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MacLachlan M, Banes D, Bell D, Borg J, Donnelly B, Fembek M, Ghosh R, Gowran RJ, Hannay E, Hiscock D, Hoogerwerf EJ, Howe T, Kohler F, Layton N, Long S, Mannan H, Mji G, Odera Ongolo T, Perry K, Pettersson C, Power J, Delgado Ramos V, Slepičková L, Smith EM, Tay-Teo K, Geiser P, Hooks H. Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disabil Rehabil Assist Technol 2018; 13:454-466. [PMID: 29790393 DOI: 10.1080/17483107.2018.1468496] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors. To seize the opportunity that assistive technology offers, regional, national and sub-national assistive technology policies are urgently required. This paper was developed for and through discussion at the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit; organized under the auspices of the World Health Organization's Global Collaboration on Assistive Technology (GATE) program. It outlines some of the key principles that AT polices should address and recognizes that AT policy should be tailored to the realities of the contexts and resources available. AT policy should be developed as a part of the evolution of related policy across a number of different sectors and should have clear and direct links to AT as mediators and moderators for achieving the Sustainable Development Goals. The consultation process, development and implementation of policy should be fully inclusive of AT users, and their representative organizations, be across the lifespan, and imbued with a strong systems-thinking ethos. Six barriers are identified which funnel and diminish access to AT and are addressed systematically within this paper. We illustrate an example of good practice through a case study of AT services in Norway, and we note the challenges experienced in less well-resourced settings. A number of economic factors relating to AT and economic arguments for promoting AT use are also discussed. To address policy-development the importance of active citizenship and advocacy, the need to find mechanisms to scale up good community practices to a higher level, and the importance of political engagement for the policy process, are highlighted. Policy should be evidence-informed and allowed for evidence-making; however, it is important to account for other factors within the given context in order for policy to be practical, authentic and actionable. Implications for Rehabilitation The development of policy in the area of asssitive technology is important to provide an overarching vision and outline resourcing priorities. This paper identifies some of the key themes that should be addressed when developing or revising assistive technology policy. Each country should establish a National Assistive Technology policy and develop a theory of change for its implementation.
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Affiliation(s)
- Malcolm MacLachlan
- a Assisting Living & Learning (ALL) Institute, Maynooth University , Maynooth , Ireland.,b Centre for Rehabilitation Studies , Stellenbosch University , Tygerburg , South Africa.,c Olomouc University Social Health Institute, Palacky University Olomouc , Olomouc , Czech Republic
| | | | - Diane Bell
- e Centre for Rehabilitation Studies, Stellenbosch University , Cape Town , South Africa
| | | | | | | | | | - Rosemary Joan Gowran
- j Department of Clinical Therapies, Faculty of Education and Health Sciences , University of Limerick , Limerick , Ireland
| | | | | | | | - Tracey Howe
- n Glasgow Caledonian University , Glasgow , UK
| | - Friedbert Kohler
- o Hammond Care Braeside Hospital, University of New South Wales , Sydney , Australia
| | - Natasha Layton
- p Department of Health Professions, Swinburne University of Technology , Hawthorn , Australia
| | - Siobhán Long
- q Assistive Technology and SeatTech Services , Enable Ireland , Dublin , Ireland
| | - Hasheem Mannan
- r Health Systems Research Group , University College Dublin , Dublin , Ireland
| | - Gubela Mji
- b Centre for Rehabilitation Studies , Stellenbosch University , Tygerburg , South Africa
| | | | - Katherine Perry
- t Independent Consultant & Policy Advocate , Brussels , Belgium
| | - Cecilia Pettersson
- u Department of Architecture and Civil Engineering , Chalmers University of Technology , Goteborg , Sweden
| | - Jessica Power
- v Centre for Global Health , Trinity College Dublin , Dublin , Ireland
| | | | - Lenka Slepičková
- x Olomouc University Social Health Institute, Palacky University Olomouc , Olomouc , Czech Republic
| | - Emma M Smith
- y Graduate School, University of British Columbia , Vancouver , British Columbia , Canada
| | - Kiu Tay-Teo
- z Melbourne School of Population and Global Health , Melbourne University , Melbourne , Australia
| | | | - Hilary Hooks
- a Assisting Living & Learning (ALL) Institute, Maynooth University , Maynooth , Ireland
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McVeigh J, MacLachlan M, Gilmore B, McClean C, Eide AH, Mannan H, Geiser P, Duttine A, Mji G, McAuliffe E, Sprunt B, Amin M, Normand C. Promoting good policy for leadership and governance of health related rehabilitation: a realist synthesis. Global Health 2016; 12:49. [PMID: 27558240 PMCID: PMC4997679 DOI: 10.1186/s12992-016-0182-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/01/2016] [Indexed: 11/26/2022] Open
Abstract
