Assistive devices

Assistive devices are enabling tools for persons with disabilities to communicate and participate in social, economic and cultural aspects of society. Assistive devices can differ depending on an individual's requirements: examples include crutches, wheelchairs, white canes, hearing aids and accessibility software for computers. Evidence to date has shown that access to mobility aids, assistive devices and latest developments in technology can result in improved capacity, self-confidence, social participation and an improved quality of life for persons with disabilities in both low and high-income countries. From a development perspective, information and communication technologies play a key role in delivering positive development outcomes. Yet research has shown that persons with disabilities encounter barriers in accessing available and affordable devices and technologies.

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) contains several articles requiring all governments to promote the availability, knowledge and use of assistive devices and technologies as they relate to habilitation and rehabilitation (Article 26) and to promote access to appropriate mobility aids for persons with disabilities at affordable cost (Article 20). It also requires international cooperation activities undertaken by the international community to facilitate access to quality assistive technologies, for instance by making them available at affordable cost (Article 32).

The World Health Organization is increasing its focus on this area, and its Action Plan 2014–2021 outlines evidence, gaps and opportunities, as well as proposed actions for governments and the international community in relation to assistive devices.

Resources provided below include links to relevant surveys and research papers, position papers and fact sheets and to World Health Organization guidelines, resolutions, and Action Plans. Guidelines exist for the provision of mobility devices in less resourced settings, and there is a need for guidance on the provision of various other appropriate assistive devices, to ensure sustainable provision, fitting, repair and maintenance where support services may be less available.

See also: Information and Communication Technologies, Community Based Rehabilitation, Health, Children and Youth with Disabilities

Kett, Maria (2022) Assistive Technology in two humanitarian contexts: Bangladesh and Jordan

Despite the increased focus on the need for assistive technology (AT), along with estimates of need and gaps in provision in humanitarian contexts, very little is actually known about how people who need AT are managed in these contexts. This study explored the use of assistive technology (assistive devices) in two humanitarian response contexts: Bangladesh and Jordan. The research found that it is clear that the provision of AT (in this case mainly assistive devices) is ad hoc, and largely related to the access, availability and focus of NGO-funded projects in camps or communities, despite it being extremely beneficial for people with disabilities.

WHO (2021) Assistive product specifications and how to use them

This document was developed to guide procurement of assistive devices (ADs). It is intended primarily for procurement teams working in less resourced settings. It should be read alongside the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) publication A manual for public procurement of assistive products, accessories, spare parts and related services, which sets out the procurement process in detail, including key steps and good practice (LINKED BELOW). The document is a compilation of 26 model specifications describing the assistive product functional requirements and related services to be considered in procurement. The document also provides guiding information on how to adapt and apply the model specifications in tender processes.

WHO & UNICEF (2022) Global Report on Assistive Technology

The Global Report on Assistive Technology highlights the status of access to assistive technology (AT), and draws attention to the need for and benefit of AT, including the return of investment. This report recommends action which will improve access to AT, especially in resource-limited settings, supports the implementation of the Convention of the Rights of Persons with Disabilities, and helps to ensure Universal Health Coverage is inclusive.

World Health Organization (2020) Assistive Technology Procurement Study Technical Report

Globally, WHO estimates that 1 billion people need access to assistive technology (AT) and this figure will rise to more than 2 billion by 2050 as the global population ages and prevalence of non-communicable diseases (NCD) increases. There is now greater awareness of and advocacy for equitable access to both rehabilitation and AT than ever before. The study was conducted to understand the challenges that people in Pacific Island Countries currently face when trying to access AT. A summary and full report are available which provide an overview of findings, recommendations and next steps on how access to AT in the region could be improved. The Study was commissioned by the World Health Organization Western Pacific Regional Office and funded by the Australian Government, through the Department of Foreign Affairs and Trade. Motivation Australia led the process in partnership with the Pacific Disability Forum and the Nossal Institute for Global Health.

