Sintef Health Research and an industrial designer were commissioned by Norsk Form’s “Design without Borders” programme to carry out this study. The project was financed by Norad. The main objectives of the study focusing on Southern Africa were to assess the mobility needs of children with disabilities in their daily life. Today, solutions for assistive devices based on low technological solutions, available local resources and technology exist in various workshops in Africa (Kenya, Namibia, Zimbabwe, Uganda, Tanzania, Zambia etc). Most of the workshops have the potential to include new assistive devices in their product range.

Previous studies of living conditions among people with activity limitations in Namibia, Zimbabwe (Eide et al 2003) and Malawi (Loeb et al 2004) revealed that people with disabilities generally have a lower level of living condition than people without disabilities. Only a limited number of the people who need assistive devices have received one.

The results of the interviews with health personnel and people with disabilities in our study confirm the findings in the studies of living conditions.

Both the interviews and the observations showed that there is lack of appropriate assistive devices for children with mobility limitations. Children with mobility limitations need assistive devices that will help them to get up from the ground, be stimulated and enable mobility.

One of the problems is that children “grow out” of the assistive devices that are properly adapted to their body size. Resources for follow up are not available and many product designs are not made to grow with the child. A common problem with some available assistive devices is that important product features are not always designed with the user and terrain in mind.

One of the main challenges for local workshops is the funding of assistive devices for the individual customer. Most customers cannot afford to buy a wheelchair. When parents have to buy a wheelchair for their child, they want their investment to last as long as possible. As a result the parents select an adult wheelchair which might not benefit the child.

Local workshops and international organisations working with assistive technology could benefit from cooperation through the recently established Pan African Wheelchair Builders Association (PAWBA). The goals of PAWBA are to come up with standardised mobility technology testing standards for Africa.

Assessment of manufacturing feasibility tends to focus on production costs. More attention should be given to “design for manufacture”. The seven dimensions of manufacturability (production costs, quality, flexibility, risk, lead time, efficiency and environmental effects) should be used when assessing the effect a certain product design has on manufacturing.

This study concludes that there is a potential for product development in several product categories. Seven product development projects were proposed, ranging from mobility products for the home to assistive devices for longer distances.

The following projects were proposed for development:

1. Workshop for parents and local craftsmen
   Facilities where parents can learn to make inexpensive appropriate assistive devices for their children, guided by local craftsmen and health personnel.
2. Measuring and fitting devices
   Toolkit to be used in the field by health personnel to find the best positions for a child through fitting, measuring and testing before more definitive device is made.
3. A wheel board for young children
   To increase the radius of movement and allow children to explore and play together with other children.
4. A walker suited for sandy conditions
   Walkers that can grow with the child and stimulate further development.
5. A new wheelchair concept including special seating
   Focus on details, increased functionality and local manufacturability.
6. Tricycle for children/youth
   Transport children safely over longer distances.
7. Foldable wheelchair that can be easily adapted as children grow
   As the child grows, only the width and depth of the seat of the wheelchair would have to be modified.

The wheelchair concept with special seating (5) was chosen for further development. Many children with severe disabilities in Southern Africa are totally dependent on their families and friends. Due to the family’s need to work in the field, some of these children are left alone inside the house. If not stimulated the impairments of these children might increase. Given the opportunity to sit in an upright position and with the appropriate mobility devices, this might increase their participation in daily life both inside and outside the house.

In order to follow up the study, Norsk Form (Design without Borders) has applied for funding from Norad (2006-2007). The objective is to further develop a wheelchair concept with emphasis on special seating for children with severe disabilities.

Download the full report (pdf 2 Mb)