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Ardianuari S, Pasaribu E, Amannullah G, Prana A, Widiyanta E. Assistive technology unmet need in Indonesia: challenges and opportunities for enhancing equitable access. Disabil Rehabil Assist Technol 2024; 19:2026-2037. [PMID: 37610101 DOI: 10.1080/17483107.2023.2244996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE To analyze the rapid Assistive Technology Assessment (rATA) data and identify challenges and opportunities for improving access to assistive technology products (AP) in Indonesia. MATERIALS AND METHODS An explanatory sequential mixed-methods design consisting of a quantitative survey and a qualitative interview study was used. The rATA survey was administered to households in two randomly sampled provinces to collect data on AP met and unmet need. Descriptive statistics was used to analyze the survey data. Qualitative data were collected from unstructured videorecorded interviews with rATA policymakers. Interview transcripts were coded and analyzed using thematic analysis. RESULTS On average, data from rATA respondents (n = 11,300) revealed 60% of AP unmet need. A high proportion of funding sources came from the private sector, and contributions from the government remained low. Affordability and funding were the main barriers to access. From the policymaker interviews (n = 5), four essential themes emerged, i.e., "resources and workforce", "funding", "laws and policies", and "guidelines and standards". From each theme, key challenges and opportunities were identified. CONCLUSIONS Affordability remained a major challenge, in part because government-sponsored funding was still inadequate, forcing people with low financial status to self-produce AP. One potential opportunity would be to localize AP production and improve local workforce training. Integrated national funding schemes and intersectoral coordination could accelerate improvement in meeting AP unmet need. This study may provide evidence of current challenges and opportunities to help improve the field of rehabilitation through enhanced access to AP services in Indonesia.
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Affiliation(s)
- Satria Ardianuari
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Ester Pasaribu
- Public Health and Health Promotion, Griffith University, Gold Coast, Australia
| | | | - Adhi Prana
- Ministry of National Development Planning (BAPPENAS), Jakarta, Indonesia
| | - Eka Widiyanta
- Association of Health Services (ADINKES), Jakarta, Indonesia
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Brien M, Krishna D, Borish M, Coutinho F, Bernardo A, Shah SR, Venkatachalaphy N. Enabling local provision of assistive products in rural South India: an organisational survey of needs, barriers, and facilitators. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38419594 DOI: 10.1080/17483107.2024.2321601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
Objective: Access to assistive products (APs) is essential to maximising function, participation, and inclusion of persons with disabilities. Challenges to AP access in low- and middle-income countries include stigma, costs, supply, and rehabilitation capacity gaps. This study aimed to examine AT access in the context of a low-resource setting in rural South India. Objectives were to examine rehabilitation professionals' perceptions of AP needs, barriers and facilitators of AP provision, and AT knowledge.Methods: A descriptive study design with a 2-part online survey methodology was utilized. This study was conducted in April-September 2020 at a non-governmental organization (NGO) serving children and adults with disabilities in 3 districts of rural South India. Purposive sampling of NGO's multidisciplinary rehabilitation professionals (N=62) was used. The survey was developed based on WHO's Assistive Products List (APL). Barriers and facilitators were classified according to the principles of AT access. Analyses revealed acceptability, affordability, and availability as the top three barrier themes across disciplines, including poor acceptance by clients/families due to stigma, high AP costs, and a long waitlist for government-provided devices. Acceptability, affordability, and accessibility were the top three facilitator themes, including community awareness, availability of AP funding, client/family education, and AT service provision training.Impact: Our study identified key enabling strategies for AT access, aimed at reducing reported barriers. Enabling AP provision was determined to be multi-factorial, aimed at users/ families, service providers, organizations, communities, and policymakers. Local stakeholder groups are crucial to understanding challenges and opportunities to AP provision within a low-resource context.
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Affiliation(s)
- Marie Brien
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
| | - Dinesh Krishna
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Margo Borish
- Faculty of Social Sciences, Applied Disability Studies, Brock University, St Catharines, Canada
| | - Franzina Coutinho
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Abigail Bernardo
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Syeda Rafia Shah
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Domingues CDA, Laplane ALF. Assistive technology in public policies: trends in the international debate and implications for Brazil. Disabil Rehabil Assist Technol 2024:1-13. [PMID: 38372271 DOI: 10.1080/17483107.2024.2316896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE The objectives of this study(1) were threefold: to identify the main topics related to the international debate on Assistive Technology (AT) public policies, to analyze the Brazilian case in light of these topics, and to extract lessons that could be applied in Brazil and other countries to advance progress in the field. METHODOLOGY A qualitative study was conducted through a critical literature review, involving the search for, selection, and analysis of articles indexed in two information source portals and four databases from 2007 to 2023. International and Brazilian laws, reports, and other publications specifically related to AT policies were also included. RESULTS The analysis of 186 articles and Brazilian documents facilitated the examination of four themes: AT policies from a human rights perspective, public procurement, service delivery systems, and national plans. A subset of 107 publications was then selected for detailed analysis. DISCUSSION Initiatives such as implementing a national plan, establishing an AT research center, and creating a product catalog are considered virtuous. Enhancing the freedom of choice for products and developing public procurement mechanisms are identified as additional strategies to reinforce protections of human rights in Brazil. CONCLUSIONS Policy dynamics and national and international experiences suggest the potential for expanding initiatives and creating new solutions in Brazil. Universities and other scientific institutions emerge as promising loci for generating new knowledge to support the formulation of AT policies and facilitate their debate and further development.
