An exploration of adherence to the World Health Organization’s Prosthetic Standards in Namibia

Abstract

Background: The World Health Organization (WHO) published ‘Standards for Prosthetics and Orthotics’ to improve these services globally. Research that compares services to the standards assists in developing a baseline against which future development can be measured and identifies areas needing improvement.

Objectives: This article aims to describe prosthetic services in Namibia and compare them to the 60 WHO standards.

Method: A mixed-methods exploratory design was employed. Qualitative data were collected through semi-structured interviews with purposively selected participants, including managers (n = 2), service providers (n = 9) and users (n = 16). The data were analysed using content analysis. In the quantitative phase, cross-sectional surveys were administered to managers (n = 2), service providers (n = 10) and users (n = 120). The data were analysed descriptively. Qualitative and quantitative data were triangulated to determine Namibia’s adherence to the standards.

Results: The triangulated data showed adherence to 14 standards, partial adherence to 24 and non-adherence to 22 standards. As per the standards’ requirements, the government directed the provision of prosthetic services, and a range of prosthetic products was provided free of charge at all levels of care. Funding challenges, no national prosthetics committee, and no databases as well as lacklustre support of providers’ careers and professional development, indicated areas of non-adherence.

Conclusion: A systems-based approach, utilising a people-centred conceptual framework, can aid Namibia and similar countries in implementing the standards.

Contribution: This study is the first to provide information on implementing WHO prosthetic standards in an African setting.