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Table 1 Wheelchair Service-Delivery Steps. Reprinted with permission from Guidelines on the provision of manual wheelchairs in less resourced settings a

From: Perspectives of basic wheelchair users on improving their access to wheelchair services in Kenya and Philippines: a qualitative study

Step Summary
1 Referral and appointment The system of referral will depend on existing services in the country. Users may self-refer or be referred through networks made up of governmental or nongovernmental health and rehabilitation workers or volunteers working at community, district or national level. Some services may need to actively identify potential users if they are not already receiving any social or health care services or participating in school work on community activities.
2 Assessment Each user requires an individual assessment, taking into account lifestyle, vocation, home environment and physical condition.
3 Prescription (selection) Using the information gained from the assessment, a wheelchair prescription is developed together with the user, family member, or caregiver. The prescription details the selected wheelchair type, size, special features or modifications. Also detailed is the training the user needs to effectively use and maintain the wheelchair.
4 Funding and ordering A funding source is identified and the wheelchair is ordered from the stock held by the service or from the provider.
5 Product preparation Trained personnel prepare the wheelchair for the initial fitting. Depending on the product or service facilities, this may include assembly and possible modification, of products supplied by manufacturers or production of products in the service workshop.
6 Fitting The user tries the wheelchair. Final adjustments are made to ensure the wheelchair is correctly assembled and set up. If modifications or postural support components are required, additional fittings may be necessary.
7 User training The user and caregivers are instructed on how to safely and effectively use and maintain the wheelchair.
8 Follow-up, maintenance and repairs Follow-up appointments are an opportunity to check wheelchair fit and provide further training and support. The timing depends on the needs of the user and the other services that are available to them. The service may also offer maintenance and repairs for technical problems that cannot be easily solved in the community. It is appropriate to carry out follow-up activities at the community level as much as possible. If the wheelchair is found to be no longer appropriate, a new wheelchair needs to be supplied starting again from step 1.
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