For wheelchair service provision to be effective, an appropriate wheelchair should be provided in a structured manner (e.g. ,WHO 8 steps) to assist with the following:  Prevention of health complications, abandonment of assistive technology, improved quality of life and participation.  This process includes referral and access to services at the appropriate level, adequate assessment, delivery and user training, and follow-up processes with trained personnel. Wheelchair service provision must be developed or improved to be user-centered [32].

National Assistive Technology policies should recognize the potential of small-scale good practices to be scaled in a variety of ways [27]. This may be the case when a range of local organizations (including NGOs) may developed small-scale but innovative projects; that may lack the infrastructure and capacity to scale-up (structural or systems level) or scale-out (replicate)[27]. Adopting a systematic approach to scaling is a principle that should be anticipated in policy [27].

When working on the creation of a policy to establish a care pathway for a person who needs a wheelchair consider that it should articulate different levels of services throughout the country (community-based, primary care, secondary, and tertiary) and build on already built capacity in the context [32].

Another consideration to improve and maintain the quality of the provision is organizational accreditation. This helps the service provider understand and identify areas that need to be improved and focus on good quality service delivery. Examples of accrediting services for organizations in health and human services are the Commission on Accreditation of Rehabilitation Facilities (CARF, headquartered in Tucson, Arizona, USA) and CECOPSin the United Kingdom. They are independent, non-profit accreditors of many areas including rehabilitation and durable medical equipment[1].

Overall, research on the cost-effectiveness of provision services is necessary to their advancement and potentially contributing to more services become available to more people with mobility impairments [32]. Last, also consider the inclusion of wheelchair provision for emergencies and disasters. It is common that people with disabilities are left behind in these situations, and those who acquire a disability as a consequence of the disaster, are unable to access emergency services if no wheelchairs are available. Motivation Charitable Trustin the UK has an emergency kit and the World Health Organization has published standards for emergency teams that include emergency wheelchairs [46].

[1]Durable medical equipment (DME) is device primarily used for a medical reason.