Prosthetics services in Uganda : a series of studies to inform the design of a low cost, but fit-for-purpose, body-powered prosthesis (original) (raw)
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Access to prosthetic devices in developing countries: Pathways and challenges
2015 IEEE Global Humanitarian Technology Conference (GHTC), 2015
As the number of amputees continues to grow in low-resource settings, their demand for prosthetic devices continues to be unmet. Consequently, these amputees face exhausting physical, emotional, and economic challenges like navigating unfriendly terrain, emotional trauma, loss of income, and social rejection, all on a daily basis. While there have been attempts to meet this demand, the challenges in doing so are difficult and complex. Many organizations, including governments, nongovernmental organizations (NGOs), and private entities, are trying to deliver low-cost and durable prostheses to amputees. However, all of these organizations face a wide array of challenges related to infrastructure, technology and business in achieving this goal. With numerous distribution approaches used amongst these organizations in low-resource settings, little has been done to provide a comprehensive study of major distribution pathways and their respective challenges. This article presents the current pathways and challenges in delivering prostheses to amputees through a rigorous analysis of current organizations' approaches and the existing infrastructure in lowresource settings. The end goal of this article is to enable the reader to thoroughly understand the available options and obstacles to deliver prostheses in low-resource settings.
Global Report on Assistive Technology (GReAT) Consultation, 2019
This paper presents the story behind developing the Cambodia-UK prosthetics and orthotics (P&O) project 'LMIC Limbs'. We describe the methods employed in identifying and iterating the project scope, the principles underpinning our collaboration, and our reflections on the process. In the context of growing digital technology possibilities for P&O services (CAD/CAM, 3D scanning, and 3D printing or additive manufacturing), this set of principles addresses issues of: - ensuring the project is defined by a technology pull, instead of a technology push, - objectively mapping project stakeholders and the value proposition, and - consulting these stakeholders on the potential benefits and disadvantages of these technologies, and the barriers and facilitators associated with their implementation. These issues are addressed simultaneously through approaching the project development by co-design of research with equal status partnerships across nationalities and multidisciplinary team professions. As such, the project deliverables are designed according to the definition of Appropriate Technology in the context of UN Sustainable Development Goal 3: Good Health & Wellbeing.
3D Printing in LMICs: Functional Design for Upper Limb Prosthetics in Uganda
Prosthesis
Meeting the needs of persons with upper limb loss in Uganda requires an understanding of the needs and desires of the local population. The limitations of resources and accessibility for the individual gave rise to a focused design methodology for delivering a culturally acceptable solution using 3D Printing technology. A series of co-design activities were held in Uganda and provided direct feedback to drive the design of two prototypes based on acceptable aesthetics and priority Activities of Daily Living. Two terminal device prototypes were 3D printed in the UK. These can be directly attached to a standard proximal socket thread. The passive hand was printed in a flexible filament and the prehensor was printed in a durable impact resistant material. Local researchers in Uganda have similar 3D printers, filaments, and assembly hardware, which allowed for concurrent development and refinement of the prototypes. Local participation provides a rich user feedback environment to unders...
The status and use of prosthetic devices by persons with lower limb amputation in Rwanda
African Journal of Disability
Background: Amputation is one of the leading causes of disabilities because of reduced mobility. Without assistive devices specifically prostheses, the quality of life of persons with lower limb amputation (PLLA) further deteriorates. Therefore, prostheses are fundamental to improving their quality of life.Objectives: This study aimed to establish the number of PLLA with or without prosthesis and to determine their socio-economic profile in Rwanda.Method: A descriptive, cross-sectional study was conducted in all sectors of Rwanda. As a result of coronavirus disease 2019 movement restrictions, data collection was carried out through telephone calls with participants to complete the questionnaires. Descriptive, inferential statistics and chi-square test were performed to analyse data using Statistical Package for Social Science (SPSS) 21.0.Results: Of the 3026 participants identified countrywide, 68.8% were males and 60.3% of them did not have any prosthesis (p = 0.003). The majority ...
Prosthetics & Orthotics International, 2019
Background: Ambulation with a prosthesis is the ultimate goal of rehabilitation for a person with a major lower limb amputation. Due to challenges with prosthetic service delivery in rural settings, many patients with amputations are not benefitting from prosthetic interventions. Inaccessibility to prosthetic services results in worse functional outcomes and quality of life. Learning from the experiences of current prosthetic users in this setting can assist to improve prosthetic service delivery. Objectives: To explore the experiences of lower limb prosthetic users and to understand the importance of a lower limb prosthesis to a prosthetic user in a rural area of South Africa. Study design: A generic qualitative approach and an explorative design were utilised in this study. Methods: A semi-structured interview guide was used to collect data from nine prosthetic users in a rural area in the Mpumalanga province of South Africa. Interviews were audio-recorded, transcribed verbatim an...
Prosthetics and Orthotics International
Background: Challenges exist with the provision of appropriate mobility assistive devices in rural areas. The use of the direct manufacturing prosthetic socket system is a possible solution to these challenges. Objectives: The objective of this study was to test and explore the clients’ perspectives with the application of this device. Study design: Within a mixed-methods approach, a longitudinal sequential explanatory design was applied. Methods: The Orthotic and Prosthetic User’s Survey was administered to explore the use of the direct manufacturing prosthetic socket system in terms of function, health-related quality of life and client satisfaction. A conveniently selected sample of 21 individuals who suffered a unilateral trans-tibial amputation was included. Data were collected at 1, 3 and 6 months post fitting, and two focus group discussions were also administered. Results: Of the 21 participants recruited, 11 returned for follow up. Although participants reported favourably ...