Feasibility of Implementing a Sustainable Wheelchair Seating and Mobility Clinic in Uganda, Africa

Purpose: The purpose is to assess the feasibility of a sustainable wheelchair (WC) and mobility seating clinic for children and adults with disabilities in the low resourced country of Uganda. Findings from four feasibility components will be shared to support replication in other low resource countries.

Description: Feasibility testing is optimized when project acceptability, demand, implementation, practicality, adaptation, integration, and expansion are considered. This project, entitled the Ugandan Wheelchair Project, has focused on acceptability, demand, initial implementation, and practicality. Acceptability: Individuals served by Ugandan Disabled Persons Union desired access to WC seating and mobility clinic and were accepting of Medical University of South Carolina (MUSC) Physical Therapy Program’s plan for implementing a clinic. Demand: Based on 2009 data, 750,000 Ugandans have mobility impairments. Other estimates suggest that Uganda needs 4,464 WCs per district in each of its 127 districts. The lack of access to a WC has a negative impact on physical health, functional independence, and quality of life. Implementation: In 2019, 6 WCs were delivered in a 2-day clinic at the Masindi Kitara Medical Center (MKMC). We then raised funds and shipped 60 WCs for a 5-day clinic. Individuals were scheduled by the Masindi district’s Disabled People’s Union of Uganda. Outcomes included: assembling, measuring, and delivering 40 WCs to 13 children and 27 adults with disabilities, training two Ugandans in assembly, and collecting data using the World Health Organization WC service materials, PEDI, and WC Skills Test. Practicality: The Disabled Persons Union was instrumental in identifying children and adults in need of WCs. Students were used in clinic and in training Ugandans in WC assembly. MKMC was a collaborative partner. Moving forward, we will need to promote adaptability, integrate the clinic into MKMC, and expand into other regions. Successful completion of these last components will better ensure sustainability of the project.

Summary of Use: Improvements were noted across all areas of data collection. Strong positive feedback from WC participants, WC assembly trainees, MKMC leadership, Disabled Person’s Union, and students. Future steps include creating a budget for sustaining WC costs and services, training assemblers in maintenance, and training/mentoring a PT to conduct and manage the seating and mobility clinic.

Importance to Members: Expansion of WC mobility for individuals with disabilities is imperative to optimize participation in life. This is especially true for children in low resourced countries who need mobility to optimize development in order to participate in life. Findings from this project provide a blueprint to encourage international replication of WC clinics for children and adults with disabilities.