Wheelchair and Mobility-Aid Repair Level 3

Who it is for. People who have finished Wheelchair and Mobility-Aid Repair Level 2, or who already run a repair service and can show the same skills, including wheelchair users who want to lead their own enterprise. In Ghana's framework, National Proficiency II leads to National Certificate I, which covers complex and varied work under minimum supervision. This module sits at about that level.

Bridge from Level 2: what you already know

Level 2 left out quality standards, a production line, local fabrication, leading a team, outreach clinics, service-system records and the business itself. Level 3 covers all of these. For general bookkeeping and venture skills, see the Hub's Money Skills Level 2 and Entrepreneurial Thinking Level 2; this book goes deeper into a repair workshop's own numbers.

How the module works

Each unit has learning outcomes, performance criteria, the range and the evidence your assessor needs. You are judged Competent or Not Yet Competent. About 70% of the time is practical. Each unit ends with Check yourself and homework.

• Complex needs gate. Never change the frame, seat angle, backrest or postural supports of a chair for a person with complex needs without a trained wheelchair service professional's written instructions. WHO's Intermediate level training, for people who need extra postural support, requires Basic level training plus clinical experience.
• Pressure-sore gate. Any open wound, blister or red or dark mark that does not fade is referred to a health worker the same day; stage 2 to 4 sores need an experienced health worker.
• Brakes and axles. No chair leaves the workshop without a passed brake test and locked quick-release axles.
• Hot work. Welding, brazing or heating a frame only by a trained welder with the supervisor's agreement; changes can weaken a chair.
• Workshop. Eye protection for wire brushing, cutting and grinding; solvents and glue away from flames and in a ventilated place; a clear, step-free floor; first-aid kit.
• Safeguarding. Never be alone with a child or a vulnerable adult behind a closed door; measure and examine only with consent, in a private but not hidden place.

Competency standard

Range. At least five chairs with repeated or hidden faults; one batch of donated or new chairs. Evidence. Root-cause records; product inspection reports; quality sign-off sheets.

A root-cause method: five questions

1. What exactly fails? (for example "left castor shakes at walking speed")
2. When and where? Only on rough ground? Only after rain? Only with this user?
3. What has changed? New tyres, a new rear wheel position, a heavier user, a new cushion?
4. Test one cause at a time. Change one thing, test, record.
5. Why did it happen? Fix the cause, then tell the user or the supplier how to stop it.

Standards you should know

The International Organization for Standardization (ISO) has a series of standards for wheelchairs (ISO 7176), for wheelchair cushions (ISO 16840 Part 2) and for postural support devices (ISO 16840 Part 3). They cover the overall safety and performance of a product. Some regions build product standards on them: Europe uses EN 12183 and Australia and New Zealand use AS/NZS 3695-1. The ISO standards are sold by ISO and were not read for this book; no Ghana wheelchair standard was found (not verified).

What this means for you:

• When a donor or supplier offers chairs, ask for evidence that the model has passed ISO 7176 strength, stability and brake tests, and ask for the product specification sheet. WHO says to read supplier information so you know the products, and to ask for it if it is not given.
• WHO describes problems in many countries where the market is poorly understood, leading to poor-quality products.
• Ask whether spare parts will be available locally: WHO calls for a range of appropriate wheelchairs and spare parts that meet agreed standards.

Inspect a batch of new or donated chairs

A quality sign-off system

1. Every job has a numbered job card.
2. The technician signs the work done.
3. A second person (you or a senior technician) does the safe-and-ready check and the brake test and signs "QC passed".
4. The user (or carer) signs that the chair was returned and the home-care card explained.
5. Warranty: state what you guarantee and for how long (for example "labour 30 days" — an example; choose your own) and write it on the receipt.
6. Complaints book: every complaint, the cause found and the action. Review it each month.

WHO's 2023 guidelines recommend that services measure and evaluate their performance and use the results to improve. Your job cards and complaints book are that measurement.

Check yourself

1. Which ISO series covers wheelchairs, and which covers cushions?
2. Name three causes to check when punctures keep happening.
3. What are the three signatures on a completed job card?

Competency standard

Range. At least four chairs through the line; three made aids. Evidence. Flow plan; stock book; made aids; partner brief.

The refurbishment line

WHO notes that without systems to refurbish and recycle wheelchairs and spare parts, resources are wasted and chairs are abandoned. A line lets a small team refurbish several chairs a week.

