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To investigate the practices of repair that exist for users of mobility assistive products in low resource settings, as well as the psychosocial impact that the repair, or non-repair, of these devices has on users' lives. This article collates data on repair practices and the responses from participants on the topic of repair from studies conducted by the authors across four different low resource settings in Kenya, Uganda, Sierra Leone, and Indonesia. This data was then analyzed to identify the common themes found across geographies. Three major models of repair practice emerged from the data: "Individual or Informal Repair in the Community"; "Local Initiatives"; and "Specialist AT Workshop Repair". Additionally, the wider impact on the participants' lives of "Problems & Concerns with Repair"; "Experiences of Breakages & Frequencies of Repair" and the "Impact of Broken Devices" are explored. The results of this analysis demonstrate the paramount importance of community-based repair of devices, and how despite this importance, repair is often overlooked in the planning and design of assistive products and services. There is a need to further incorporate and support these informal contributions as part of the formal provision systems of assistive device. A lack of available specialist repair services in low resource settings hinders the potential impact of assistive technology provision systems. Community-based repair is the major route by which assistive devices are repaired in low resource settings. Appropriate community-based repair strategies should be incorporated into and supported by the formal assistive technology provision models in order to optimise outcomes. A lack of data on outcomes across the lifecycle of assistive products hinders progress on improving focus on follow-up services – in particular repair & maintenance. By supporting community-based repair, repairs that are inappropriate for that approach could be better directed to specialist repair services. [ABSTRACT FROM AUTHOR]

To explore the personal and system factors that motivate and enhance outcomes for patients accessing a prosthetic service and using a lower-limb prosthesis within a low resource setting. This study employed a qualitative approach to explore the motivations and satisfaction of individuals with lower limb loss engaging with a prosthetic service in Mombasa, Kenya. In-depth interviews were conducted over Microsoft Teams with 10 lower limb prosthesis users and thematic analysis was applied. Five key themes emerged: acceptance, self-determination, hope, clinician relationship and perception. These findings demonstrate the importance of hopeful thinking and a supportive community in overcoming physical and stigmatising challenges. The findings further highlight the value of the service provider relationship beyond just prescribing an assistive device. These results have relevance in developing patient-centred services, assistive devices and personnel training that are responsive, motivating, and cognisant of the service user. This is of particular interest as assistive technology services are newly developed in low resource settings. This research provides an understanding of lower-limb prosthesis users' satisfaction of a device and motivation for engaging with a prosthetic service within a low resource setting. The relationship the rehabilitation professional has with the service user plays a significant role in facilitating motivation during rehabilitation. Rehabilitation professionals should consider how they can foster a network of support amongst service users when planning services in remote, rural locations. Rehabilitation professionals should be aware of how hopeful thinking can be facilitated during rehabilitation to support motivation. When reviewing the success of services, or designing new service models, the service users should be consulted on what they would deem as a successful outcome. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted all segments of society, but it has posed particular challenges for the inclusion of persons with disabilities, those with chronic illness and older people regarding their participation in daily life. These groups often benefit from assistive technology (AT) and so it is important to understand how use of AT may be affected by or may help to mitigate the impacts of COVID-19. Objective: The objectives of this study were to explore the how AT use and provision have been affected during the initial stages of the COVID-19 pandemic, and how AT policies and systems may be made more resilient based on lessons learned during this global crisis. Methods: This study was a rapid, international online qualitative survey in the 6 United Nations (UN) languages (English, French, Spanish, Russian, Arabic, Mandarin Chinese) facilitated by extant World Health Organization (WHO) and International Disability Alliance networks. Themes and subthemes of the qualitative responses were identified using Braun and Clarke's 6-phase analysis. Results: Four primary themes were identified in in the data: Disruption of Services, Insufficient Emergency Preparedness, Limitations in Existing Technology, and Inadequate Policies and Systems. Subthemes were identified within each theme, including subthemes related to developing resilience in AT systems, based on learning from the pandemic. Conclusion: COVID-19 has disrupted the delivery of AT services, primarily due to infection control measures resulting in lack of provider availability and diminished one-to-one services. This study identified a need for stronger user-centred development of funding policies and infrastructures that are more sustainable and resilient, best practices for remote service delivery, robust and accessible tools and systems, respond to pandemic and other crisis situations. [ABSTRACT FROM AUTHOR]