International Journal of Environmental Research and Public Health

Research

26 pages, 4289 KiB

Open AccessArticle

Access to Services from Persons with Disabilities in Afghanistan: Is Community Based Rehabilitation Making a Difference?

by Jean-Francois Trani, Kyle A. Pitzer, Juanita Vasquez Escallon and Parul Bakhshi

Int. J. Environ. Res. Public Health 2022, 19(10), 6341; https://doi.org/10.3390/ijerph19106341 - 23 May 2022

Viewed by 3762

Abstract

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), ratified in 2006, states that the achievement of equal rights, empowerment, and social inclusion of people with disabilities requires comprehensive rehabilitation services involving educational, social, economic, and medical interventions, all dimensions [...] Read more.

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), ratified in 2006, states that the achievement of equal rights, empowerment, and social inclusion of people with disabilities requires comprehensive rehabilitation services involving educational, social, economic, and medical interventions, all dimensions of the World Health Organization Community based rehabilitation (CBR) matrix. CBR programs aim at achieving those goals. In the present study, we investigated whether a large scale CBR program is improving access to multiple services (namely physical therapy, assistive technology, education, employment, advocacy, and community awareness) and providing satisfactions (by measuring the reduction in unmet needs) of Afghans with disabilities. We enrolled in the study 1861 newly recruited CBR participants with disabilities from 169 villages between July 2012 and December 2013, and 1132 controls screened with disabilities randomly selected with a two-stage process within 6000 households from 100 villages in the same provinces as the CBR but outside its catchment area. Using propensity score matching (PSM) and difference in difference analysis, we estimated the differences in accessing services. There were statistically significant differences between participants and controls on the access of available services between the baseline and endline. Using PSM we also found that needs were more often met among CBR participants compared to the controls. Our study indicates that a CBR program may be an effective way to provide services for persons with disabilities even in a conflict context such as Afghanistan. It contributes to addressing the longstanding question whether CBR can actually improve the rehabilitation of persons with disabilities. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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15 pages, 323 KiB

Open AccessArticle

Assistive Technology during the COVID-19 Global Pandemic: The Roles of Government and Civil Society in Fulfilling the Social Contract

by Daniel Mont, Natasha Layton, Louise Puli, Shivani Gupta, Abner Manlapaz, Kylie Shae, Emma Tebbutt, Irene Calvo, Mahpekay Sidiqy, Kudakwashe Dube and Ulamila Kacilala

Int. J. Environ. Res. Public Health 2021, 18(22), 12031; https://doi.org/10.3390/ijerph182212031 - 16 Nov 2021

Cited by 6 | Viewed by 4830

Abstract

The COVID-19 pandemic imposed significant challenges to users of assistive technology (AT). Three key issues emerged from a series of structured qualitative interviews with 35 AT users in six low- and middle-income countries. These were (1) access to information about COVID-19 and available [...] Read more.

The COVID-19 pandemic imposed significant challenges to users of assistive technology (AT). Three key issues emerged from a series of structured qualitative interviews with 35 AT users in six low- and middle-income countries. These were (1) access to information about COVID-19 and available supports and policies, (2) insufficiency of the government response to meet the needs of AT users, and (3) the response of civil society which partially offset the gap in government response. AT users noted the need for better communication, improved planning for the delivery and maintenance of AT during times of crisis, and higher-quality standards to ensure the availability of appropriate technology. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

23 pages, 1888 KiB

Open AccessArticle

Access to Assistive Technology during the COVID-19 Global Pandemic: Voices of Users and Families

by Natasha Layton, Daniel Mont, Louise Puli, Irene Calvo, Kylie Shae, Emma Tebbutt, Keith D. Hill, Libby Callaway, Diana Hiscock, Abner Manlapaz, Inge Groenewegen and Mahpekai Sidiqi

Int. J. Environ. Res. Public Health 2021, 18(21), 11273; https://doi.org/10.3390/ijerph182111273 - 27 Oct 2021

Cited by 28 | Viewed by 8067

Abstract

The SARS COVID-19 pandemic emerged in 2019 and has impacted people everywhere. Disparities in impact and outcomes are becoming apparent for individuals and communities which go beyond the trajectory of the disease itself, influenced by the strength and weaknesses of systems of universal [...] Read more.

