Outreach Seating Hubs

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Outreach Seating Hubs: Holistic, mobile services to prevent secondary complications & build inclusion

Cape Town, South AfricaNational, South Africa
Year Founded:
Organization type: 
Project Stage:
$250,000 - $500,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Children & adults with mobility disabilities in less resourced countries cannot access support for posture support mobility devices & suffer significant secondary complications. Mobile seating units can enable children to participate, change attitudes & create jobs for people with disabilities.

WHAT IF - Inspiration: Write one sentence that describes a way that your project dares to ask, "WHAT IF?"

What if children with mobility disabilities could access what they need to participate in their communities, what if this solution also built local capacity and created jobs for people with disabilities?
About Project

Problem: What problem is this project trying to address?

Children (and adults) with mobility disabilities cannot access centralized rehabilitation centers. Without correct posture support children develop significant secondary complications, curvatures of the spine, dislocated hips & life threatening pressure sores. Without mobility, they can not to go to school, access employment or their communities. The most common cause of death for people with mobility disabilities is preventable pressure sores.

Solution: What is the proposed solution? Please be specific!

Mobile outreach seating teams consisting of therapists & facilitators can: a) position growing children to preventing secondary complications b) upskill caregivers and train local therapists c) deliver disability awareness training to reduce disability stigma d) repair devices, keeping people mobile e) prevent nearly 100% of pressure sores and over 80% of spinal deviations in children f) assess and fit people who need new devices Coupling therapeutic support with wheelchair repair training for local adults with disabilities will create income opportunities while ensuring a local, sustainable solution to keep people mobile. Linking to day care capacity building builds support & parent champions to identify hidden children in need.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

The waiting list of users needing wheelchairs in just the Northern Cape of South Africa will be 1,200 & 3 years long by end 2015. In lower developed countries, lack of transportation is the single biggest barrier to access to rehabilitation. 36% of wheelchairs in low resourced countries are abandoned within 12 months due to inappropriateness, physical pain & breakdown. Secondary complications resulting from inappropriate support (incl. spinal curvatures & pressure sores) can be eradicated by appropriate fitting & regular adjustments by therapists. Mobile therapy units & locally trained & supplied repair techs will overcome all this. Linking this to capacity building at specialist day care centres & units will impact on social inclusion.

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

Shonaquip has delivered outreach seating services in the Western Cape for more than 10 years. Due to government budget restrictions this has been reduced to one district of 12,241 square kilometres and 212,787 people. Shonaquip currently provides seating services to 4,750 people per year. In a 3 year study, the outreach model (6 monthly assessments and appropriate devices) has been proven to reduce new pressure sores from 2% to 0.26% and new spinal deviations from 35% to 0% (Comparison sample size = 384 Optimal Management vs 282 Non-optimal). A recent study indicated that over 23% of users in the Eastern Cape Province are not even using seat cushions, a vital component for postural support and the prevention of pressure sores. Shonaquip & Uhambo Foundation wish to train self-sustainable local repair techs to scale this work to the Western, Northern and Eastern Cape provinces.

Spread Strategies: Moving forward, what are the main strategies for scaling impact?

Shonaquip and the Uhambo Foundation have been requested to bring the outreach seating model to Namibia, Botswana, Uganda, Georgia and numerous other countries. With reduced component part prices, it would become cost effective (in the reduction of logistics costs) to set up sub assembly hubs to support the local repair technicians, lower the cost of appropriate devices and bring appropriate seating to people in lower resourced areas as soon as possible. This phase of scaling will validate the model and create sufficient create sufficient demand for component parts to justify tooling costs.

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

Shonaquip wishes to scale the model to demonstrate the long term cost effectiveness to government and funders of locally accessible rehabilitation services. Local government physiotherapists will be trained building capacity. With reduced cost repairs and a recycling programme, Shonaquip will train & equip local people with disabilities as self sustainable wheelchair repair techs, centered around existing day care centers trained in inclusion.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

No one else is addressing these problems. The South African national health strategy is attempting to address this but does not have the capacity or training on the ground. Skilled resources relevent to people with this level of disabilities are tied up in tertiary hospitals making it a three point referral system. This creates lengthy delays which results in compounded medical problems. This problem is even worse in other SADC countries where budgets for rehabilitation are even smaller, and a local solution creating jobs while reducing price levels is vital.

Founding Story

Established in 1992, Shonaquip was the first woman run wheelchair business of its kind in Africa. It was established as a social enterprise to provide appropriately fitted wheelchairs for children and adults, capacity-building training for local wheelchair practitioners. Shonaquip was founded as a result of Shona's personal experience as a mother of a child with a disability and inspired by other families seeking support. Shonaquip’s aim is to facilitate & develop the expansion of local skills & infrastructure that will provide & ensure that appropriate devices & responsible services for people with disabilities living in Africa & other developing economies grows to meet the demand.


