Provision of Global Prosthetics and Orthotics Services: A Position Paper on Systems, Context, and Pathways for Shaping Collaborative Progress

Background: Advances in prosthetic and orthotic device design, materials, digital technologies, and clinical education have expanded what is possible. However, access to high-quality and contextually appropriate services remains uneven, particularly in low and middle-income countries where service models are fragmented, workforce development is limited, and assistive technologies are constrained by trade and regulatory barriers. Objectives: This position paper provides a state-of-the-art overview of prosthetics and orthotics service provision, with particular focus on resource-constrained settings, drawing on interdisciplinary evidence and expert insight to describe strengths, gaps, and priorities for change. Results: The paper reviews six domains: education and training, service provision, advances in technology and their global reach, international initiatives and organizations, the case for interdisciplinary collaboration, and the influence of local context, culture, and national systems. Across these domains, it highlights how inequalities arise from the interaction of clinical capacity, financing, policy, and trade. Examples from Cambodia, Sri Lanka, Ukraine, and other settings illustrate how digital tools, mixed methods research, and locally led innovation can inform more responsive services, but also how externally driven models can undermine sustainability when they are not aligned with local systems. The role of collaborative research networks in generating shared evidence and guidance is emphasized. Conclusions: The paper concludes with recommendations to strengthen prosthetics and orthotics by investing in contextual education, sustainable service models, appropriate technology pathways, regulatory and trade reforms, and support for interdisciplinary and user-engaged research. It argues that coordinated, evidence-informed, and culturally responsive action is needed if ambitions for equitable access to prosthetic and orthotic care are to be realized. Clinical Relevance Statement: This paper identifies practical priorities for improving prosthetic and orthotic services, including workforce development, sustainable service delivery, context-appropriate technology adoption, and stronger system coordination. These insights are directly relevant to clinicians, educators, and service leaders working to improve equitable access and long-term outcomes in diverse practice settings. ( J Prosthet Orthot . 2026;X:XX–XX)