National governments have to develop a national guiding framework that includes laws, policies, plans, standards, regulations and rules for wheelchair provision; developing and monitoring the framework should be in collaboration with all national wheelchair sector stakeholders [6, 32].

Very commonly policy makers – including those in the health and welfare sector – are not familiar with disability and assistive technology issues [42]. Therefore, an important barrier to policy implementation and adoption is the awareness and expertise on the right to personal mobility. This is known as the policy awareness gap [27]. Consider advocacy and awareness raising campaigns that articulate the right to appropriate wheelchairs and services as a facilitator to other basic human rights.

In addition, raise the level of awareness education and training may need to be done at different levels depending on the context’s needs. The WHO Guidelines and Wheelchair Service Training Packages, as described in the Personnelsection, are instrumental to raise awareness. As a first step after a situation analysis, a stakeholders meeting may be planned to confirmimportant aspects: Who are the key players, formal and informal, in the wheelchair sector? What are the relationships between the stakeholders? Who has the power or influence in this situation? How do the stakeholders influence the policy process? [25]. It is crucial to have at the table local leaders and stakeholders if the country is decentralized [25].

Depending on the outcome of this meeting and the priorities identified by the group, working groups involving relevant wheelchair sector experts and actors with adequate space and time for dialogue should be implemented [25]. While this approach may be time consuming, it is a crucial investment, since it has the potential to unite those who have a stake in the sector into a common understanding of the root causes of the challenges and common solutions [25]. It is proved effective in proposing policies that have sustainable long-term impact [25]. Ideally, these actions will be led by a “steering committee” with leadership and a representation of the team’s access to higher-level decision-makers in the government [25]. The national wheelchair sector strategy must be developed in line with current national health strategies and development plans [32].

Special considerations are needed when the country may have ongoing conflicts, fragile infrastructure and/or have unstable governments [25]. In such scenarios, persons with disabilities rely primarily on donations to meet mobility needs, or in-country provision may be facilitated through the assistance of international development programs; for example: United States Agency for International Development Leahy War Victims Fund [43], the United States Humanitarian Mine Action Program [44], and the International Committee of the Red Cross[45]. A brief summary of the roles played by Non-Governmental Organizations (NGOs) in policy development is found in the Resources section. These organizations must be involved in the discussion to advance the wheelchair sector policy development.

When a policy process gap is identified, that is when the concerns of people with disabilities, DPOs, and other grassroots level stakeholders are not taken into consideration [27], efforts should be made to include their voice and promote their leadership.

Last, when policy implementation and monitoring gap is present, the discussion should focus on how to promote coordinated efforts (including funding) to assess the progress that therefore informs back the activities [27]. Consider articulating this to the CRPD governmental monitoring efforts and civil society efforts (if present). In fact, Assistive technology policies, systems, service provision models and best practices is greatly needed worldwide to support evidence-informed decision making [41].

Examples of national (or local) assistive technology policies in different contexts are available here.