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Developing product quality standards for wheelchairs used in less-resourced environments

MHATRE, Anand
MARTIN, Daniel
MCCAMBRIDGE, Matt
REESE, Norman
SULLIVAN, Mark
SCHOENDORFER, Don
WUNDERLICH, Eric
RUSHMAN, Chris
MAHILO, Dave
PEARLMAN, Jon
2017

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Background: Premature failures of wheelchairs in less-resourced environments (LREs) may be because of shortcomings in product regulation and quality standards. The standards published by the International Organization for Standardization (ISO) specify wheelchair tests for durability, safety and performance, but their applicability to products used in the rugged conditions of LREs is unclear. Because of this, wheelchair-related guidelines published by the World Health Organization recommended developing more rigorous durability tests for wheelchairs.


Objectives: This study was performed to identify the additional tests needed for LREs.


Methods: First, a literature review of the development of ISO test standards, wheelchair standards testing studies and wheelchair evaluations in LREs was performed. Second, expert advice from members of the Standards Working Group of the International Society of Wheelchair Professionals (ISWP) was compiled and reviewed.


Results: A total of 35 articles were included in the literature review. Participation from LREs was not observed in the ISO standards development. As per wheelchair testing study evidence, wheelchair models delivered in LREs did not meet the minimum standards requirement. Multiple part failures and repairs were observed with reviewed field evaluation studies. ISWP experts noted that several testing factors responsible for premature failures with wheelchair parts are not included in the standards and accordingly provided advice for additional test development.


Conclusion: The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies.

Occupational therapy synergy between Comprehensive Community Based Rehabilitation Tanzania and Heifer International to reduce poverty

HANSEN, Anne Marie W
CHAKI, Albert P
MLAY, Ruth
2013

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Background: This article describes a partnership between a community-based rehabilitation organisation and a non-governmental organisation (NGO) in Tanzania. The partnership focused on income-generating (IG) activities to tackle the problems of poverty faced by families with a child with a disability (CWD).

 

Objectives: The aim of this case study was to describe the partnership between Comprehensive Community Based Rehabilitation Tanzania in Moshi (CCBRT-Moshi), a non-governmental organisation, and families to create an income-generating business, namely raising goats.

 

Method: This was a team approach between CCBRT-Moshi and Heifer International, an organisation that focuses on IG activities to create a synergy or partnership between community-based rehabilitation and IG activities.

 

Results: This partnership between occupational therapy rehabilitation services at CCBRT-Moshi and the NGO resulted in strengthening the effectiveness of occupational therapy services and leaving a more lasting impact on the people they served within the community by helping to reduce poverty in addition to providing rehabilitation and prevention interventions.

 

Conclusion: This collaboration was successful as it provided a means for families to generate income from raising goats. Although the results have not been empirically verified, observational and anecdotal evidence suggests that families with CWDs have better quality of life and ultimately improved health through this synergistic partnership.

Stakeholder consultations on community-based rehabilitation guidelines in Ghana and Uganda

WICKENDEN, Mary
MULLIGAN, Diane
FEFOAME, Gertrude O
KATENDE, Phoebe
2012

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Background: The focus of this paper is the new broadened conceptualisation of community-based rehabilitation (CBR), which promotes the empowerment and inclusion of people with disabilities (PWDs) in diverse ways within their communities. New guidelines for CBR were launched in October 2010 by WHO/ILO/UNESCO/IDDC, and this paper describes part of the process by which these were produced using participatory approaches involving International Non-Government Organisations (INGOs) and local partners. The paper reviews the evolution of CBR and describes how grassroots consultation by INGOs working with key stakeholders in the disability arena can influence policy on disability issues, and reciprocally how policy change can inform organisations’ practice and research activities. This ongoing bidirectional influence is illustrated with data from the participatory consultation process about the new CBR guidelines carried out by Sightsavers in Uganda and Ghana

 

Objectives: To consult with key stakeholders in the disability arena in Uganda and Ghana, in order to gain their opinions and suggestions for improvements to the then draft CBR guidelines, as part of a wider global participatory process of consultation on the document.

 

Methods: The INGO Sightsavers gathered qualitative data through focus group discussions and questionnaires in both countries.

 

Results: The participants’ critiques of the draft guidelines carried out in multiagency participatory processes were analysed thematically and fed back to the CBR guidelines editorial team.

 

Conclusion: The paper concludes that stakeholders in diverse communities can actively contribute to shaping policy and practice through participatory consultations. Local and national government and non-government organisations and other key informants can inform the development of national and international guidelines and policies. This participatory approach can be successfully facilitated by INGOs. In turn, these processes have prompted organisations to adapt their own policies and programmes in order to be more responsive to the local needs and concerns of PWDs.

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