabetes services to identify barriers and facilitators to access diabetic foot care services
  • Run workshops with health personnel to discuss and plan ways to reduce barriers and increase facilitators, based on what service users say
  • Support the development of key recommendations to the Ministry of Health and Medical Services for the design of services to be more equitable and improve access for all people.
Two women walk along a grassy path, one is pushing a partially folded transfer wheelchair.

How and who

This project has received ethics approval from the Solomon Islands Health Research and Ethics Review Board (SIHRERB). Partners at the National Referral Hospital have expressed enthusiasm and are excited to learn more from people in different regions of the Solomon Islands.

This project will be driven by local project officers Goretti Kodovaru and Sira Tauriki from the Solomon Islands National University (SINU) with support from nurses at the National Referral Hospital, Roselyn Mataki and Jordanna Laejama. The barriers and facilitators are unique in each context throughout the Solomon Islands, with 85% of the population living in rural areas.

Our team of interviewers made initial plans to travel to different areas of the Solomon Islands by car, boat and plane to talk with people about the barriers and facilitators in their own context. The planned locations for interviews and focus groups included:

  • Malaita – Kilu’ufi Hospital
  • Ngella – Tulagi Hospital
  • Good Samaritan Hospital
  • National Referral Hospital
  • Kukum Clinic
  • Visale Clinic.

However, lockdowns and travel restrictions due to civil unrest and a recent outbreak of COVID-19 have changed our plans. The team in the Solomon Islands have displayed outstanding resilience and creativity to adapt to the challenges of the turbulent environment and continue the project.

A service user sits at a desk across from two women service providers dressed in uniforms. He has a axilla crutch in his lap. The two women are writing notes on paper and on a tablet as he talks.

What is next?

The interview team are now working to reach out to people across the Solomon Islands and conduct interviews over the phone. Interview participants will receive diabetic foot care bags which include information about how to access services, how to care for your feet and basic foot care materials, such as soap.

The team at Motivation Australia are inspired by our partners’ commitment to the project and their ongoing resilience, creativity and hard work to overcome challenges. We are proud to be able to support our partners and look forward to learning more from people throughout the Solomon Islands about how diabetic foot care service design can be more equitable and improve access for all people.

Two white bags with a graphic print. The graphic shows a man or women checking their feet, the phrase "Checkem legi blo iu evride'the number of the diabetes clinic, and logos for the Ministry of Health, CFLI and Motivation Australia.

Want to help?

Stand with our partners overseas to build strong, sustainable and equitable health services ensuring that the work we do benefits communities for generations. You can contribute in so many ways, to the level that you feel comfortable.

Acknowledgements

This project is funded by The High Commission of Canada, Australia through the Canada Fund for Local Initiatives Programme in Australia.

Canada Fund logo

References

  1. Sources: In-person consultation with National Referral Hospital, October 2019; diabetic foot care training of trainers, Solomon Islands, August to November 2020
  2. Asian Development Bank. (2015). Solomon Islands Country Gender Assessment.
  3. Hall G, 2020, Gender, disability and inclusion analysis for COVID-19 and tropical cyclone Harold, Live & Learn Solomon Islands and CARE.

Report concerns

You can report a concern, raise an issue or get in touch with us by contacting: report@motivation.org.au.