A World Diabetes Foundation (WDF) project is bringing diabetes footcare to 171 rural health centres across 20 districts of Pakistan, in a region home to about 58 million people.
The project, run by the Association for Social Development (ASD) with Pakistan’s provincial health services, is the second phase of a rural diabetes care model. It extends diabetes services from 84 rural health centres in 10 districts to 87 more centres in 10 additional districts, and adds a footcare component across all 171 centres, along with referral capacity for foot complications. The project runs from 2024 to 2026 and is in its completion phase, with a WDF budget of USD 549,988.
Targets
- 171 rural health centres and 20 district hospitals strengthened
- At least 500 doctors, 40 footcare specialists and 350 other health workers trained
- 200 cobblers trained to make suitable footwear
- 40,000 people diagnosed and treated for diabetes
- 50,000 people with diabetes screened, cared for or referred for foot problems
- A digital app for peer support and teleconsultation
These are the project’s stated targets; final results have not yet been published.
Cobblers as part of the care team
One of the project’s most distinctive features is its plan to train 200 local cobblers. In rural Pakistan, specialist therapeutic footwear is rarely available or affordable. Teaching local shoemakers to make protective shoes that reduce pressure and friction brings an essential part of ulcer prevention within reach of patients who could not otherwise access it.
The scale of the need
Pakistan faces one of the world’s heaviest diabetes burdens. Experts at a Karachi conference this year cited nearly 300,000 diabetes-related amputations a year, as reported by Dawn, which also covered the launch of a 24-hour diabetic foot helpline.
IMEA POD Perspective
This project shows how foot health can be built into primary care where specialists are scarce. Training doctors, health workers and cobblers together creates a practical chain from screening to footwear to referral. For pedorthists and footwear specialists, the cobbler model is worth close attention: it adapts pedorthic principles to local materials and skills. If the published results confirm the targets, the approach could be replicated in other countries across South Asia and Africa with large rural populations and few podiatrists.
Sources and further reading
- World Diabetes Foundation: Integrated diabetes footcare at rural health centres in twenty districts, Pakistan
- World Diabetes Foundation: National diabetes and foot programme, Pakistan
- Dawn: Diabetic foot helpline launched