Evaluation of the current status of prosthetic rehabilitationservices for major limb loss: a descriptive study in UgandanReferral Hospitals

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