Measuring Current Usage of Silicone Gel Liners and the Potential Impact of 
Access to a Low-Cost Version for Prosthesis Users in Low-Income Settings: 
Results from a Survey of International Direct Care Providers

BACKGROUND
In the developing world, prosthetic care is far less accessible than in middle and high income countries(1).  This includes a critical component, the elastomeric liner, which serves as a cushioning layer between the residual limb and the prosthetic socket to protect the limb from force, and increase the stability and comfort of the prosthesis enabling higher levels of activity.(2)  For lower-limb amputees a quality liner is critical to standing for long periods and being productive at work and play. A standard component available to amputees in wealthy countries for more than 30 years – silicone gel prosthetic liners, are still not readily available in many low-resource settings. Financially disadvantaged amputees are often using liners made of inferior materials or using their liner long beyond its recommended lifespan reducing prosthesis performance and limiting the ability to secure gainful employment and enjoy an active family and social life.

In April 2022 Operation Namaste launched a research effort to gather data to guide distribution planning and funding development for the ‘Namaste Liner’ and ‘Namaste Limb Solutions’; the low-cost silicone prosthetic liner and DIY manufacturing package developed by Operation Namaste.  This survey, designed to quantify the current availability of silicone gel liners in the developing world and estimate the potential impact of a low-cost version, is a key element of that market research.