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Do legs matter: Why take-up of prosthetic legs is low in Rwanda

Development Challenge

In lower income countries, persons with disabilities have lower educational attainment and poor labor market outcomes, and are more likely to be in poverty. Technologies exist which can support people with physical disabilities, such as prostheses and orthotics. However, there is limited evidence in lower income countries on the extent of adoption of these technologies, potential reasons for non-adoption, and their effects on labor market outcomes.


5% of the population of Rwanda is categorized as persons with disabilities. The government of Rwanda has made significant efforts to support persons with disabilities, including paying for prostheses and orthotics for some extreme poor persons with disabilities. However, uptake of these services is extremely low. In a population of approx. 100,000 single leg amputees, only 5-20% of individuals have opted to receive a free prosthetic leg.   

Evaluation Strategy

This research will include a randomized control trial (RCT) to measure the effects of behavioral constraints on the adoption of low cost prosthetic technologies by ultra-poor single leg amputees. Behavioral barriers, such as uncertainity and perceived costs vs. returns, may be inhibiting individuals from adopting prosthetics. In a small RCT intervention of 130 individuals, subjects will be provided with information about the availability of these technologies, a demonstration of the uses of the prosthetic, and/or a small incentive to adopt these technologies.  After the intervention, adoption will be observed to test which constraints are inhibiting uptake. 

Results and Policy Implications

Understanding the economic returns to prosthetic and orthotic technologies is necessary for conducting a cost benefit analysis of investment in these technologies, which is important for governments in lower income countries with constrained budgets. Moreover, results from this study will deepen an understanding of which behavioral constraints most affect adoption of prosthetic technology, and allow for a successful scale up of the intervention. 


Ongoing (2016-)

Photo Credit: Elisa Cascardi