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Senjam SS, Mannan H. Assistive technology: The current perspective in India. Indian J Ophthalmol 2023; 71:1804-1809. [PMID: 37203033 PMCID: PMC10391423 DOI: 10.4103/ijo.ijo_2652_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
The world, today, recognizes the increasing importance of assistive technology (AT) that can reduce the functional limitations of persons with disabilities, individuals with chronic debilitating diseases, and elders. This indicates that at some point, everyone, either temporary or permanent, will require AT to improve their physical and functional abilities, thus contributing to independent living, social inclusion, and education. Besides this, the need for AT will be growing with a majority from low-middle-income countries. The same is true for India though we are not sure how many people have met a need, and unmet need for AT to date, but the requirement will continue to increase. There is a significant gap between needs and access to AT. Recently, the WHO has led many initiatives related to AT services after the 71st World Health Assembly's resolution in 2018, to improve access to AT for its member states. The UN Sustainable Development Goals (SDGs) have pledged that no one should be left behind irrespective of personal characteristics. India, a ratified member state, needs to align with various initiatives undertaken by the WHO and the UN. Despite many challenges, India needs to formulate evidence-based AT policy, planning within the purview of the healthcare delivery system in collaboration with various government and nongovernment sectors, including industries. This article explores the need, access, and potential challenges associated with AT services in India. Finally, we discussed various initiatives on AT in the country and possible recommendations to improve AT services across.
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Affiliation(s)
- Suraj S Senjam
- Assistive Technology, Vision Rehabilitation, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Hasheem Mannan
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Baird S, Abu Hamad B, Baniodeh K, Carew M, Goel N, Ismail A, Oakley E, Seager J, Woldehanna T, Jones N. Creating a better post-pandemic future for adolescents with disabilities. BMJ 2023; 380:e072343. [PMID: 36940979 PMCID: PMC10028661 DOI: 10.1136/bmj-2022-072343] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
Adolescents with disabilities must have their needs prioritised in recovery and future pandemic responses to improve health, educational, and social outcomes, argue Sarah Baird and colleagues
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Affiliation(s)
- Sarah Baird
- Department of Global Health, George Washington University, Washington DC, USA
| | | | - Kifah Baniodeh
- Gender and Adolescence: Global Evidence, Ramallah, State of Palestine
| | | | - Nimisha Goel
- Norway India Partnership Initiative, New Delhi,India
| | | | - Erin Oakley
- Department of Global Health, George Washington University, Washington DC, USA
| | - Jennifer Seager
- Department of Global Health, George Washington University, Washington DC, USA
| | - Tassew Woldehanna
- Department of Economics, Addis Ababa University, Addis Ababa, Ethiopia
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Pinilla-Roncancio M. Multidimensional Measures and the Extra Costs of Disability: How Are They Related? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2729. [PMID: 36768094 PMCID: PMC9916346 DOI: 10.3390/ijerph20032729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/18/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
People with disabilities are more likely than individuals without disabilities to face higher levels of deprivation and multidimensional poverty, and those deprivations might be associated with the extra costs of living with a disability. However, there has not been an analysis of how multidimensional poverty measures are related to the extra costs of disability or whether these measures can be used as a proxy of the standard of living in the analysis of the extra costs of disability. This paper aims to analyse whether multidimensional poverty measures can be used to study the extra costs of disability and, based on the capability approach, how multidimensional poverty is related to the extra costs of disability. This paper discusses theoretical, technical, and methodological aspects to be considered when studying the relationship between extra costs and multidimensional poverty, and we used data from Chile and Nigeria to illustrate this relationship. We conclude that when analysing the extra costs of disability, multidimensional measures might be an option; however, it is necessary to clearly stablish the relationship among income, deprivation, and the extra costs of disability.
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Borg J, Zhang W, Smith EM, Holloway C. Introduction to the companion papers to the global report on assistive technology. Assist Technol 2021; 33:1-2. [PMID: 34951823 DOI: 10.1080/10400435.2021.2003658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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