A qualitative synthesis to explore clinician and user experiences of accessing prosthetic and orthotic services in low- and middle-income countries using the three-delays model as a framework.

Abstract

To use the "three delays model" as a framework to identify and synthesise qualitative literature that identifies barriers to accessing and utilising P&O services in low-middle-income countries from the perspective of individuals with disabilities and clinicians. A systematic search of four databases was used to identify research exploring user and clinician experiences in accessing P&O services in LMICs. Selected search terms and combinations identified through an adapted version of the SPIDER tool were used to identify studies. All retrieved articles were critically appraised using the CASP tool. Data were extracted, and themes were synthesised using a deductive thematic approach guided by the three-delays model. Ten key themes were generated and linked to the three-delays model. Fear of perceived financial implications, transportation, and respectful care were some of the themes affecting accessibility in the first, second, and third delays, respectively. The findings suggest that the delays are interconnected components that might have a cascading effect on access to P&O services as a whole. Minimising delays can improve the accessibility of P&O services in low-middle-income countries.