Abstract
Background: There are 2.8 million diabetic patients in South Africa (SA), most of whom are seen at primary healthcare (PHC) facilities. Although diabetic patients are known as being at risk of diabetic foot complications, foot health services remain omitted as part of the primary healthcare package of care. Arguably, lack of data on the prevalence of foot pathologies and related risk factors in diabetic patients presenting at primary healthcare clinics (PHCCs) may be to blame. The main purpose of the study was to investigate the need for podiatrists as members of the primary healthcare team.
Method: Two primary healthcare clinics (PHCCs) were selected to participate in the study using homogeneous sampling. Data on the chief & secondary complaint of each consenting patient presenting at the selected clinics were collected. Data was also collected on presenting foot pathologies in all consenting patients as part of their routine consultation.
Results: Data was collected from 1077 patients. The results showed that as much as 54% patients presenting at the two facilities had a systemic condition. Diabetes was recorded as a chronic condition in 29% of the patients and notably, 74% of these patients had symptoms related to diabetic peripheral neuropathy and 28% had a foot ulcer.
Conclusion: There is a need for diabetic foot health services for diabetic patients presenting at PHCCs. In the absence of structured foot health services, it is unclear how diabetic patients presenting at these facilities with foot pathologies and related risk factors are being managed.  Thus, the findings of this study, are indicative of both the need and demand for foot health services are needed at primary healthcare clinics.

Evidence of the need for diabetic foot health services at primary health care clinics around Johannesburg, Gauteng, SA