Provision of prosthetic and orthotic services in low-income countries: a review of the literature

Disability is inextricably linked to poverty. A total of 80% of the disabled population lives in low-income countries. The demand for prosthetic and orthotic services in these countries is increasing, and a variety of methods to provide services are currently used.
To assess current models of provision to facilitate sustainable, evidence-based prosthetic and orthotic services.
A literature search was performed through Medline (Ovid), PubMed, ISI Web of Knowledge, EMBASE and RECAL Legacy using combinations of subject heading and text word searching strategies. Full-text publications were critically appraised and ranked according to the Scottish Intercollegiate Guidelines Network guidelines.
Three areas were deemed pertinent to the research question. Studies were grouped into one or more of these categories based on the issues addressed: instigators, types of service provision, demographics and region-specific issues. It was found that many complex factors influence prosthetic and orthotic services in low-income countries. Demographic and regional idiosyncrasies require prosthetic and orthotic services to be tailored to address the specific needs of individual countries.
The lack of and quality of available research made efficacy of methods used to provide services in low-income countries difficult to determine.
This review aims to highlight areas of best practice in prosthetic and orthotic services in low-income countries and to show where further research is required in order to develop evidence-based prosthetic and orthotic services.