The United Nations states that to attain the highest right to health a country should have policies and programs that promote the availability (sufficient quantities), accessibility (physically and provision of information), affordability (economically), acceptability (culturally, socially, gender appropriate), adaptability (appropriate to local contexts), and quality (durable and safe according to standards and evidence-based) of services[26]. In this specific case these apply to wheelchair services and products [27]. To understand the current situation and root causes of potential challenges faced, the first step is to conduct a rapid situational analysis to generate a deeper understanding and an overall picture of the development of the wheelchair sector within a context. This first step is especially useful to produce a publishable analysis; however, it is important to understand that by itself it would not be able to build the country’s wheelchair sector capacity nor to buy-in from all the relevant stakeholders [25]. We describe several strategies to engage the stakeholders after this situational analysis in the Strategies section. To assess the situation of a country and identify roots causes where the market (i.e. wheelchair sector) falls short [28], this PAK proposes to classify the five interlocking areas of the wheelchair sector in a country (figure below) into three stages of development (low, middle, and high) [29, 30], by also considering the Planning Tool for the Stakeholders workshop and the Assistive Technology Assessment Toolkit, both from WHO [23, 31]. Each of these areas is described in detail separately: Policy, Provision, Personnel, Products, and People.
People, Policy, Provision, Personnel, and Products: 5Ps that are inter-locking areas of the wheelchair sector in a country, proposed by the Global Cooperation on Assistive Technology from the World Health Organization