Legislation on the provision of AT devices in Cameroon is inferential and in its infancy. Though not explicitly stated, laws No. 83/013 of July 21, 1983, and the mandate to its implementation, No. 90/156 of November 26, 1990, refer to protecting Cameroonians with disability through empowerment and inclusion in mainstream society, for example, in education, employment, and through universal design of buildings and structures [34-36]. More recently, in parallel to signing the United Nations Convention on the Rights of Persons with Disabilities in 2008, the President of Cameroon, Paul Biya, appealing the statutes of 1983 and 1990, invoked ordinance No. 2010/002 of April 13, 2010, focusing on the prevention of disabilities through the social development approach of national solidarity [34, 37]. National solidarity refers to an outcome driven agenda promoting “security mechanisms, compensation, promotion or valorization of socially vulnerable populations for their empowerment and the restoration of their human dignity”[37, 54]. AT could, therefore, be seen as an underlying entity deeply embedded in current national development schemes that is yet to be sanctioned.

Romania signed the UNCRPD in 2007 and ratified it through Law no .221/2010, assuming the government’s moral and legal obligation to implement it. The Optional Protocol to the Convention was signed by Romania in 2011, but it is not yet ratified. In Romania, the National Authority for Persons with Disabilities (NAPD) was originally assigned as central coordinating authority to implement the UNCRPD. Subsequently, however, another institution under Law no. 8/2016 took on this role with the creation of the Council for monitoring the Convention’s implementation, under the Parliament control. The council’s main purpose is to monitor the exercising of rights for individuals with disabilities in residential public or private facilities, as well as hospitals and psychiatry units. The impact made by the council is not yet evident, as implementation of services is still under development, with personnel and infrastructures currently being established.

The Romanian legislation on disability assumes to a certain extent the Convention’s recommendations about the right to mobility. The social protection of persons with disabilities is regulated mainly by three important pieces of legislation:

• Law no. 448/2006 that sets out the general framework of rights and obligations of persons with disabilities, dedicated to social integration and inclusion
• Law no. 292/2011 on social assistance that defines and regulates the national welfare system
• Government Decision no.655/2016 that approves the National Strategy “A society without barriers for persons with disabilities” 2016 – 2020 and the Operational Plan for implementing the National Strategy
• A clear understanding of wheelchair service delivery in Romania is lacking, given limited statistical data and research evidence available. In order to address the needs of people who use wheelchairs, greater awareness and understanding of the issues is required.

The Motivation Romania Foundation investigated the wheelchair sector in Romania, considering level of need, funding, access to wheelchairs and wheelchair services, in-county providers, formal education and training, existing research and stakeholder perspectives. Findings generated a better understanding of the situation to assist in the production of a Strategic Plan to address disparities that exist to provide appropriate wheelchairs.

1. There were no official statistics found specifically about the people with personal mobility impairments or about the people who need and/or use a wheelchair. Based on international figures, it was estimated that the percentage of people requiring a wheelchair should be around 1.5% of Romania’s population (19,820,000), or approximately 297,000 people would need a wheelchair.
2. People with personal mobility impairments’ access to wheelchairs depends on the potential funding sources. The Romanian government assumes responsibility to provide a small subsidy for a wheelchair every five years. The national health scheme covers technology products (not services), including wheelchairs but excluding wheelchair services. The Ministry of Health is responsible for the provision of wheelchairs. Evidence suggests that the Romanian health system is seriously underfunded and poorly managed. Wheelchairs are provided by suppliers approved by the Ministry of Health and are contracted yearly by the County Health Insurance Authority (CHIA). Private insurance does not specifically cover the cost of a wheelchair; this is usually included within an overall lump sum compensation for invalidity.
3. The process of prescribing a wheelchair does not include a comprehensive assessment, and prescription is related to product rather than individual needs. Referred by the family physician, the user goes to the specialist physician (neurologist or orthopedist) and gets a prescription for a wheelchair. The prescription includes no specific details or requirements about the wheelchair, just a general recommendation as to the need for a device. With the prescription, the person submits a request to the County Health Insurance Authority. Once approved by CHIA, the user gets a voucher and the approved list of the local contracted suppliers. Suppliers provide a wheelchair within the agreed fixed price. Wheelchair products are imported, usually low in cost and quality. Follow up and maintenance services are limited.
4. Formal education and training is ad hoc, lacking in uniformity across therapy programs. Course content contains some related subjects; however, no specific wheelchair service delivery education courses exist. Motivation Romania Foundation (MRF) provides non-formal programs with specific focus on wheelchair provision.
5. Limited published scientific research exists regarding wheelchair user population and service delivery.

National health insurance in Indonesia precludes coverage of assistive aids such as wheelchairs and prosthetic & orthotic devices [19, 55]. However, since 2013, the provincial government in Yogyakarta (city in Java) has implemented a unique social health insurance scheme catering to people with disabilities within that region. The insurance scheme titled ‘Jamkesus Disabilitas – Jaminan Kesehatan Khusus Disabilitas’, provides coverage for medical care, treatment and assistive aids, which include wheelchairs. Based on several years of implementation of the scheme, stakeholders found that an area that needed to be focused on was reference standards when it came to assistive technology (AT) service provision.

Since WHO guidelines on the provision of manual wheelchairs in less-resourced settings was launched in 2008, Sirindhorn National Medical Rehabilitation Institute (SNMRI)^[1] started to work in partnership with Motivation Australia to improve wheelchair service provision in Thailand. The 3-year project started by building capacities of SNMRI’s staff. A 2-week training course called ‘Fit for Life’ was conducted, followed by ‘the Supportive Seating’, which is also a 2-week training course. After that, SNMRI implemented wheelchair services and developed the Guideline on the Provision of Manual Wheelchairs for Health Personnel [56]. A 3-day training course was conducted along with the guideline between 2010-2012. Around 68 health personnel from 45 community and provincial hospitals attended.

After the WSTP-Basic level was launched in 2012, a representative from SNMRI attended the WHO WSPT-B regional training in Hong Kong supported by the WHO – Western Pacific Region (WPRO). Since then, the WHO WSTP-B has been implemented in Thailand. Health personnel from hospitals were invited to attend the training, which is conducted annually. The WHO WSTP-I has been conducted since 2013 after the Global launch in Cape Town. The Department of Medical Services, Ministry of Public Health financially supports the trainings. Around 25 participants from 10-15 different hospitals attended the trainings each year. From 2013 to 2016, around 100 health personnel from over 40 hospitals attended the WHO WSTP-B & I. Moreover, in 2015-2016, participants from Myanmar, Laos, Vietnam, Malaysia, and Brunei were invited to attend the WHO WSTP-I in Thailand, which aimed to build networks among WPRO service providers in the Association of South East Asian Nations (ASEAN) community. Thai government financially supported the training.