The SARS COVID-19 pandemic emerged in 2019 and has impacted people everywhere. Disparities in impact and outcomes are becoming apparent for individuals and communities which go beyond the trajectory of the disease itself, influenced by the strength and weaknesses of systems of universal health care, and the actions of civil society and government. This article is one of a series exploring COVID-19-related experiences of assistive technology (AT) users across the globe and implications for AT systems strengthening. AT such as mobility products, braille devices, and information communication technologies are key enablers of functioning, necessary to the achievement of the UN Sustainable Development Goals and enshrined in the Convention on the Rights of Persons with Disabilities. Reporting on a survey of 73 AT users across six global regions, we demonstrate that minority groups already living with health inequities are unduly impacted. An AT ecosystem analysis was conducted using the WHO GATE 5P framework, that is, people, products, personnel, provision and policy. AT users and families call for inclusive pandemic responses which encompass their needs across the lifespan, from very young to very old. We offer specific recommendations for future action to strengthen access to AT across public policy and civil society in pandemic preparedness and response. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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20 pages, 14428 KiB

Open AccessArticle

Assistive Technology Provider Experiences during the COVID-19 Pandemic

by Louise Puli, Natasha Layton, Daniel Mont, Kylie Shae, Irene Calvo, Keith D. Hill, Libby Callaway, Emma Tebbutt, Abner Manlapaz, Inge Groenewegen and Diana Hiscock

Int. J. Environ. Res. Public Health 2021, 18(19), 10477; https://doi.org/10.3390/ijerph181910477 - 6 Oct 2021

Cited by 19 | Viewed by 6877

Abstract

Globally, health systems face challenges in the delivery of assistive technology (AT) and only 10% of people are currently able to access the assistive products they need. The COVID-19 pandemic presented an uncharted path for AT providers to navigate, placing them under pressure [...] Read more.

Globally, health systems face challenges in the delivery of assistive technology (AT) and only 10% of people are currently able to access the assistive products they need. The COVID-19 pandemic presented an uncharted path for AT providers to navigate, placing them under pressure to be agile and rapidly adapt. This article, part of a series, explores the experiences and impacts of the COVID-19 pandemic on AT providers and aims to inform how AT providers can be better prepared and supported in the future. A mixed methods approach was used to gather service data and perspectives from AT providers via a survey. A total of 37 responses were received from 18 countries. Service data showed extensive service disruption throughout 2020. Thematic analysis suggested significant changes to routine AT service delivery including rapid momentum towards home-based, decentralised, and digital services for which many AT providers were not prepared. Providers were required to make difficult decisions and deliver services in new ways to balance meeting demands, complying with government restrictions, and ensuring the safety of staff and clients. Few but important positives were expressed including the belief that expanded capacity to use remote and digital AT service delivery would remain useful in the future. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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19 pages, 2303 KiB

Open AccessArticle

Estimating Need for Glasses and Hearing Aids in The Gambia: Results from a National Survey and Comparison of Clinical Impairment and Self-Report Assessment Approaches

by Dorothy Boggs, Abba Hydara, Yaka Faal, John Atta Okoh, Segun Isaac Olaniyan, Haruna Sanneh, Abdoulie Ngett, Isatou Bah, Mildred Aleser, Erima Denis, Ian McCormick, Tess Bright, Suzannah Bell, Minjung Kim, Allen Foster, Hannah Kuper, Matthew J. Burton, Islay Mactaggart and Sarah Polack

Int. J. Environ. Res. Public Health 2021, 18(12), 6302; https://doi.org/10.3390/ijerph18126302 - 10 Jun 2021

Cited by 2 | Viewed by 3588

Abstract

Few estimates are available of the need for assistive devices (ADs) in African settings. This study aimed to estimate population-level need for glasses and hearing aids in The Gambia based on (1) clinical impairment assessment, and (2) self-reported AD awareness, and explore the [...] Read more.

Few estimates are available of the need for assistive devices (ADs) in African settings. This study aimed to estimate population-level need for glasses and hearing aids in The Gambia based on (1) clinical impairment assessment, and (2) self-reported AD awareness, and explore the relationship between the two methods. The Gambia 2019 National Eye Health Survey is a nationally representative population-based sample of 9188 adults aged 35+ years. Participants underwent standardised clinical vision assessments including the need for glasses (distance and near). Approximately 25% of the sample underwent clinical assessment of hearing and hearing aid need. Data were also collected on self-reported awareness, need and access barriers to vision and hearing ADs. Overall, 5.6% of the study population needed distance glasses (95% CI 5.0–6.3), 45.9% (95% CI 44.2–47.5) needed near glasses and 25.5% (95% CI 22.2–29.2) needed hearing aids. Coverage for each AD was very low (<4%). The agreement between self-report and clinical impairment assessment for AD need was poor. In conclusion, there is high prevalence and very low coverage for distance glasses, near glasses and hearing aids in The Gambia. Self-report measures alone will not provide an accurate estimate of AD need. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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30 pages, 1890 KiB

