Improving access to prosthetic services in Western Nepal: a local stakeholder perspective

Purpose Evidence of effective strategies to improve access to assistive technology (AT) like prostheses is limited, especially in rural and remote areas of low- and middle-income countries where unmet needs are the greatest. This study aimed to identify barriers and facilitators to accessing prosthetic services in rural areas of western Nepal and explore strategies to improve access from the perspective of local stakeholders. Method Semi-structured interviews were conducted with 13 service providers and consumers. Barriers and facilitators of access were highlighted and potential solutions to overcome access barriers were explored using thematic analysis of transcripts. Results Six themes concerning barriers and facilitators arose: awareness and literacy of prosthetic services, attitudes and belief systems, financial supports, geographical access, health system and referral processes, as well as service provider capacity and regulation. Six themes regarding potential solutions were also identified: awareness campaigns, procurement pathways, referral pathways, subsidised and shared costs of AT, professional support networks and development opportunities, as well as task shifting and sharing. Conclusions While facilitating interventions support access to prosthetic services, they remain insufficient to overcome several barriers that continue to inhibit this access. Nevertheless, real opportunities to alleviate barriers and address the unmet need exist and must be explored.