Rohwerder, Brigitte (2018) Assistive technologies in developing countries, Knowledge, Evidence and Learning for Development

It is estimated that over one billion people need one or more assistive devices, but only 5% have access to them. This literature review looks at the availability of assistive technologies in developing countries and efforts to make them more accessible and affordable. Key findings: • Access is low, variable by impairment type, gender, age and constrained by availability and affordability. • Devices are often donated but spare parts cannot be accessed in country. • Services to fit and maintain devices are scarce and often expensive. • Glasses are becoming more affordable and training eye health workers is improving. • Hearing aids are amongst the least available devices and are often of limited quality. Policy makers should encourage systems strengthening at all levels, discourage dumping of unsuitable products from high income countries, encourage lowering customs duties on imported devices, encourage local manufacturers to make some custom made parts.

World Health Assembly (2018) Resolution WHA71.8 Improving access to assistive technology

This resolution made by the World Health Assembly in 2018 is recognised as a call to action and the basis for the development of a mandate in the assistive technology sector, especially with consideration to the 2030 Agenda for Sustainable Development.

Motivation Australia WHO wheelchair service training package

Training courses were developed by WHO to assist services in implementing the WHO Guidelines on the provision of manual wheelchairs in less resourced setting. They are intended for wheelchair service personnel in less resourced settings to be trained in comprehensive wheelchair service provision and enable increasing numbers of adults and children to receive a wheelchair which meets their needs. WHO also recognises that trained personnel require support from managers and national stakeholders to ensure appropriate wheelchair provision is established and sustained within a country. To raise awareness and promote good practice, WHO developed a training package for managers, and a training package for stakeholders. Included in this link are the basic and intermediate level training packages, the manager and stakeholder training packages. It also includes the training of trainers package.

Guidelines Steering Committee (2016) National Guidelines on the Provision of Assistive Technology in Papua New Guinea

These Guidelines support and guide best practice service delivery for assistive technology in PNG, in line with the Government’s commitments to persons with disabilities. While designed specifically for PNG, many of the concepts in the guidelines are applicable more broadly in Pacific Island contexts and may help inform programs looking to invest in this area. The Guidelines particularly highlight the importance of providing assistive technology as part of a service system equipped with trained personnel and appropriate products.

World Health Organisation (2016) WHO Priority Assistive Products List

To support and improve access to high quality, affordable assistive products globally, the WHO has introduced the Priority Assistive Products List (APL). It lists 50 priority assistive products and is intended to guide and support Member States to fulfil their commitment to improving access to assistive products as mandated by the United Nations Convention on the Rights of Persons with Disabilities (CRPD). It is useful for guiding programs looking to invest in the area of assistive technology.

Borg J (2011) Assistive technology, human rights and poverty in developing countries: Perspectives based on a study in Bangladesh

The findings of this doctoral thesis offer support for addressing human rights deprivation and poverty among persons with disabilities through provision of assistive technology on theoretical, legal and empirical grounds. This thesis is useful for those seeking to understand how assistive technology service provision is a human rights issue which can contribute to poverty.

Global Alliance on Accessible Technologies and Environments

GAATES is an international organisation which promotes the understanding and implementation of accessibility of the built, social and virtual environments, including architectural, infrastructural design, transportation systems, habitat, and electronic information and communication technologies. GAATES produces a regular newsletter which outlines assistive technology developments, including news from developing countries. The GAATES website and newsletter is of interest to individuals seeking to remain up-to-date with advancements in the assistive technology sector.

World Health Assembly (2005) World Health Assembly Resolution WHA58.23, Disability, including prevention, management and rehabilitation

This resolution made by the World Health Assembly in 2005 is recognised as a call to action and the basis for the development of a mandate in the assistive technology sector. While significant progress has been made since this Resolution, it remains a key document and continues to provide the basis for advocacy and action items on future agendas related to assistive devices and disability prevention, management and rehabilitation.

