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Evaluation of the current status of prosthetic rehabilitation services for major limb loss: a descriptive study in Ugandan Referral hospitals

Mulwinda, B; Nalwoga, Racheal P.; Mwaka, Erisa S.; Kenney, Laurence P. J.; Ackers, Louise; Ssekitoleko, Robert Tamale

Evaluation of the current status of prosthetic rehabilitation services for major limb loss: a descriptive study in Ugandan Referral hospitals Thumbnail


Authors

B Mulwinda

Racheal P. Nalwoga

Erisa S. Mwaka

Robert Tamale Ssekitoleko



Abstract

Background: Low-income-and-middle-income countries (LMICs) have a large
burden of major limb loss. No recent study has reported on Uganda’s state of
public sector prosthetics services. This study aimed to document the landscape of
major limb loss, and the structure of available prosthetics services in Uganda.
Methods: This study involved a retrospective review of medical records at
Mulago National Referral Hospital, Fort Portal Regional Referral Hospital, and
Mbale Regional Referral Hospital, and a cross-sectional survey of personnel
involved in the fabrication and fitting of prosthetic devices across orthopaedic
workshops in the country.
Results: Upper limb amputations accounted for 14.2%, and lower limb
accounted for 81.2%. Gangrene (30.3%) was the leading cause of amputation,
followed by road traffic accidents and diabetes mellitus. Orthopaedic workshops
offered decentralised services, and most materials used were imported. Essential
equipment was largely lacking. Orthopaedic technologists had diverse experience
and skillsets, but many other factors limited their service provision.
Conclusion: The Ugandan public healthcare system lacks adequate prosthetic
services both in terms of personnel and supporting resources, including
equipment, materials, and components. The provision of prosthetics rehabilitation
services is limited, especially in rural regions. Decentralising services could
improve patients’ access to prosthetic services.

Citation

Mulwinda, B., Nalwoga, R. P., Mwaka, E. S., Kenney, L. P. J., Ackers, L., & Ssekitoleko, R. T. (2024). Evaluation of the current status of prosthetic rehabilitation services for major limb loss: a descriptive study in Ugandan Referral hospitals. Disability and Rehabilitation, 46(5), 969-978. https://doi.org/10.1080/09638288.2023.2188266

Journal Article Type Article
Acceptance Date Mar 2, 2023
Online Publication Date Mar 24, 2023
Publication Date Feb 27, 2024
Deposit Date Mar 20, 2023
Publicly Available Date Mar 25, 2024
Journal Disability and Rehabilitation
Print ISSN 0963-8288
Electronic ISSN 1464-5165
Publisher Taylor and Francis
Volume 46
Issue 5
Pages 969-978
DOI https://doi.org/10.1080/09638288.2023.2188266
Keywords Rehabilitation
Publisher URL https://doi.org/10.1080/09638288.2023.2188266
Additional Information Additional Information : This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 24th March 2023, available at: http://www.tandfonline.com/10.1080/09638288.2023.2188266

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