Open AccessArticle

“Give Us the Chance to Be Part of You, We Want Our Voices to Be Heard”: Assistive Technology as a Mediator of Participation in (Formal and Informal) Citizenship Activities for Persons with Disabilities Who Are Slum Dwellers in Freetown, Sierra Leone

by Victoria Austin, Cathy Holloway, Ignacia Ossul Vermehren, Abs Dumbuya, Giulia Barbareschi and Julian Walker

Int. J. Environ. Res. Public Health 2021, 18(11), 5547; https://doi.org/10.3390/ijerph18115547 - 22 May 2021

Cited by 11 | Viewed by 4683

Abstract

The importance of assistive technology (AT) is gaining recognition, with the World Health Organisation (WHO) set to publish a Global Report in 2022. Yet little is understood about access for the poorest, or the potential of AT to enable this group to participate [...] Read more.

The importance of assistive technology (AT) is gaining recognition, with the World Health Organisation (WHO) set to publish a Global Report in 2022. Yet little is understood about access for the poorest, or the potential of AT to enable this group to participate in the activities of citizenship; both formal and informal. The aim of this qualitative study was to explore AT as mediator of participation in citizenship for persons with disabilities who live in two informal settlements in Freetown, Sierra Leone (SL). The paper presents evidence from 16 participant and 5 stakeholder interviews; 5 focus groups and 4 events; combining this with the findings of a house-to-house AT survey; and two national studies—a country capacity assessment and an informal markets deep-dive. Despite citizenship activities being valued, a lack of AT was consistently reported and hindered participation. Stigma was also found to be a major barrier. AT access for the poorest must be addressed if citizenship participation for persons with disabilities is a genuine global intention and disability justice is to become a reality. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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11 pages, 1554 KiB

Open AccessArticle

Development and Pilot Testing of Smartphone-Based Hearing Test Application

by Kashyap Patel, Linda Thibodeau, David McCullough, Emma Freeman and Issa Panahi

Int. J. Environ. Res. Public Health 2021, 18(11), 5529; https://doi.org/10.3390/ijerph18115529 - 21 May 2021

Cited by 8 | Viewed by 4477

Abstract

Background: Identifying and treating hearing loss can help improve communication skills, which often leads to improved quality of life. Many people do not seek medical treatment and, therefore, go undiagnosed for an extended period before realizing they have hearing loss. This study presents [...] Read more.

Background: Identifying and treating hearing loss can help improve communication skills, which often leads to improved quality of life. Many people do not seek medical treatment and, therefore, go undiagnosed for an extended period before realizing they have hearing loss. This study presents a self-administered, low-cost, smartphone-based hearing test application (HearTest) to quantify the pure-tone hearing thresholds of a user. The HearTest application can be used with commercially available smartphone devices and an earphone with the mentioned specification. Methods: Air-conduction-based pure-tone audiometry for the smartphone application was designed and implemented to detect hearing thresholds using a traditional “10 dB down and 5 dB up” approach. Employed smartphone-earphone combination was calibrated with respect to a GSI-61 audiometer and insert earphone ER-3A to maintain clinical standards with the help of subjective testing on 20 normal-hearing (NH) participants. Results: Further subjective testing on 14 participants with NH and retesting on five participants showed that HearTest achieves high-accuracy audiogram within clinically acceptable limits (≤10 dB HL mean difference) when compared with the reference clinical audiometer. Hardware challenges and limitations in air-conduction-based hearing tests through smartphones and ways to improve their accuracy and reliability are discussed. Conclusion: The proposed smartphone application provides a simple, affordable, and reliable means for people to learn more about their hearing health without needing access to a formal clinical facility. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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12 pages, 331 KiB

Open AccessArticle

Supported Decision Making in South America: Analysis of Three Countries’ Experiences

by Alberto Vásquez Encalada, Kimber Bialik and Kaitlin Stober

Int. J. Environ. Res. Public Health 2021, 18(10), 5204; https://doi.org/10.3390/ijerph18105204 - 13 May 2021

Cited by 5 | Viewed by 3498

Abstract

Background. Following the adoption of the UN Convention on the Rights of Persons with Disabilities, there has been increased interest in supported decision making (SDM) as a strategy to realize the right to legal capacity of persons with intellectual and psychosocial disabilities. [...] Read more.

