Understanding the Global Challenges to Accessing Appropriate Wheelchairs: Position Paper.

Rosemary Joan Gowran,Marie Barhouche Abou Saab,Jonathan Pearlman,Mary Goldberg,Paula Rushton,Ritu Ghosh,Nathan Bray,David Constantine

doi:10.3390/ijerph18073338

Abstract

Introduction: Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. Approach: To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. Conclusion: The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us.

Highlights

Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity
We propose five position points to address the global challenges to access appropriate wheelchairs towards sustainable wheelchair provision
It is estimated that 50% of all wheelchairs supplied by the National Health Service (NHS) are refurbished [80]; cost savings of between 9% and 14% are achieved through this approach [81]

Summary

Introduction

Several authorities employ ad hoc, unsustainable systems instead of providing accessible person-centered services, skilled personnel, quality products, training, maintenance, follow up and management To this end, universal wheelchair provision appears piecemeal, with tenuous links among stakeholders, such as wheelchair service users and families, therapists, service providers, manufacturers, regulators and policy makers. The meeting goal was to establish key priorities for the five years to strengthen wheelchair services through policies, trained personnel and a range of appropriate wheelchairs To achieve this goal, ten priority actions were identified to affect change towards sustainable development. (8) stimulating collaboration through multistakeholder platforms, supporting user-driven advocacy and champions; (9) supporting competency development to promote competent wheelchair sector personnel; and (10) supporting good practice through in-country initiatives, capacity building and policy development [8] The authors of this position paper believe that there is a need for sustainable wheelchair provision systems. An integrated approach is needed to develop wheelchair provision systems that are “people-centered comprehensive, context-specific and prevention-oriented responses that strengthen the protection and empowerment of all people” [12]

Approach

Key Positions

Findings

Conclusions