World Health Organization (2008) Guidelines on the provision of manual wheelchairs in less resourced settings

These guidelines outline good practices in the design, production, supply and service delivery of manual wheelchairs. They are much needed to counter potentially inappropriate or harmful interventions. The guidelines are targeted at a range of audiences, including policy-makers; planners, managers, providers and users of wheelchair services; designers, purchasers, donors and adapters of wheelchairs, trainers of wheelchair provision programmes, representatives of DPOs; and individual users and their families. Compliance with these guidelines would strengthen the suitability and sustainability of service provision and improve development effectiveness in this area.

World Health Organization Assistive devices/technologies

This website provides links to pages which describe the activities of WHO in relation to assistive devices/technologies, and to a small number of useful resources. The WHO leads global efforts toward increasing access to quality assistive technologies; this webpage provides a useful introduction to current efforts and discourse.

World Health Organization and World Bank (2011) World report on disability

Chapters 4, 5 and 6 of this report address issues and evidence surrounding access to assistive devices and technology, the unmet need, the role of assistive devices and technology in rehabilitation and enhancing access to wider life opportunities, and their potential to reduce the need of older persons with disabilities to rely on carers. Recommendations in Chapter 4 include the need to increase access to assistive technology that is appropriate, sustainable, affordable, and accessible.

World Health Organization (2010) Community based rehabilitation guidelines

The ‘Health Component’ chapter of these guidelines includes a section on Assistive Devices (pages 57-72) which provides introductory material targeted at mid-level health workers. It explains in clear language what assistive devices are and covers topics such as appropriate technology, assessment, training, facilitating access, and setting up small scale workshops. Case studies are provided from a range of countries.

World Health Organization and USAID (2011) Joint position paper on the provision of mobility devices in less-resourced settings: A step towards implementation of the Convention on the Rights of Persons with Disabilities (CRPD) related to perso

This paper aims to guide and support nations, especially developing countries, in the implementation of relevant articles of the UNCRPD associated with the provision of assistive technology, with a focus on mobility devices.

World Health Organization (2013) Draft global disability action plan 2014-2021: Better health for all people with disabilities

Increasing access to assistive technology is an important WHO objective, and this plan documents this mandate for initiatives in assistive technology. The plan is a key resource for stakeholders intending to plan investments to support strengthened assistive device policy and services in developing countries.

WHO (2016) Fact sheet on Assistive Devices & Global Cooperation on Assistive Technology (GATE)

WHO is developing a flagship programme – Global Cooperation on Assistive Technology (GATE) – in partnership with UN Agencies, international organizations, donor agencies, professional organizations, academia, and organizations of/for persons with disabilities. GATE will open the doors for children with disabilities to access education and adults to earn a living, overcome poverty, participate in all societal activities, and live with dignity, which are some of the key objectives of the global development goals. Assistive Technology, Information and Communication Technology (ICT), Accessible Technology, Universal Design, Accessible or Enabling Environment are all interlinked and are preconditions for mainstreaming disability in development priorities. Investment in technology to make it available and affordable is definitely a practical step to establish the “Promise of Technology to Achieve Sustainable Development for All.”

Motivation Australia describes how people in Papua New Guinea dealt with challenges in accessing appropriate assistive technologies that met their needs. The Case Study outlines the challenge, response, outcomes and learning.

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Picture of a teenage boy from Tanzania sitting in his wheelchair whilst it is being adjusted. There are two technicians carrying out the repairs, one of the technicians is also a wheelchair user. His mother is watching the process from behind.

Photo: Thomas Einberger, 2010

Abdullah Munish is a Quality Control Supervisor at the House of Hope (CCBRT) in Tanzania. Abdullah (right) and Massue Remy (left) are adjusting the wheelchair of David* (13 years old) while David’s mother looks on. (*pseudonym used) Copyright: CBM/argum/Einberger