Mobility Assistive Technology Provision in Saudi Arabian Healthcare: Identifying Barriers and Developing Implementation Strategies

Background: Mobility-related disabilities are the most prevalent in Saudi Arabia,
significantly impacting quality of life. While mobility assistive technologies (MATs) help mitigate impairments, unmet needs persist in Saudi Arabia’s healthcare system, with a critical knowledge gap regarding factors influencing their provision.
Aim: To investigate the factors influencing MAT provision in Saudi Arabia’s healthcare system and recommend strategies to overcome the identified barriers to inform policy. Methods: First, a scoping review was conducted to understand the barriers to MAT provision by summarising and synthesising theories, models and frameworks (TMF) and identifying key determinants and gaps (Chapter 2). Second, an online survey across three hospitals in two geographical regions assessed MAT availability in Saudi Arabia’s healthcare system, with descriptive statistics used to summarise the findings (Chapter 3). Third, a qualitative embedded multiple-case study was conducted, involving 33 semi-structured interviews with healthcare professionals, managers and leaders, along with an analysis of six documents. The Consolidated Framework for Implementation Research (CFIR) guided data collection and analysis (Chapter 4). Finally, the findings from the previous chapters were triangulated, and the CFIR-Expert Recommendations for Implementing Change (ERIC) matching tool was used to develop strategies (Chapter 5).
Results: The scoping review synthesised 8 TMFs into nine propositions describing MAT provision barriers. The survey showed limited and inconsistent MAT provision across hospitals. The qualitative investigation identified barriers across the CFIR domains, with integration identifying six key barriers: healthcare system and policy, procurement and delivery, device-related, information and awareness, resource and infrastructure, and personal and environmental barriers. The CFIR-ERIC matching process identified priority strategies, including identifying and preparing champions, conducting educational meetings, assessing readiness, and conducting local consensus discussions.
Conclusion: This research provides the first comprehensive investigation of MAT provision barriers in Saudi Arabia and identifies strategies for improvement. Future research should evaluate these strategies within the Saudi context.