Rules for the line: one tray per chair so parts are not mixed; a chair moves on only when its station card is signed; retired chairs go to a scrap-for-parts shelf (good wheels, castors, footrests, bolts), each part checked before re-use.

Stock control

Record every part in (date, supplier, quantity, price) and out (date, job card number, quantity). Count the shelf each month and compare with the book (Unit 6 uses this stock count).

Make simple aids locally

Working with fabrication partners

WHO lists welders, plumbers (metal parts), carpenters, furniture makers and tailors as local people who can help with repairs. As workshop leader you:

1. Write a brief: what to make or repair, sizes, material, deadline, price.
2. Check the partner's skill and, for welding, training and equipment. Ask whether the welder knows the frame metal.
3. Inspect the work before it goes on a chair: welds, smooth edges, strength, finish.
4. Run the full safe-and-ready check yourself.
5. Keep the partner's invoice for your books.

Check yourself

1. Why does each chair on the line have its own tray?
2. Give the WHO size of a transfer board.
3. What do you check before a partner's weld goes onto a chair?

Competency standard

Range. A team of at least two; one outreach clinic; a follow-up register of at least 20 users. Evidence. Work board; training records; clinic report; follow-up register.

Roles and competence

WHO's 2023 guidelines recommend that wheelchair provision roles be done by people with role-specific competencies, and describe clinical, technical, training and management roles. Technical staff assemble, adjust, modify, maintain and repair; training of users may be done by clinical or technical staff or by dedicated trainers, including peer trainers who share their own experience.

The International Society of Wheelchair Professionals offers a free online Basic test based on WHO's Basic level package, with a certificate for those who pass. Encourage technicians to take it once they have Level 2 skills.

Supervising day to day

Apprentices

The 2026 national budget set aside GH¢170 million for the National Apprenticeship Programme. Ask the Assembly or the GEA Business Advisory Centre how a small workshop can take part (not verified). Pay apprentices and casual workers at least the national minimum wage for each day worked, GH¢21.77 a day in 2026.

Run an outreach repair clinic

WHO notes that follow-up can be done at home, at a centre or at another place that suits the user, and that wheelchair services can link follow-up to community-based rehabilitation visits.

Before

1. Agree a date and place with a partner (church, school, disability organisation, health centre). Check it is step-free and shaded.
2. Announce by WhatsApp, radio or the partner a week ahead; ask users to bring their chairs, crutches and frames.
3. Pack the outreach box: tools, pump, tubes, patches, bearings, spokes, ferrules, brake parts, Velcro, foam, job cards, follow-up forms, receipt book, price list.

On the day

4. Set up a check table, a repair table and a teaching corner (peer trainer).
5. Every aid gets a safe-and-ready check and a job card.
6. Fix what you can on the spot; book the rest for the workshop with a date.
7. Pressure care: ask at-risk users about their skin in private; refer any sore the same day.
8. Teach home care to every user and carer.

After

9. Write a clinic report: users seen, jobs done, parts used, money taken, referrals, jobs booked.
10. Enter every user in the follow-up register.

The follow-up register

WHO's guidelines give an example from Argentina where local health workers send photos or videos of users in their chairs, with consent, to distant advisers, and two local people trained in simple repairs fix problems; this cut abandoned wheelchairs. You can do the same by WhatsApp with your partners.

Check yourself

1. Name two things an apprentice may not do in your workshop.
2. What three areas does an outreach clinic set up?
3. When is a child's follow-up due?

Competency standard

Range. The trainee's district. Evidence. Service map; referral forms; a data summary.

The system around you

WHO's 2023 guidelines recommend that identification, referral and service delivery be seamless and integrated across all levels of the health system and other sectors.

Written referral

Use a referral slip for every user you send on, and keep a copy:

• user's name and phone (with consent), age;
• reason: complex postural needs / pressure sore / chair no longer fits / other;
• what you saw (for example "leans to the left; stage 2 sore reported");
• what you have done (for example "brakes repaired; no seating changes made");
• your name, workshop, phone; date.

Ask the user's permission before referring; WHO's sample referral form asks whether the user has agreed. Follow up within a week: did the user get seen?

Records and privacy

• Records about pressure sores and health conditions are sensitive. Keep paper files locked and phone records password-protected. Share only what a partner needs, with the user's consent. Ask the Data Protection Commission whether your business must register (not verified).
• Use your data. Each month count: users served, jobs by type, repeat faults, referrals made and completed, follow-ups done and overdue, complaints. WHO recommends measuring and evaluating provision to strengthen it. Partners and funders want these numbers.

