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Journal of Science Policy & Governance | Volume 16, Issue 02 | May 27, 2020

Op-Ed: ​Assistive Technologies: Addressing the Divide Between the Developed and Developing World

Stuti Chakraborty 
Christian Medical College, Vellore, Department of Physical Medicine and Rehabilitation, Christian Medical College and Hospital, Ida Scudder Road, Vellore, Tamil Nadu – 632004, India
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https://doi.org/10.38126/JSPG160204
Keywords: assistive technologies; low income countries; lower-middle income countries; high income countries; UNCRPD; people with disabilities
Executive Summary: Assistive technologies are used to enhance the day-to-day functionality of people with disabilities by improving their quality of life and by reducing the impact of disability in their lives. Various socio-economic, cultural, contextual, medical, personal, and family-related factors determine the feasibility and outcomes of using assistive technologies. While various forms of assistive technologies are being widely used for rehabilitation, recreational, or personal purposes around the world many still remain inaccessible and vastly unaffordable in countries around the world. Literature suggests that, when comparing high income countries with low and lower-middle income countries, differences among the longevity, availability, ease of users, affordability and, most importantly, the recognition of the need for an assistive technology, are common, with those measures lagging in low and lower-middle income countries. Certain targeted interventions have been suggested to provide insight into how discrepancies in promoting the use of assistive technologies between developed and developing nations can be minimised with the goal of reducing the global impacts of disability.

I. Introduction

Assistive technologies can be broadly considered as “any item or piece of equipment or product system, whether acquired commercially, off-the-shelf, modified or customised, that is used to increase, maintain or improve functional capabilities of people with disabilities” (Assistive Technology Act 2004; Bausch et al. 2005). In the context of healthcare specifically, the use for assistive technologies is widespread and can also be referred to as health state assistive technology devices. These devices can be either intrinsic or extrinsic. Intrinsic devices are implanted and optimise functioning by replacing a body function of body structure such as cochlear implants, cardiac pacemakers. Extrinsic devices are not implanted and optimise function by augmenting, restoring, or compensating for body function, and structure impairments, such as wheelchairs, glasses, hearing aids, or augmentative and alternative communication devices. Both extrinsic and intrinsic assistive technologies are used extensively to reduce the impact of disability (Bauer et al. 2011).
 
The World Health Organisation (WHO) estimates that there are around one billion people living with disabilities worldwide. Increasing incidences of non-communicable diseases will cause more than two billion people globally to use at least one assistive technology product (World Health Organisation 2018). The World Bank defines a low income country (LIC) as having a gross national income (GNI) per capita of US$1,025 or less, a lower-middle income country (LMIC) as having a GNI per capita between US$1,026-US$3,995, and a high income country (HIC) as having a GNI per capita of US$12,376 or more (Prydz and Wadhwa 2019). Almost 80% of people with disabilities in lower-middle income countries experience difficulty accessing rehabilitative services and could potentially benefit from increased use or availability of assistive technology. However, this estimate cannot be considered comprehensive as it does not include different types of assistive technologies such as wheelchairs or devices aiding in communication and vision, nor does it take into consideration people with disabilities using more than one form of assistive technology (Borg, Lindström, and Larsson 2011; World Health Organisation 2011; Matter et al. 2017; Prydz and Wadhwa 2019).

