Feasibility Study on Production and Provision of Wheelchairs and Tricycles in Uganda

The study was commissioned by Whirlwind Wheelchair International Project in order to map the present situation pertaining to appliance technology, production and distribution in Uganda in general, and wheelchair technology, production and distribution in Uganda in particular. The principal objectives of the study were to survey the needs for mobility devices; their present availability, quality and suitability and finally the present status of local production.
The team found that there is a lack of awareness, information and skills at many levels of the society in the field of disability and hence a need for training and capacity building of relevant stakeholders.

DPOs have a strong position in the civil society in Uganda and have been influential in legislation and policy processes in the country. In the field of legislation and policy development with relevance to persons with disabilities, Uganda can report substantial achievements. Although there is a long way to go before one can say that these achievements have had significant practical impact on the living conditions of persons with disabilities, they constitute a climate conducive for changes and improvements. The team however concludes that there is a major gap between the need for mobility devises and the access to such devises in general and for children with disabilities in particular.

Executive Summary

This study was commissioned by WWIP in order to map the present situation pertaining to appliance technology, production and distribution in Uganda in general, and wheelchair technology, production and distribution in Uganda in particular. The principal objectives of the study were to survey the needs for mobility devices; their present availability, quality and suitability and finally the present status of local production. To achieve these objectives; the team studied information made available through meetings with relevant stakeholder in Uganda at all levels. The team studied available literature and documents. The team visited different production units in and around Kampala and in Tororo and Mbale towns. Finally the team attended a workshop organised by the Ministry of Health and NUDIPU, where the team had an opportunity to extract information and to discuss various aspects and challenges that the stakeholders face in their respective positions pertaining to production and distribution of appliances.

The team spent time at central level, visiting both wheelchair producers as well as providers. The team also went to Tororo District in order to observe the rural settings and the daily situation under which the majority of the people live; and the special challenges wheelchair users experience in a rural environment and the implications of living in the periphery.

Findings and recommendations

General
The team found that there is a lack of awareness, information and skills at many levels of the society in the field of disability and hence a need for training and capacity building of relevant stakeholders. DPOs (Disabled Persons Organisations) have a strong position in the civil society in Uganda and have been influential in legislation and policy processes in the country. In the field of legislation and policy development with relevance to persons with disabilities, Uganda can report substantial achievements. Although there a long way to go before one can say that these achievements have had significant practical impact on the living conditions of persons with disabilities, they constitute a climate conducive for changes and improvements.

In the search for data regarding “types of disabilities” and “needs for mobility devices” in Uganda; the team comprehend that there is a need for more complete statistics. The team however concludes that there is a major gap between the need for mobility devises and the access to such devises in general and for children with disabilities in particular. Present types of mobility devices

In Tororo District the team had the opportunity to visit a number of wheelchair users in their home environment. The team came across basically three types of mobility devices; Huckstep wheel chairs, tricycles and imported hospital wheelchairs donated by charity organisations. The users reported that these had their advantages and disadvantages; the Huckstep is durable, it is good for domestic use and accessibility and gives more access to buildings in town. The tricycle is better for intermediate distance travelling and transport of goods and is preferred by traders and business people. None of these two mobility devices are suitable for long distance travelling where one is dependent on private or public transport. Neither the Huckstep nor the 3 tricycles are foldable and therefore basically denied access to public transport. The imported hospital chair is foldable, an advantage for transporting, but has its disadvantages in lack of durability and inappropriate technology. The chair easily breaks down in a rural environment and spare parts are not available.

Design
Most producers are concentrating on either the Huckstep model or the Tricycle because they are easily marketable due to the high demand. The design of Ugandan mobility devices needs to be upgraded in order to better meet the needs of various users groups and in order to meet the environmental demands. There is also a need to address the needs of children in particular, because most of the devices available to them are of adult sizes. Availability of maintenance services and spare parts in rural areas is limited; basically because of present technology choice. The technology should build on bicycle technology enabling the users to draw on the bicycle services available in their locality.

Standardisation
To ensure proper quality and to avoid inferior domestic as well as imported wheelchairs flowing the market, standards and guidelines for import and production should be developed.

Cost – availability
The mobility devices are expensive and not easy for ordinary people to access. Lack of available funding for mobility devices is a major challenge and funding schemes as well as systems for provision should be established to ensure equity throughout the country.

Service delivery – distribution
The system for assessment, prescription and referral should be strengthened. This should include a clear definition of roles and responsibilities of various stakeholders

Production, assembly and maintenance of mobility devices
A system for production, assembly, distribution and maintenance of mobility devices needs to be developed. It needs to build on a decentralised system favouring supply and maintenance of mobility devices as near the consumer as practical possible. In order to secure highest possible quality in terms of durability and appearance and at the same time keep the cost low; the manufacturing could be divided between numbers of manufacturers, benefiting from respective comparative advantages.

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