Assistive Technology

Rehabilitative and Assistive Technology

Rehabilitative and assistive technologies are tools, equipment, or products that can help people with disabilities function successfully at school, home, work, and in the community.

Assistive technology can be as simple as a magnifying glass or as complex as a digital communication system. An assistive device can be as large as a power wheelchair lift for a van or as small as a handheld hook that assists with buttoning a shirt.1

Tools to help people recover or improve their functioning after injury or illness are sometimes called “rehabilitative technology.” But the term is often used interchangeably with the term “assistive technology.”

NICHD supports research on developing and evaluating technologies, devices, instruments, and other aids to help people with disabilities achieve their full potential.

Source: Rehabilitative and Assistive Technology, NIH, 2018

WHO on Assistive Technology for the Disabled

Key facts

  • Assistive technology is an umbrella term covering the systems and services related to the delivery of assistive products and services.

  • Assistive products maintain or improve an individual’s functioning and independence, thereby promoting their well-being.

  • Hearing aids, wheelchairs, communication aids, spectacles, prostheses, pill organizers and memory aids are all examples of assistive products.

  • Globally, more than 1 billion people need 1 or more assistive products.

  • With an ageing global population and a rise in noncommunicable diseases, more than 2 billion people will need at least 1 assistive product by 2030, with many older people needing 2 or more.

  • Today, only 1 in 10 people in need have access to assistive products.

Assistive technology enables people to live healthy, productive, independent, and dignified lives, and to participate in education, the labour market and civic life. Assistive technology reduces the need for formal health and support services, long-term care and the work of caregivers. Without assistive technology, people are often excluded, isolated, and locked into poverty, thereby increasing the impact of disease and disability on a person, their family, and society.

Today, only 1 in 10 people in need have access to assistive technology due to high costs and a lack of awareness, availability, trained personnel, policy, and financing.

Who can benefit from assistive technology?

People who most need assistive technology include:

  • people with disabilities

  • older people

  • people with noncommunicable diseases such as diabetes and stroke

  • people with mental health conditions including dementia and autism

  • people with gradual functional decline.

Health, well-being and socioeconomic benefits

Assistive technology can have a positive impact on the health and well-being of a person and their family, as well as broader socioeconomic benefits. For example:

  • Proper use of hearing aids by young children leads to improved language skills, without which a person with hearing loss has severely limited opportunities for education and employment

  • Manual wheelchairs increase access to education and employment while reducing healthcare costs due to a reduction in the risk of pressure sores and contractures.

  • Assistive technology can enable older people to continue to live at home and delay or prevent the need for long-term care

  • Therapeutic footwear for diabetes reduces the incidence of foot ulcers, preventing lower limb amputations and the associated burden on health systems

Unmet global need for assistive technology

Across the globe, many people who need assistive technology do not have access to it. Examples of the unmet global need for assistive technology include:

  • 200 million people with low vision who do not have access to assistive products for low-vision.

  • 75 million people who need a wheelchair and only 5% to 15% of those in need who have access to one.

  • 466 million people globally experience hearing loss. Hearing aid production currently meets less than 10% of the global need.

  • Huge workforce shortages in assistive technology: over 75% of low-income countries have no prosthetic and orthotics training programmes. Countries with the highest prevalence of disability-related health conditions tend to be those with the lowest supply of health workers skilled in provision of assistive technology (as low as 2 professionals per 10 000 population)

Lack of affordability in low-income countries is a major reason people in need do not possess assistive products

Challenges

Policy

Very few countries have a national assistive technology policy or programme.

In many countries, access to assistive technology in the public sector is poor or non-existent. Even in high-income countries, assistive products are often rationed or not included within health and welfare schemes, leading to high out-of-pocket payments by users and their families.

For example, it is common policy in a number of European countries for the state to provide older people with only 1 hearing aid, despite the fact that most people with age related hearing loss require 2 hearing aids to function.

Products

The assistive products industry is currently limited and specialized, primarily serving high-income markets. There is a lack of state funding, nationwide service delivery systems, user-centred research and development, procurement systems, quality and safety standards, and context-appropriate product design.

Provision

In high-income countries services are often stand-alone and not integrated. People are forced to attend multiple appointments at different locations, which are costly and add to the burden on users as well as caregivers, and on health and welfare budgets.

In many low- and middle-income countries, national service delivery for assistive products does not exist. Those who can afford them buy assistive products direct from a pharmacy, private clinic, or workshop.

People from the poorer sectors of society must rely on erratic donations or charity services, which often focus on delivering large quantities of low-quality or used products. These are often not appropriate for the user or the context, and lack mechanisms for repair and follow up. A similar scenario is also common in emergency response programmes.

Personnel

Trained health personnel are essential for the proper prescription, fitting, user training, and follow-up of assistive products. Without these key steps, assistive products are often of no benefit or abandoned, and they may even cause physical harm (as is the case of providing wheelchairs without pressure relief cushions for people with spinal injury).

Assistive technology within universal health coverage

The 2030 Agenda for Sustainable Development places good health and well-being at the centre of a new development vision. It emphasizes universal health coverage (UHC) to ensure a sustainable development for all, so that everyone everywhere can access the health services needed without facing financial hardship.

Universal Health Coverage can be advanced inclusively only if people are able to access quality assistive products when and where they need them.

Addressing the unmet need of assistive products is crucial to achieve the Sustainable Development Goals, to provide UHC, and to implement the UN Convention on the Rights of Persons with Disabilities, ratified by 177 countries.

‘Leaving no one behind’ means ensuring the people with disabilities, the older population and those affected by chronic diseases are included in society and enabled to live a healthy and dignified life.

WHO response

WHO is coordinating the Global Cooperation on Assistive Technology (GATE), which exists to improve access to high-quality affordable assistive technology for everyone, everywhere. The GATE initiative is developing 4 practical tools to support countries to address the challenges described above.

WHO sees the GATE initiative as a concrete step towards realizing the goals of the UN Convention on the Rights of Persons with Disabilities, universal health coverage and the Sustainable Development Goals.

The GATE initiative will reinforce WHO’s global strategy on people-centred and integrated health services across the lifespan, as well as action plans on noncommunicable diseases, ageing and health, disability and mental health.

Source: Assistive Technology, WHO, 2018

AT @ DEEPAK

What are some types of assistive devices and how are they used?

Examples of AT:

  • Mobility aids, such as wheelchairs, scooters, walkers, canes, crutches, prosthetic devices, and orthotic devices

  • Hearing aids to help people hear or hear more clearly

  • Cognitive aids, including computer or electrical assistive devices, to help people with memory, attention, or other challenges in their thinking skills

  • Computer software and hardware, such as voice recognition programs, screen readers, and screen enlargement applications, to help people with mobility and sensory impairments use computers and mobile devices

  • Tools such as automatic page turners, book holders, and adapted pencil grips to help learners with disabilities participate in educational activities

  • Closed captioning to allow people with hearing problems to watch movies, television programs, and other digital media

  • Physical modifications in the built environment, including ramps, grab bars, and wider doorways to enable access to buildings, businesses, and workplaces

  • Lightweight, high-performance mobility devices that enable persons with disabilities to play sports and be physically active

  • Adaptive switches and utensils to allow those with limited motor skills to eat, play games, and accomplish other activities

  • Devices and features of devices to help perform tasks such as cooking, dressing, and grooming; specialized handles and grips, devices that extend reach, and lights on telephones and doorbells etc.

Further information:


Source: What are some types of assistive devices and how are they used?, NIH, 2018

The Good Samaritan: Assistive Technology

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