Manual Wheelchairs - World Health Organization
Manual Wheelchairs - World Health Organization
Manual Wheelchairs - World Health Organization
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122 I guIdelInes on the provIsIon of manual wheelchaIrs In less resourced settIngs<br />
Donor funding<br />
In many contexts, the initiation of a wheelchair service may depend on funding from national<br />
and international donors. Owing to its usually short-term nature, donor funding should be<br />
complemented by advocacy for government and other more sustainable sources of funding.<br />
Wheelchair funds managed by committee<br />
A local “wheelchair fund” may be established to subsidize the cost of wheelchairs for individual<br />
users. Wheelchair funds exist to source funding and equitably manage donations secured for<br />
wheelchair provision. Users apply to the fund committee for a full or partial subsidy of the cost of a<br />
wheelchair. It is recommended that such funds apply a means test to determine how much financial<br />
assistance should be given. Government funding may also be channelled through a wheelchair fund.<br />
Committees should comprise a cross-section of individuals who have a vested interest in sustainable<br />
wheelchair provision, such as (though not limited to) users, representatives of disabled people’s<br />
organizations, clinicians and technicians, government representatives and local dignitaries.<br />
Contributions from users<br />
Unless full government funding is provided for wheelchair purchase, it is recommended that<br />
any financing system incorporates an element of financial contribution from users themselves.<br />
Contribution programmes should be run in conjunction with individual means tests to ensure that<br />
users contribute no more and no less than they can realistically afford. Users’ contributions also<br />
stimulate demand for products and services of appropriate quality.<br />
A credit scheme is an option that allows users to borrow funds to purchase a wheelchair and<br />
to repay it over a period of time. Another option is an employment scheme, linking wheelchair<br />
provision with the opportunity for the user to obtain a job or funds to start a business and to pay<br />
for the wheelchair over time.<br />
Fees on donated or imported wheelchairs<br />
Even when a wheelchair is donated free of charge, there are costs associated with its responsible<br />
provision to the user, including follow-up with the user and maintenance of the wheelchair.<br />
<strong>Organization</strong>s that import wheelchairs on a large scale without ensuring the necessary services,<br />
as described in Chapter 3, could be required to pay a fee to support the services.<br />
Income generation<br />
Wheelchair services can be subsidized through income from the sale of other products such as<br />
canes, crutches, walkers, and toilet and shower chairs.<br />
Voucher system<br />
A voucher system may enable users to make their own purchasing decisions. The user is assessed<br />
and receives a prescription for a wheelchair with certain features. The user is given a voucher to<br />
the value of the cheapest wheelchair that fits the user’s prescription and that also meets minimum<br />
standards for safety, strength and durability. Users who want a more expensive chair that meets<br />
the prescription have to find the additional funds themselves.