Manual Wheelchairs - World Health Organization

3.1 Introduction
Purpose and outputs
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The purpose of the service delivery guidelines is to improve the way in which users receive
wheelchairs and to ensure that the wheelchairs are appropriate.
Implementation of the recommendations in this chapter will contribute to:
• a greater number of wheelchair services;
• better knowledge of wheelchair service delivery among health care and social service workers;
• better service quality delivered by existing wheelchair services;
• a greater number of appropriate wheelchairs provided to users;
• a greater number of users able to make informed decisions about the most appropriate wheelchair
for them;
• a greater number of users and caregivers receiving training in the use and maintenance of
wheelchairs, and on how to stay healthy in a wheelchair;
• links between users and producers, leading to producers obtaining feedback on the wheelchairs
they produce; and
• coordinated efforts in the planning, implementation and support of wheelchair service delivery
among stakeholders.
What is a wheelchair service?
In the rehabilitation of a person with a walking limitation, the provision of an appropriate wheelchair
is critical. It is important that the wheelchair fits correctly and meets the user’s physical, functional
and environmental needs as much as possible (1). This requires an approach that responds to
individual needs. An effective way of meeting the individual needs of users is to promote the
provision of wheelchairs through wheelchair services.
Wheelchair services provide the framework for assessing individual user needs, assist in selecting
an appropriate wheelchair, train users and caregivers, and provide ongoing support and referral
to other services where appropriate.
• Assessment. This is a process of mutual consultation between a person with disability and service
personnel, the aim being to assist the user to select the right product. The outcome is often a
prescription detailing the features of the wheelchair most suitable for the person in question.
• Provision. Following assessment, wheelchair services provide an appropriate wheelchair. This
includes ordering, assembly if needed, and fitting of equipment.
• Training. In order for users to gain maximum benefit from their wheelchair, the services
provide them and their caregivers training in how to maintain the wheelchair and how to use it
effectively.
• Support. For all users, the services offer continuing clinical and technical support. This includes
providing basic health care advice, especially on how to avoid pressure sores or any further
deformities or complications, and follow-up and repair services.
• Referral. Where appropriate, the services will refer users to other services that may be of benefit
to them, such as physiotherapy, peer group training and vocational training.
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