Promoting Universal Health Coverage for Amputees through Social Enterprise and Engineering Innovation
Much of the research in upper limb prosthetics focuses on complex and expensive systems, the use of which requires access to various auxiliary services (e.g. reliable charging points, fitting and repair centres). Globally, the majority of people with upper limb absence live in settings where they cannot afford to pay for expensive devices and travel to specialist centres for fitting and repair. The result is that many people simply do not have access to prosthetics, and the consequences of living without a suitable prosthetic device can be severe. Indeed, our early work, presented at the World Health Organisation, found that many people with upper limb absence in Uganda survive without suitable upper limb prosthetics, and the devices which are prescribed are poorly maintained. Supply chains are ineffective, leading to unnecessary delay and cost. To address these issues, we led a programme of work, funded by the Engineering and Physical Sciences Research Council to develop new, purely mechanical prostheses that are lower cost, easier to manufacture and maintain, and begin to tackle the systemic under-supply problem. We have shown the fundamental limitations of current body-powered (harness driven) upper limb prostheses, which led to our focus on devices which can be used without harnessing. We are designing a new open-frame adjustable socket, which should be easier to manufacture and maintain locally and better suited to hot climates. We are also using digital tools to capture both use/non-use and the real world experiences of users. The work is also supported by undergraduate placements and internships.
Our long-term aims are to use our innovations in prosthesis design, coupled with fine-resolution modelling of demand, to pilot new, distributed prosthesis service models. The work includes 3 linked objectives:
- Supply Chain Innovation: Co-design and test the contribution that a Public-Private-Partnership approach can make to sustainable supply chain integration for prosthetics componentry and repair services.
- Demonstrate the role that technological innovation can have on prosthetic services: Test the potential for local manufacture and supply-chain entry of a user-adjustable, locally repairable socket design.
- Generate the evidence-base for a new model for Overseas Development Assistance (ODA) based on principles of partnership, social enterprise and sustainability.
Funder
EPSRC (EP/RO13985/)
MRC (MR/V015214/1)
Tropical Health and Education Trust
Commonwealth Professional Fellowship Scheme with support from Knowledge For Change.
Publications
Morgado Ramirez, D., Nakandi, B., Ssekitoleko, R., Ackers, H.L., Mwaka, E., Kenney, L., Holloway, C and Donovan-Hall, M. (2022) The lived experience of people with upper limb absence living in Uganda: African Journal of Disability (11) ISSN: (Online) 2226-7220, (Print) 2223-9170
Mulindwa, B., Nalwoga, R.P., Nakandi, B.T., Mwaka, E.S., Kenney, L.P.J., Ackers, H.L., & Ssekitoleko, R.T. (2023): Evaluation of the current status of prosthetic rehabilitation services for major limb loss: a descriptive study in Ugandan Referral hospitals, Disability and Rehabilitation, DOI: 10.1080/09638288.2023.2188266
Kenney, L., Horder, C., Howard, D., Ackers, H.L., Ssekitoleko, R. and Mulindwa, B., Hussaini, A., Kyberd, P. and Donovan-Hall, M. (2023) Virtual Volunteering. A Collaborative Prosthetics Research Project, IPEM SCOPE, Autumn 2023, pp24-27
Oldfrey, B., Holloway, C., Walker, J., McCormack, S., Deere, B., Kenney, L., Ssekitoleko, R., Ackers, H.L., & Miodownik, M. (2023): Repair strategies for assistive technology in low resource settings, Disability and Rehabilitation: Assistive Technology, DOI: 10.1080/17483107.2023.2236142
Team
Dr Jonny Huck, Manchester University
Dr Robert Ssekitoleko, Makerere University, Uganda
Allan Ndawula, Makerere University, Uganda
Benedict Mulindwa, Makerere University, Uganda
For Information Contact:
Professor Laurence Kenney or Professor Louise Ackers
