EXECUTIVE SUMMARY

Publication Details

These guidelines seek to promote personal mobility and enhance the quality of life of wheelchair users by assisting Member States in developing a system of wheelchair provision to support the implementation of the Convention on the Rights of Persons with Disabilities (and specifically Articles 4, 20 and 26) and World Health Assembly resolution 58/23 of 25 May 2005.

The guidelines focus on manual wheelchairs and the needs of long-term wheelchair users. The recommendations are targeted at those involved in wheelchair services, ranging from design and planning, to providing or supplying wheelchairs and their maintenance.

The guidelines are divided into five chapters:

1. Introduction

The introductory chapter describes the need for and benefits of wheelchairs, types of wheelchairs, and systems for their provision. It also defines the requirements of adequate wheelchairs and introduces the reader to the stakeholders and their roles.

A wheelchair must meet the user's individual needs and environmental conditions, provide postural support, and be safe and durable. The wheelchair must be available and affordable and be maintainable and sustainable in the country of use. This is not always easy, because wheelchair users are a diverse group with different requirements and environmental and socioeconomic conditions.

The chapter argues that a wheelchair is more than an assistive device for many people with disabilities; it is the means by which they can exercise their human rights and achieve inclusion and equal participation. A wheelchair provides mobility, ensures better health and quality of life, and assists people with disabilities to live full and active lives in their communities.

2. Design and production

Chapter 2 sets out guidelines on the design and selection of wheelchairs and how to produce and supply them. The focus here is to increase the quality and range of manual wheelchairs available in less-resourced settings. Health and safety, strength and durability, suitability for use, and effective production methods are the main design criteria. The design of a wheelchair determines its functional performance in matters of stability, manoeuvrability, pushing and transferring efficiency, transport and reliability.

The guidelines address the design process, including the need for product testing, field trials and long-term follow-up. The need to involve wheelchair users in the design process is highlighted, as they are the most knowledgeable about their physical, environmental, social and cultural needs. Minimum guidelines and corresponding evaluation methods are given in the areas of functional performance, seating and postural support elements, and strength and durability.

Governments are encouraged to develop and adopt national wheelchair standards to ensure a reasonable level of quality, for instance by using the ISO 7176 series of wheelchair standards as a basis.

3. Service delivery

In this chapter, structural guidelines for systems that provide wheelchairs and that improve access to wheelchairs are described. The need to provide wheelchairs together with other related services is shown to be essential. Careful planning and management of services and well-thought-out strategies for wheelchair provision, user instruction and care are needed to facilitate the important link between the user and the wheelchair.

Guidelines in this chapter look at good practice at all stages of the service delivery process, from referral to assessment and prescription, funding, ordering, product preparation, fitting, user training and maintenance. The chapter includes a discussion of the roles of those involved in wheelchair service delivery, from manufacturers and clinicians to technical and training personnel. Recommendations are made on monitoring, how to obtain feedback from wheelchair users, and evaluating and analysing information on wheelchair service delivery.

4. Training

Chapter 4 looks at training requirements for those involved in the delivery of wheelchair services, with the aim of improving the level of skill of local people providing these services. Strategies are provided for identifying trainers, linking to existing training programmes, developing modular training packages, and capacity building at the local level. The guidelines set out the training requirements for those involved in referral networks, managers of wheelchair services, and clinical and technical personnel at basic and intermediate levels.

5. Policy and planning

Chapter 5 looks at the role of policy and policy-makers in wheelchair provision, with a special focus on cost-effectiveness and sustainability. Suggestions are made about financing options and ways of linking wheelchair services to other sectors. A national policy on wheelchair provision is recommended, with mechanisms for monitoring and evaluation, to ensure that users receive wheelchairs that meet minimum requirements for safety, strength and durability and are appropriate for their individual needs. Such a policy would look at need assessment, planning at the national level, collaboration among service providers, the integration of wheelchair services with existing rehabilitation services, and the adoption of national standards, with the aim of empowering users and their families and facilitating user participation in community life.

Terminology

For the purpose of these guidelines, the following terms are used in this document as defined below.

wheelchair

a device providing wheeled mobility and seating support for a person with difficulty in walking or moving around

less-resourced setting

a geographical area with limited financial, human and infrastructural resources to provide wheelchairs (a common situation in low- and middle-income countries, but also in certain areas of high-income countries)

manual wheelchair

a wheelchair that is propelled by the user or pushed by another person

appropriate wheelchair

a wheelchair that meets the user's needs and environmental conditions; provides proper fit and postural support; is safe and durable; is available in the country; and can be obtained and maintained and services sustained in the country at the most economical and affordable price

wheelchair user

a person who has difficulty in walking or moving around and uses a wheelchair for mobility

personal mobility

the ability to move in the manner and at the time of one's own choice

wheelchair provision

an overall term for wheelchair design, production, supply and service delivery

wheelchair service

that part of wheelchair provision concerned with providing users with appropriate wheelchairs

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