Reducing Costs, Increasing Care: A New Approach to Prosthetic Rehabilitation

By Ncedo Ludada

Founder & Managing Director

MSc Business Administration* (Reg)

MSc Clinical Rehabilitation (Aus)

BSc Orthotics and Prosthetics (TZ)

Introduction

Blue Ocean Strategy

Historically, efforts to reduce healthcare costs have often focused on limiting the scope of care — a practice that has, unfortunately, contributed to widening disparities across the healthcare system.

In a world where the divide between private and public healthcare continues to grow, we chose to take a different path. We took a bold step to close that gap, even if just for one child. We donated a private-standard prosthetic leg to 8-year-old Zingce Mzimela — not as a social compliance exercise or a public relations initiative, but because we believe in addressing the deeper, systemic issues head-on. The reality is that current prosthetic care models are not working effectively or efficiently for many — whether in the private or public sectors. Access, affordability, and quality often fall short, leaving patients with compromised outcomes or out of pocket payments.

To explore this issue meaningfully and to help educate the broader public, we are going to use Zingce business case study not only to highlight the challenges but also to inspire new solutions — so that more individuals like Zingce can receive the care they truly deserve, regardless of their background or means. Through a blue ocean strategy of reducing cost and increasing value to the patient.

The Motive behind Donating the Prosthetic Leg

Responsible Consumption and Production

At Ludada and Associates Orthopaedic Services we don’t believe that donations cannot change the world under the current profit driven business models.

After all, as the saying goes, “You cannot pour from an empty cup.” Donations only work when you’ve accumulated enough for yourself to give, when your own resources are overflowing. But in Zingce’s case, our donation wasn’t just about giving only—it was about educating the public and shifting the mindset around the way prosthetic healthcare is approached in South Africa.

In order to shift towards sustainable practices that show responsible consumption and production in order to have equitable access (SDG 3) to prosthetic limbs.

A Call for Change in Healthcare Models

Linear Economy

The current business model—focused mainly on maximizing profits—does not serve the greater good. While businesses strive for profit, an impactful business is one that balances good and profit. Impact-driven businesses are designed to enhance human capacity while still being financially viable, rather than solely aiming for bottom-line gains.

Why is the current model failing both private and public sectors? Let’s look at the case of Zingce. The cost of her prosthetic leg, which we donated, would have been R246,000 in South Africa’s private healthcare system. For many individuals, this is simply unaffordable. Based on our 8 years of experience working with Road Accident Fund (RAF) and Compensation of Injury on Duty (COIDA) sectors, such amounts are typically covered, but this option is limited to those with specific insurance or compensation plans. On the other hand, medical aid schemes in South Africa would only cover half of the cost—around R123,000—with the remaining shortfall falling to the member to cover out of pocket.

Meanwhile, those in the public sector without medical insurance face an even bleaker reality, as a below-knee prosthetic can cost a minimum of R40,000, and an above-knee prosthetic with a minimum of R80,000.

To which our recent social media market research that reached of 350 amputees, 97% of the demographic could not afford these minimum prosthetic prices. However, on the promising side 38% indicated they could afford to pay at least 50% of the cost of their prosthetic legs, while 58% could only manage at most 30%.

Private vs. Public Sector: The Struggle for Access to Quality Healthcare

Equity over Equality

This scenario makes it evident that there is a significant gap in the system: high-cost concerns in the private sector versus low technology and limited access in the public sector.

Many in the public healthcare system are forced to rely on standard outdated and lower-quality prosthetics (equality) simply because they cannot afford the high-tech, high-quality options available in the private sector. The old approach of cutting costs by reducing care is no longer sufficient. We need to rethink how healthcare is delivered and how we can create systems that reduce costs while simultaneously increasing care quality. We cannot continue to ignore the gaps between private (equity) and public healthcare (equality), especially when the most vulnerable, like amputees, are left behind.

A New Approach: Reducing Cost While Increasing Care

Prosthetic Upgrade Service

Our donation to Zingce is part of a bigger picture: a new approach to healthcare that balances cost reduction with increased care.

It’s about finding innovative solutions that allow us to provide better, more accessible care to everyone, regardless of their socioeconomic status. One example of our current running innovation is the Prosthetic Upgrade Program, which aims to help upgrade low-quality public prosthetic legs to a private standard at a minimal cost. This initiative ensures that those who receive prosthetics through public healthcare aren’t stuck with outdated, subpar technology, but can instead enjoy the benefits of high-quality, functional prosthetics—without the overwhelming financial burden. Secondly, the circular Prosthetic Upgrade Program has resulted to 21-38% cost reduction for medical insurances.

Which would save medical aid members from either copayment or reinvest to increase the quality of technology beyond Prescribed Minimum Benefits. 

Conclusion

Zingce’s story is not just about a single act of giving—it is a call to action for a healthcare system in urgent need of transformation.

At Ludada and Associates Orthopaedic Services, we envision a future where quality prosthetic care is not a privilege, but a basic human right accessible to all. Through initiatives like the Prosthetic Upgrade Program and our commitment to balancing cost efficiency with technological excellence, we are demonstrating that it is possible to bridge the gap between public and private healthcare. True impact is achieved not by reducing the scope of care, but by reimagining how we deliver it—innovatively, compassionately, and inclusively. Our hope is that Zingce’s journey sparks a broader conversation and inspires collective action, so that no child, no individual, ever has to settle for less simply because of financial constraints.

Healthcare must evolve — and together, we can build a system that empowers, uplifts, and restores dignity to every patient it touches.