A WHEELCHAIR is one of the most essential assistive devices for people who cannot walk, or have difficulty walking, providing mobility, postural support, and independence that enables meaningful participation in society.
According to the World Health Organisation (WHO), the term wheelchair includes all types of wheeled mobility devices; manual chairs, power-assisted chairs, tricycles, scooters, and related components such as cushions and postural supports.
An appropriate wheelchair is one that meets the user’s physical needs, suits their environment, fits properly, is safe and durable, is available locally, and can be maintained and repaired at a sustainable cost.
A wheelchair user is therefore anyone who relies on a wheelchair to support their mobility and daily functioning.
The WHO Global Report on Health Equity highlights that more than 1,3 billion people, about 16% of the world’s population live with some form of disability.
Although precise global data on wheelchair need remains limited, WHO estimates that at least 80 million people, or approximately 1% of the world’s population, are likely to require a wheelchair. This number is expected to rise due to ageing populations, chronic health conditions, accidents, and other health-related factors.
Ensuring broad access to wheelchairs is therefore essential not only for mobility but also for guaranteeing access to education, employment, community life, and opportunities for people to fully realise their potential.
In Zimbabwe, the importance of wheelchairs and other assistive technologies is strongly emphasised in both the National Disability Policy (2021) and the National Assistive Technology Strategy (2024-2025).
- Bulawayo City fire coach Ncube
- Bulawayo City, Beefy part ways
- Zim coach in Rwanda success
- Miss Albinism vaccination drive gathers steam
Keep Reading
These frameworks recognise that when wheelchair provision adopts a user-centred and rights based approach, individuals are empowered, their dignity is upheld, and their independence and overall well-being are significantly enhanced.
To address the global shortage and inequitable access to appropriate devices, WHO, together with the International Society of Wheelchair Providers and the International Society for Prosthetics and Orthotics, developed guidelines to support countries.
These guidelines highlight the importance of proper wheelchair design, production, fitting, maintenance, and service delivery as part of strong health systems that respond to individual user needs. Despite their importance, many people still struggle to access appropriate wheelchairs. The barriers range from unavailability and unaffordability to lack of trained personnel who can assess, prescribe, and fit wheelchairs correctly.
As a result, many people receive wheelchairs without proper guidance or training, and in some cases they receive devices that are unsuitable or unsafe.
The consequences of inappropriate wheelchairs can be severe. Poorly fitted chairs significantly increase the risk of pressure ulcers, particularly around the buttocks, heels, and elbows, which may lead to serious infections.
Inadequate postural support can cause chronic back, neck, and shoulder pain, spinal misalignments, and long-term joint strain. Prolonged sitting in an unsupportive position also affects circulation and blood pressure, raising the risk of cardiovascular complications.
For learners (children), outgrowing a wheelchair presents additional risks: a too-small chair no longer supports proper posture, leading to spinal curvature, pressure points, muscle strain, reduced stability, and increased risk of tipping over.
For manual wheelchair users, poorly positioned push rims contribute to upper-limb injuries. In worst cases, unstable wheelchairs can lead to falls resulting in fractures, head injuries, or long term disability.
Evidence shows that people who need wheelchairs are overwhelmingly concentrated in low and middle income countries, including Zimbabwe. Unfortunately, these countries also experience the highest unmet need.
In many cases, development partners, donors, and well-meaning sponsors distribute wheelchairs without sufficient technical guidance, often due to limited knowledge, lack of rehabilitation services, resource constraints, and fragmented supply chains.
Many devices are imported without consideration of environmental conditions or the specific needs of users.
Historically, the focus has been on the quantity of devices donated rather than the quality or suitability of the wheelchairs provided. While generous, such interventions have often created more harm than good, with many users abandoning uncomfortable or unsafe wheelchairs shortly after receiving them.
To address these challenges, WHO recommends a service-based model for wheelchair provision, emphasising systems that ensure each user receives a device that truly meets their needs.
Central to this model is individual assessment, where wheelchair users work alongside trained rehabilitation personnel to determine their physical abilities, functional requirements, environmental conditions, and lifestyle preferences. Only after such an assessment should a wheelchair be selected.
Once chosen, each wheelchair must be carefully prepared and fitted, which includes adjusting or modifying the frame, seat, cushion, and postural supports to ensure comfort, mobility, and safety. This personalised fitting process is essential for preventing injuries and ensuring the chair enhances, rather than restricts, mobility.
Another key element of effective wheelchair provision is training. Users, and where necessary, family members or caregivers must be taught how to use the wheelchair safely, including transferring in and out of the chair, navigating different terrains, operating components, and performing basic maintenance and repairs.
Without such training, even an appropriate wheelchair may not serve its purpose effectively.
Ongoing follow-up is an integral part of quality wheelchair service delivery. Users’ needs can change over time due to growth, health conditions, or environmental factors. Routine follow-up ensures adjustments can be made early to avoid discomfort, prevent injuries, and extend the life of the wheelchair.
Regular reviews also help identify emerging problems and ensure devices remain functional, safe, and appropriate.
The success of this model depends heavily on the availability of competent, appropriately trained personnel within the health and community support systems.
Rehabilitation workers, technicians, and clinicians all play critical roles in identifying users, conducting assessments, performing fittings, and providing follow-up care. Zimbabwe’s National Assistive Technology Strategy highlights the importance of strengthening these competencies while ensuring wheelchair provision is integrated into the primary health care system, creating smoother referral pathways and more efficient service delivery.
It also calls for strong monitoring and evaluation mechanisms to assess service performance, user satisfaction, and equity of access.
Policy frameworks must also ensure wheelchairs, cushions, and postural support devices meet minimum standards for safety, performance, and reliability. For Zimbabwe, addressing the cross-cutting needs associated with wheelchair provision requires a multi -stakeholder approach.
Government ministries must provide leadership in policy development and coordination, bringing together service providers, researchers, development partners, and, most importantly, representative organisations of wheelchair users.
Effective implementation also requires sustainable financing models so that products and services are available, affordable, and responsive to local needs.
To further strengthen the system, it is recommended that key ministries work closely with the Standards Association of Zimbabwe (SAZ) and organisations of persons with disabilities (OPDs) to build a coordinated, rights based wheelchair service framework.
SAZ can ensure all wheelchairs and related services meet national standards aligned with international best practice, while OPDs bring lived experience, community insights, and accountability to ensure the system remains inclusive, responsive, and user centred.
Through such collaboration, Zimbabwe can expand access to comprehensive assessments, proper prescription, routine follow up, repair and maintenance services, and high quality mobility devices.
This will not only improve health outcomes but also enhance independence, participation, and overall quality of life for wheelchair users across the country.
Tigere is a disability expert and founder and executive director of Vision Ability Zimbabwe. These weekly New Horizon articles published in the Zimbabwe Independent are coordinated by Lovemore Kadenge, an independent consultant, managing consultant of Zawale Consultants (Private) Limited, past president of the Zimbabwe Economics Society (ZES and past president of the Chartered Government and Accountancy Institute in Zimbabwe (CGAIZ). Email — [email protected] or Mobile — +263 772 382 852