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References

  1. Assistive Technology Act, 29 U.S.C (2004). Accessed: 16 May 2020. https://www.govtrack.us/congress/bills/108/hr4278/text
  2. Bausch, Margaret E., Joel E. Mittler, Ted S. Hasselbring, and Donald P. Cross. 2005. "The Assistive Technology Act of 2004: What Does It Say and What Does It Mean?." Physical Disabilities: Education and Related Services 23, no. 2: 59-67.
  3. Borg, Johan, Anna Lindström, and Stig Larsson. 2011. "Assistive technology in developing countries: a review from the perspective of the Convention on the Rights of Persons with Disabilities." Prosthetics and Orthotics International 35, no. 1: 20-29. https://doi.org/10.1177/0309364610389351
  4. Boger, Jennifer, Piper Jackson, Maurice Mulvenna, Judith Sixsmith, Andrew Sixsmith, Alex Mihailidis, Pia Kontos, et al. 2017. “Principles for fostering the transdisciplinary development of assistive technologies.” Disability and Rehabilitation: Assistive Technology 12, no. 5: 480-490. https://doi.org/10.3109/17483107.2016.1151953
  5. Kristiansen, Lisbeth. 2018. "Wanting a Life in Decency!: A Qualitative Study from Experienced Electric Wheelchairs Users’ perspective." Open Journal of Nursing 8, no. 7: 419-433. https://doi.org/10.4236/ojn.2018.87033
  6. MacLachlan, Malcom and Leslie Swartz, ed. 2009. Disability & International Development: Toward Inclusive Global Health. New York: Springer.
  7. Matter, Rebecca, Mark Harniss, Tone Oderud, Johan Borg, and Arne H. Eide. 2017. "Assistive technology in resource-limited environments: A scoping review." Disability and Rehabilitation: Assistive Technology 12, no. 2: 105-114. https://doi.org/10.1080/17483107.2016.1188170
  8. Rohwerder, Brigitte. 2018. Assistive Technologies in Developing Countries. K4D Helpdesk Report. https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/13599
  9. Sund, Terje, ed. 2017. Assistive Technology in Norway - a Part of a Larger System. Norway Department of Assistive Technology. https://www.nav.no/en/home/about-nav/publications/_/attachment/download/7b119b1c-fe72-488a-a1ef-be424e72faff:c52b8c6ee759299749538a6fd0554d1efa695abf/assistive-technology-in-norway-170217v2.pdf
  10. Prydz, Espen Beers and Divyanshi Wadhwa. 2019. “Classifying countries by income.” The World Bank. Accessed: May 16, 2020. https://datatopics.worldbank.org/world-development-indicators/stories/the-classification-of-countries-by-income.html
  11. Tangcharoensathien, Viroj, Woranan Witthayapipopsakul, Shaheda Viriyathorn, and Walaiporn Patcharanarumol. 2018. "Improving access to assistive technologies: challenges and solutions in low-and middle-income countries." WHO South-East Asia Journal of Public Health 7, no. 2: 84-89. https://doi.org/10.4103/2224-3151.239419 
  12. United Nations General Assembly. 2006. Convention on the Rights of Persons with Disabilities, A/RES/61/106 (13 December 2006).
  13. Weden, Margaret M., Regina A. Shih, Mohammed U. Kabeto, and Kenneth M. Langa. 2018. "Secular trends in dementia and cognitive impairment of US rural and urban older adults." American Journal of Preventive Medicine 54, no. 2:164-172. https://doi.org/10.1016/j.amepre.2017.10.021
  14. Whitacre, Brian, 2016. “Technology Is Improving – Why Is Rural Broadband Access Still a Problem?” The Conversation. Accessed April 19, 2020. http://theconversation.com/technology-is-improving-why-is-rural-broadband-access-still-a-problem-60423
  15. Williams, Emma, Elizabeth Hurwitz, Immaculate Obaga, Brenda Onguti, Adovich Rivera, Tyrone Reden L. Sy, R. Lee Kirby, et al. 2017. "Perspectives of basic wheelchair users on improving their access to wheelchair services in Kenya and Philippines: a qualitative study." BMC International Health and Human Rights 17, no. 1: 22. https://doi.org/10.1186/s12914-017-0130-6
  16. World Federation of Occupational Therapists (WFOT). 2019. Global Indicators of Assistive Technology Use amongst Occupational Therapists: Report from the World Federation of Occupational Therapists’ (WFOT) Global Surveys. WFOT. Accessed: 16 May 2020. https://www.wfot.org/resources/global-indicators-of-assistive-technology-use-amongst-occupational-therapists-report-of-wfots-global-surveys
  17. World Health Organisation. 2001. International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organisation. Accessed May 16, 2020. https://apps.who.int/iris/bitstream/handle/10665/42407/9241545429.pdf
  18. World Health Organisation. 2002. Towards A Common Language for Functioning, Disability and Health: ICF. Geneva: World Health Organisation. Accessed: May 16, 2020. https://www.who.int/classifications/icf/icfbeginnersguide.pdf
  19. World Health Organisation. 2011. World Report on Disability 2011. Geneva: World Health Organisation, Accessed: May 16, 2020. https://apps.who.int/iris/bitstream/handle/10665/44575/9789240685215_eng.pdf
  20. World Health Organisation. 2018. “Assistive Technology Factsheet.” WHO Accessed: 16 May 2020. https://www.who.int/news-room/fact-sheets/detail/assistive-technology
  21. Yusif, Salifu, Jeffrey Soar, and Abdul Hafeez-Baig. 2016. "Older people, assistive technologies, and the barriers to adoption: A systematic review." International Journal of Medical Informatics 94: 112-116. https://doi.org/10.1016/j.ijmedinf.2016.07.004
Stuti Chakraborty is currently an intern at Christian Medical College, Vellore. She is also a country representative for Healthcare Information for All; a country correspondent for YourCommonwealth; a member of the Global Healthcare Workforce Network and a country correspondent for IHP Global. She recently started working with Global Health Mentorships as a content facilitator and has also been a pioneer member for the launch of the India Chapter of Women in Global Health as a Chapter Officer over the last few months. In her work, she advocates for young people's health with a special focus on the rights of people with disabilities. She wishes to pursue research in the field of neurosciences in the near future.
 
Acknowledgements
The author would like to thank Mr. Abhishek Chandramouli who pursued his Bachelor of Technology degree in Computer Science and Engineering from Vellore Institute of Technology, Vellore and is currently doing research at the Massachusetts Institute of Technology Media Lab.
DISCLAIMER: The findings and conclusions published herein are solely attributed to the author and not necessarily endorsed or adopted by the Journal of Science Policy and Governance. Articles are distributed in compliance with copyright and trademark agreements.

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