Original Research - Special Collection: Wheelchair-related topics for less-resourced environments

Wheelchair services and use outcomes: A cross-sectional survey in Kenya and the Philippines

Eva S. Bazant, Elizabeth J. Himelfarb Hurwitz, Brenda N. Onguti, Emma K. Williams, Jamie H. Noon, Cheryl A. Xavier, Ferdiliza D.S. Garcia, Anthony Gichangi, Mohammed Gabbow, Peter Musakhi, R. Lee Kirby
African Journal of Disability | Vol 6 | a318 | DOI: https://doi.org/10.4102/ajod.v6i0.318 | © 2017 Eva S. Bazant, Elizabeth J. Himelfarb Hurwitz, Brenda N. Onguti, Emma K. Williams, Jamie H. Noon, Cheryl A. Xavier, Ferdiliza D.S. Garcia, Anthony Gichangi, Mohammed Gabbow, Peter Musakhi, R. Lee Kirby | This work is licensed under CC Attribution 4.0
Submitted: 22 September 2016 | Published: 20 October 2017

About the author(s)

Eva S. Bazant, Jhpiego, Baltimore, United States
Elizabeth J. Himelfarb Hurwitz, Jhpiego, Baltimore, United States
Brenda N. Onguti, Jhpiego, Nairobi, Kenya
Emma K. Williams, Jhpiego, Baltimore, United States
Jamie H. Noon, Noon Design, Cerrillos, United States
Cheryl A. Xavier, Private Sector, Matale, Sri Lanka
Ferdiliza D.S. Garcia, College of Allied Medical Professions, University of the Philippines, Manila, Philippines
Anthony Gichangi, Jhpiego, Nairobi, Kenya
Mohammed Gabbow, National Council for Persons With Disabilities, Government of Kenya, Kenya
Peter Musakhi, Ministry of East African Community (EAC), Labour and Social Protection, Government of Kenya, Kenya
R. Lee Kirby, Division of Physical Medicine & Rehabilitation, Dalhousie University, Canada


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Abstract

Background: The World Health Organisation recommends that services accompany wheelchair distribution. This study examined the relationship of wheelchair service provision in Kenya and the Philippines and wheelchair-use–related outcomes.
Method: We surveyed 852 adult basic manual wheelchair users. Participants who had received services and those who had not were sought in equal numbers from wheelchair-distribution entities. Outcomes assessed were daily wheelchair use, falls, unassisted outdoor use and performance of activities of daily living (ADL). Descriptive, bivariate and multivariable regression model results are presented.
Results: Conditions that led to the need for a basic wheelchair were mainly spinal cord injury, polio/post-polio, and congenital conditions. Most Kenyans reported high daily wheelchair use (60%) and ADL performance (80%), while these practices were less frequent in the Philippine sample (42% and 74%, respectively). Having the wheelchair fit assessed while the user propelled the wheelchair was associated with greater odds of high ADL performance in Kenya (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.6, 5.1) and the Philippines (OR 2.8, 95% CI 1.8, 4.5). Wheelchair-related training was associated with high ADL performance in Kenya (OR 3.2, 95% CI 1.3, 8.4). In the Philippines, training was associated with greater odds of high versus no daily wheelchair use but also odds of serious versus no falls (OR 2.5, 95% CI 1.4, 4.5).
Conclusion: Select services that were associated with some better wheelchair use outcomes and should be emphasised in service delivery. Service providers should be aware that increased mobility may lead to serious falls.

Keywords

Wheelchairs; wheelchair services; training; wheelchair use; outcomes; wheelchair users; less-resourced settings; Kenya; Sub-Saharan Africa; Philippines; Asia; Adult; Basic wheelchairs

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