Shonaquip staff, together with Uhambo Foundation, are committed to the principles of a fully inclusive society which recognizes diversity and the right of all people to have equal opportunities and to participate to their fullest potential. Both Shonaquip and Uhambo Foundation have voluntary boards consisting of leaders in business, policy and advocacy as well as providing legal and financial oversight. Of the 66% of people are currently employed across the social enterprise, 27% have disabilities. Management Team: Shona McDonald - Founder. Advisor, contributor and peer reviewer to the International workgroup and training - WHO & ISPO David Jones - Finance Manager and qualified auditor Sarah Driver-Jowitt - COO with over 20 years international NGO managment experience. Veon Cupido – Production Manager Therapy Team: including full time 11 therapists, seating practitioners and technicians and 2 part time therapists Design Team: 2 Award winning designers Production Team: 27 full time staff working in an inclusive factory Administration and Finance: 6 full time staff members Uhambo Foundation: 8 full time staff and 7 part time staff comprising social workers, community workers and facilitators. In addition to the General Manager, the team includes a Programme Manager, Relationship Manager and part time accountant.
CO-CREATION IDEA: Please offer a brief description of how you imagine a win-win partnership with Boehringer Ingelheim to better serve unmet needs in health. (Hint: Please mention the underlying business model envisioned that would make such a partnership sustainable.)

Shonaquip and the Uhambo Foundation envisage three main ways.

1. Demonstrate effective cost reduction as a result of the model - support from Boehringer Ingelheim to conduct evaluation as to the public health economics of the model.
With this data, to leverage further government support and international funding and spread this model through policy change to globally deliver appropriate support.
2. Access to capital, to assist with tooling to ensure sustainable local repair capacity and distribution channels as the model spreads.
3. Co-branding mobile unit vehicles and partnering to couple mobile units with diabetes clinics and distribution of nutrition based interventions.

In the future to develop online mentoring platforms.

NEEDS: Based on you response above, please specify which of the following resources, operations or expertise by Boehringer Ingelheim you imagine leveraging to actualize the proposed co-creation opportunity. Please check all that apply. (Hint: while financing is often critical to scale, we are also interested in understanding what other assets or expertise could be leveraged).

Distribution Channels, Research and Development, Relationships/New Contacts, Manufacturing, Access to Capital, Other.

EXPLANATION OF NEEDS: Please explain your choices in more detail.

The need to scale has been significantly outlined above. Children and adults with mobility disabilities are suffering unnecessary secondary complications and delay in receiving the appropriate wheelchairs due to distances to access care, limited local training and stigma.

Shonaquip hasdemonstrated significant improvement in the lives of children with mobility disabilities on a district level throughmobile outreach seating services. Couple with training local therapists to support basic services, and trained local repair technicians and support networks.

We wish to scale this regionally.

OFFER: What are the main assets you may contribute in a co-creation partnership with Boehringer Ingelheim that would better serve unmet needs in health?

Deep understanding of an unmet need in a specific market/context, Access to and established trust with customers/beneficiaries, Insights into pricing and financing of health products/services, Insights into distribution, Other.

FOCUS AREAS: Which of the following best describes the main focus of your project? (select all that apply)

Improving the affordability of healthcare (e.g., microinsurance, reducing the economic cost of care), Increasing physical access to healthcare to people with restricted mobility or restricted access (senior people, people with disability, remote or difficult areas, etc.), Holistic solutions that work across the entire care continuum (including education, prevention, detection, treatment, management, follow-up), Models that engage other industry players (e.g., nutrition, athletic, mobility organizations)., Remote care solutions for health management, treatment, and diagnosis, Packaging of health products and services to address needs currently unmet.

Please share what your organisation and Boehringer Ingelheim will Co-Create together
Please specify what your Co-Creation will result in:

If you selected "other" above, please explain:
Please provide a 1-2 sentence summary of your Co-Creation idea
How does this project link to the core mission of your organisation?
Beyond social impact, how does this project link to Boehringer Ingelheim’s core business?
What are the specific inputs and actions that each side will contribute to this Co-Creation idea based on each of your unique competencies and experiences?
Please describe the potential revenue model for this Co-Creation idea.
What possible risks or challenges do you foresee?
Is there anything else you would like to share about your Co-Creation idea?
How much input do you hope to receive from Boehringer Ingelheim?

If you selected "other" above, please explain:
Besides Boehringer Ingelheim, what other types of partners might be valuable to carrying out your Co-Creation idea, and why?