Background Good governance may result in strengthened performance of a health system. Coherent policies are essential for good health system governance. The overall aim of this research is to provide the best available scientific evidence on principles of good policy related leadership and governance of health related rehabilitation services in less resourced settings. This research was also conducted to support development of the World Health Organization’s (WHO) Guidelines on health related rehabilitation. Methods An innovative study design was used, comprising two methods: a systematic search and realist synthesis of literature, and a Delphi survey of expert stakeholders to refine and triangulate findings from the realist synthesis. In accordance with Pawson and Tilley’s approach to realist synthesis, we identified context mechanism outcome pattern configurations (CMOCs) from the literature. Subsequently, these CMOCs were developed into statements for the Delphi survey, whereby 18 expert stakeholders refined these statements to achieve consensus on recommendations for policy related governance of health related rehabilitation. Results Several broad principles emerged throughout formulation of recommendations: participation of persons with disabilities in policy processes to improve programme responsiveness, efficiency, effectiveness, and sustainability, and to strengthen service-user self-determination and satisfaction; collection of disaggregated disability statistics to support political momentum, decision-making of policymakers, evaluation, accountability, and equitable allocation of resources; explicit promotion in policies of access to services for all subgroups of persons with disabilities and service-users to support equitable and accessible services; robust inter-sectoral coordination to cultivate coherent mandates across governmental departments regarding service provision; and ‘institutionalizing’ programmes by aligning them with preexisting Ministerial models of healthcare to support programme sustainability. Conclusions Alongside national policymakers, our policy recommendations are relevant for several stakeholders, including service providers and service-users. This research aims to provide broad policy recommendations, rather than a strict formula, in acknowledgement of contextual diversity and complexity. Accordingly, our study proposes general principles regarding optimal policy related governance of health related rehabilitation in less resourced settings, which may be valuable across diverse health systems and contexts.
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Affiliation(s)
- Joanne McVeigh
- Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland.,School of Psychology, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Malcolm MacLachlan
- Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland. .,School of Psychology, Trinity College Dublin, College Green, Dublin 2, Ireland. .,Centre for Rehabilitation Studies, Medicine and Health Sciences Faculty, Stellenbosch University, P.O. Box 241, Cape Town, 8000, South Africa.
| | - Brynne Gilmore
- Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland
| | - Chiedza McClean
- Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland
| | - Arne H Eide
- Centre for Rehabilitation Studies, Medicine and Health Sciences Faculty, Stellenbosch University, P.O. Box 241, Cape Town, 8000, South Africa.,SINTEF Technology and Society, P.O. Box 124 Blindern, NO-0314, Oslo, Norway.,Department of Health Science, Norwegian University of Science and Technology, Tungasletta 2, 7047 Trondheim, Norway
| | - Hasheem Mannan
- School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Priscille Geiser
- Handicap International Fédération, 138, avenue des Frères Lumière, 69008, Lyon, France
| | - Antony Duttine
- Handicap International, 8757 Georgia Avenue, Suite 420, Silver Spring, MD 20910, USA
| | - Gubela Mji
- Centre for Rehabilitation Studies, Medicine and Health Sciences Faculty, Stellenbosch University, P.O. Box 241, Cape Town, 8000, South Africa
| | - Eilish McAuliffe
- School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Beth Sprunt
- Nossal Institute for Global Health, Level 4, Alan Gilbert Building, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, 3010, Australia
| | - Mutamad Amin
- Ahfad University for Women, P.O. Box 167, Omdurman, Sudan
| | - Charles Normand
- Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland.,Health Policy & Management, Trinity College Dublin, Room 0.21, 3-4 Foster Place, College Green, Dublin 2, Ireland
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Abstract
1. Safer-sex education is crucial for controlling the spread of HIV and this education is within the realm of nursing practice. 2. Safer-sex education for persons with mental illness must include repetitive, interactive education capitalizing on verbal, visual, written, tactile, and motor skill teaching methods to compensate for learning disabilities that have been identified in this population. 3. In this study, individual rather than a group teaching approach to the sensitive subject of safer-sex provided the most learning. The study subjects did not exhibit overt sexual behavior, increased sexual acting out, regression, or overstimulation when safer-sex education was presented.
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Affiliation(s)
- K Hajagos
- Nursing Service, Research, Department of Veterans Affairs Medical Center, Northport, New York 11768, USA
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