Ethics

• Be honest when a chair is not worth repairing, and when a user needs a different chair.
• Do not sell donated chairs or parts for private profit; follow the donor's terms. The Jomoro Municipal Chief Executive warned recipients not to sell donated wheelchairs.
• Charge fairly; offer a basic service the poorest users can afford, and help them seek funding.
• Persons with disabilities have the right to personal mobility with the greatest possible independence (Article 20 of the UN Convention). Your work serves that right.

Check yourself

1. Name four items on a referral slip.
2. Why must health information be kept locked?
3. Name three numbers to report each month.

Competency standard

Range. The trainee's own business plan. Evidence. Registration checklist with costs; payroll sheet; start-up budget.

Choose a legal form

Companies file annual returns, GH¢175 a year, with late fees from GH¢1,000.

Tax

• Your Ghana Card number is your tax number (TIN); a company gets a TIN after registering.
• Income tax (sole trader). Residents with business income only, not VAT-registered, with turnover from GH¢20,001 to GH¢750,000 a year, may pay 3% of turnover under the Modified Taxation Scheme. GRA's own page still showed GH¢500,000 in October 2026; the higher ceiling comes from the Income Tax (Amendment) Act 2026.
• Companies pay 25% standard corporate income tax.
• VAT. VAT is 20% in total from 2026. Under the VAT Act 2025 there is no turnover threshold for services: a person making taxable supplies of services registers within 30 days of starting, unless the GRA Commissioner-General permits otherwise; goods have a GH¢750,000 threshold. Repair is a service. Before you open, ask GRA Takoradi in writing: must a small repair workshop register for VAT, and are repairs or parts for persons with disability exempt or relieved? (Not verified.) A VAT-registered business cannot use the Modified Taxation Scheme.
• Withholding tax. Large clients such as Assemblies may withhold 7.5% of what they pay you for services; ask for the withholding certificate and keep it.

Permits, insurance and records

Employing staff

• Pay at least GH¢21.77 a day.
• SSNIT: worker 5.5% plus employer 13% of basic salary, paid by the 14th of the next month; register workers when you hire them.
• PAYE: first GH¢588 a month tax-free, then 5% on the next GH¢80, 10% on the next GH¢100, 17.5% on the next GH¢2,900; deduct SSNIT 5.5% first; pay by the 15th.
• Labour Act: a written contract for work of six months or more (s.12); written terms within two months (s.13); 15 working days' paid leave a year (s.20); 12 weeks' maternity leave (s.57); casual workers paid the full minimum for each day (s.74).

Premises and start-up budget

Premises checklist: step-free ground floor; room for chairs to turn; a seated workbench; secure storage for users' chairs overnight; water for washing; good light and ventilation for glue and paint; near transport and parts shops.

Finance options

• Own savings, susu and VSLA groups.
• GEA: Business Advisory Centres in Takoradi, Shama, Effia-Kwesimintsim, Mpohor and Ahanta West. GEA ran a PWD Enterprise Support Programme in 2023 with about GH¢12 million of grants and technical help for 150 businesses owned by persons with disabilities; grants could pay for equipment repair, working capital, rent and product certification. Ask whether a new round is open.
• Assemblies' disability fund: 5% from 2026, aimed at assistive devices, skills training and start-up capital. A disabled owner may qualify for start-up support; the Assembly may also buy your services.
• Microfinance and banks: bring your plan and records (Unit 6).
• Donors and companies: after-care contracts for the chairs they give.

Accessibility

Ghana's Persons with Disability Act 2006 (Act 715) required public buildings and services to become accessible by 2016, and set employment expectations for persons with disabilities, but disability groups report weak enforcement. A mobility-aid workshop owned or staffed by persons with disabilities is a strong model: users trust people with lived experience, and WHO names peer trainers as good trainers for users. Every task in this book has a seated option; lifting chairs onto benches can use a short ramp or a partner; deaf staff use written job cards and picture price lists; blind staff can lead user training and phone follow-up, with tactile tool boards and labelled trays.

Check yourself

1. Which ORC form suits two technicians who want to own a workshop together, and what does it cost?
2. Why might VAT apply to a repair workshop even with a small turnover?
3. By what dates must SSNIT and PAYE be paid?

Competency standard

Range. One month of real or example records. Evidence. Books; statements; reconciliation; break-even; forecast.

The records

Keep records for at least 6 years. Keep owner's money and business money apart: pay yourself a fixed amount (drawings) from the business account.

