Situational Analysis of Manual Wheelchair Provision: Nepal

Introduction

Assistive products are used by people with disabilities (PwDs) and elderly people as well as by people who temporarily acquire a disability (e.g. broken leg). Therefore it is likely that each person on the planet will need an assistive product at some point in their lives, and the WHO estimates 2 billion people will require one or more assistive products by 2030. Low Resource Environments (LREs) have higher rates of people living with disabilities, however, they often also have poorer reporting mechanisms of AT need. This can be seen in the discrepancy between, for example, the 2004 World Health Survey found that the prevalence rate of disability in the adult population in low-income countries was 18% [2].

However, according to census data, the estimated population of people with disabilities in Nepal is around 2% (approximately 550,000 people) [3]. In Nepal there are several institutions - NGOs, INGOs, governmental agencies, private clinics and P&O centers actively working to provide AT and rehabilitation. They do excellent work with the constrained resources available, however a majority of the population in need still go without provision. Without improved national and local services to ensure the right products reach the right people at the right time, those desperately in need of AT (including low-cost items like the crutches or walking sticks) are frequently left with inappropriate or inadequate items or simply none at all. This is often due to poor and unsustainable processes (assessment, delivery, follow up, repair and maintenance) and infrastructure (policy and guidelines, skilled personnel, local manufacturing, supply and repair, refurbishment, recycling and accessibility) .

The Enabling Friday Community (EFC) Nepal has proposed a vision for change based on 3 working sessions over the past few months - Enabling Fridays Vision. We now want to propose this work to governing bodies in Nepal. While we want to focus on building sustainable assistive technology innovation and systems, we as a group recognised the obvious need for specific data to inform the work. Collaboratively we have agreed that a situational analysis and action plan for sustainable manual wheelchair provision should be prioritised to develop a working methodology and service system template, noting them as a major priority product for Nepal