Community collaboration for the financing, design and production of 30 standing devices for children with motor disabilities

Abstract

Introduction
Standing is essential for children with motor disabilities, as it promotes physical development, functioning, emotional well-being, inclusion, and social participation. However, in low- and middle-income countries, only 10% of those who need assistive technologies have access to them. To address this gap, a project based on Fawcett's community collaboration model was implemented, with five phases: participatory diagnosis, planning, action, participatory evaluation, and sustainability. The results were analyzed using the 6 F-Words model (Fitness, Function, Family, Friends, Fun, and Future) for child development and its interdependence with the HAAT model (Human, Activity, Assistive Technology, and Context).

Objective
To demonstrate how a community collaboration model can reduce barriers to accessing assistive technologies through the design, funding, and delivery of 30 customized standing devices for children with motor disabilities.

Method
The intervention was carried out in partnership with the LuisFe Foundation, which supports 500 families with feeding and respiratory care. The phases were:

Participatory diagnosis: Clinical, functional, and contextual evaluation of 30 selected children.
Planning and design: Two device models were created: a folding wooden floor-standing device and a manual standing table.
Resource mobilization: 24 devices were funded through raffles organized by the Foundation; the rest were funded by the families.
Implementation: Healthcare professionals, families, and the community participated.
Participatory evaluation: Follow-up was conducted using the 6 F-Words and the components of the HAAT model.

Results: 30 personalized devices were delivered, with a user-centered design (child/caregiver), promoting autonomy and functionality in real-world contexts. 90% of the children were dependent on a caregiver for transfers and mobility. 83% of the families used the device between 3 and 5 times per week; 60% tolerated more than 30 minutes daily for activities such as play, homework, or eating. Caregivers reported improvements in physical function (alignment), activity performance (playing, eating), emotional well-being (enjoyment, interaction), and function (strength, head control, visual tracking). Ten percent reported difficulties organizing intervention time, requiring support from another family member or prioritizing care such as feeding or respiratory care. Ninety percent of caregivers perceived a positive future impact.

The intervention showed results in all four HAAT components (human, activity, assistive technology, context) and integrated the 6 F-Words as a development framework.

Conclusion: The Fawcett model enabled effective collaboration between the community, professionals, and families, generating accessible and sustainable solutions. The HAAT and 6 F-Words frameworks facilitated a comprehensive evaluation of the physical, emotional, and social impact, consistent with the design of the devices. It is recommended to diversify the models according to age, weight, and prognosis, as well as to maintain long-term clinical follow-up. A future challenge is to move toward autonomous and sustainable funding models, reducing dependence on volunteers.