Three rules. Assets = liabilities + owner's equity. Straight-line depreciation = (cost − end value) ÷ years of use. Small businesses' accounts follow IFRS for SMEs; a new edition applies from 1 January 2027.

Worked example (all figures are examples)

Trial check and month-end routine

1. Add up the cash book and MoMo book; compare with the cash counted and the MoMo and bank statements (reconciliation). Explain every difference.
2. Count the stock shelf; compare with the stock book.
3. Update debtors and creditors.
4. Post depreciation for the month.
5. Prepare profit and loss and balance sheet. Check: assets = liabilities + equity.
6. Pay SSNIT by the 14th and PAYE and withholding tax by the 15th.
7. File the month's papers in one envelope or folder.

Sample cash book page (from the worked example, first lines)

Costing and pricing a job

Price = parts + labour + share of overheads + profit. Margin and mark-up are different: a GH¢200 job that costs GH¢150 has a mark-up of 50 ÷ 150 = 33% on cost but a margin of 50 ÷ 200 = 25% of price.

Break-even

Software and the calendar

Use a spreadsheet, or a free plan such as Zoho Books or Wave.

Check yourself

1. Why is the Assembly's unpaid GH¢9,000 profit but not cash?
2. How is monthly depreciation of GH¢9,600 of tools over 4 years worked out?
3. What is the difference between mark-up and margin?

Competency standard

Range. The trainee's own business. Evidence. Proposal; 12-month cash forecast; capstone presentation.

Growth options

Location settings that give good returns

Winning a contract: a one-page proposal

1. The problem in the partner's words (for example "chairs given out in 2025 are breaking").
2. What you will do (check, repair, refurbish, train, follow up), where and how often.
3. Price per chair or per visit, what is included, payment terms.
4. Quality and safety: QC sign-off, the complex-needs rule, pressure-sore referral, data privacy.
5. Reporting: the monthly numbers from Unit 4.
6. About you: registration, insurance, team, references.

Remember that a large client may withhold tax and pay late: plan your cash for 60 days or more.

Market yourself

• WhatsApp Business catalogue and a Google Business Profile marked step-free.
• A clear sign readable from a seated position.
• Referral slips with physiotherapists and disability groups.
• A portfolio: job numbers, before-and-after photos with consent, partner letters.
• Talk at disability organisation meetings and on local radio about home care.

Ethics and succession

• Train at least one person who could run the workshop if you are ill.
• Keep the follow-up register and job cards so another technician can take over.
• Never trade safety for speed or price; never sell donated items for private profit.

Capstone: 12-month cash forecast (example)

A new workshop starts in January. Owner puts in GH¢15,000 and receives a GH¢6,000 loan in month 1. Equipment GH¢9,600 in month 1. Cash sales grow from GH¢4,000 to GH¢8,000 a month. Parts cost 40% of cash sales. An Assembly refurbishment contract runs in months 2, 5, 8 and 11 (GH¢3,500 of extra parts each time) and pays GH¢9,000 two months later (months 4, 7 and 10; the month 11 job is paid in the next year). Fixed costs are GH¢3,500 a month. Loan repayments of GH¢500 and owner's drawings of GH¢1,000 a month start in month 3. (All figures are examples.)

Check yourself

1. Name three growth options for a mobility-aid workshop.
2. Why must a forecast plan for late payment from big clients?
3. Name the six parts of a one-page proposal.

1. Name the five root-cause questions.
2. What do ISO 7176 and ISO 16840 Part 2 cover?
3. Name the eight stations of a refurbishment line.
4. What size is a WHO transfer board?
5. Which roles in your workshop may do QC sign-off?
6. How often should a child's chair be followed up?
7. Name four items on a referral slip.
8. Name the four ORC business forms and their 2026 fees.
9. What is the VAT question to ask GRA before opening?
10. Work out SSNIT for a GH¢1,500 basic wage (worker and employer).
11. Write the balance sheet equation.
12. Why is a debtor not cash?

Best next reads: WHO Wheelchair provision guidelines (2023); WHO Wheelchair Service Training Package, Basic and Intermediate levels; the Hub's Money Skills Level 2, Entrepreneurial Thinking Level 2 and Basic Welding manuals.

What this module does not cover: clinical assessment and postural support for users with complex needs (trained wheelchair service professionals only), electric wheelchair electronics and batteries, welding (see the Hub's Basic Welding), and legal or tax advice for your own case (ask ORC, GRA, SSNIT and your Assembly).

Every source used in this manual is listed, with links, in the Teacher Copy.