Background. Following the adoption of the UN Convention on the Rights of Persons with Disabilities, there has been increased interest in supported decision making (SDM) as a strategy to realize the right to legal capacity of persons with intellectual and psychosocial disabilities. Support for decision making has been delivered formally through SDM services as well as informally through interpersonal networks. Various SDM programs have made efforts to systematize informal support, showcasing a variety of SDM delivery models that could benefit SDM implementation in low- and middle-income countries. Methods. This article examines and discusses three SDM projects in South America (Colombia, Peru, and Argentina) that have been directly implemented by civil society organizations, including organizations of persons with disabilities and their families. Analyzed program components include person-centered planning, the nature of support relationships, the presence of supporter training, community involvement, and the utilization of quality assurance measures such as monitoring and program evaluation. Conclusions. The results and learning from these initiatives constitute a valuable source of information for legislators and policymakers for the future development of supported decision-making programs, which are an essential form of support and a mechanism for fulfilling the right to legal capacity in low resource settings. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

16 pages, 1101 KiB

Open AccessFeature PaperArticle

Examining the Availability and Accessibility of Rehabilitation Services in a Rural District of South Africa: A Mixed-Methods Study

by Qhayiya Magaqa, Proochista Ariana and Sarah Polack

Int. J. Environ. Res. Public Health 2021, 18(9), 4692; https://doi.org/10.3390/ijerph18094692 - 28 Apr 2021

Cited by 12 | Viewed by 4338

Abstract

Introduction: Rehabilitation services aim to optimise individuals’ functioning and reduce disability. However, people with disabilities, who represent a key population of users of rehabilitation services, continue to have unmet needs for rehabilitation services that include the provision of assistive devices. This paper examines [...] Read more.

Introduction: Rehabilitation services aim to optimise individuals’ functioning and reduce disability. However, people with disabilities, who represent a key population of users of rehabilitation services, continue to have unmet needs for rehabilitation services that include the provision of assistive devices. This paper examines the availability and accessibility of rehabilitation services in a rural district of South Africa in order to explore why unmet needs for rehabilitation services persist. Methods: All nine district hospitals in a rural district of South Africa were included in the study. Rehabilitation services capacity was assessed by examining the available assistive devices, consumables and human resources at the level of the health facility. Data collection was conducted using the Global Co-operative Assistive Technology [GATE] Assistive Products List, AT2030’s ATScale priority list and the South African National Catalogue of Commodities for Primary Health Care Facilities. Descriptive statistics were then used for the analysis. For the qualitative component, semi-structured interviews were conducted with adults with physical disabilities at household level to explore barriers to accessing assistive device inclusive rehabilitation services and the consequences thereof in the same rural district. An interview guide based on the WHO health system building blocks was used. Thematic content analysis guided the analysis of the interview transcripts. Findings: The findings of the research demonstrate that rehabilitation service capacity in the district was constrained as a result of low availability of assistive devices [2–22%] and consumables [2–47%], as well as, possibly, a shortage of rehabilitation providers [n = 30] with an unequal distribution across health facilities [n = 9]. In addition, people with physical disabilities reported poor referral pathways, financial constraints, transport and road consideration and equipment unavailability as barriers to accessing rehabilitation services. Moreover, these barriers to access predisposed individuals to finance-, health- and person-related harm. Conclusion: Rehabilitation service availability is constrained by a lack of service capacity in rural South Africa. In addition, the rehabilitation services in district hospitals are not adequately accessible because of existing barriers to enable key populations to achieve optimised functioning. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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20 pages, 368 KiB

Open AccessArticle

“When They See a Wheelchair, They’ve Not Even Seen Me”—Factors Shaping the Experience of Disability Stigma and Discrimination in Kenya

by Giulia Barbareschi, Mark T. Carew, Elizabeth Aderonke Johnson, Norah Kopi and Catherine Holloway

Int. J. Environ. Res. Public Health 2021, 18(8), 4272; https://doi.org/10.3390/ijerph18084272 - 17 Apr 2021

Cited by 34 | Viewed by 8093

Abstract

Disability stigma in many low- and middle-income countries represents one of the most pervasive barriers preventing people with disabilities from accessing equal rights and opportunities, including the uptake of available assistive technology (AT). Previous studies have rarely examined how disability stigma may be [...] Read more.

Disability stigma in many low- and middle-income countries represents one of the most pervasive barriers preventing people with disabilities from accessing equal rights and opportunities, including the uptake of available assistive technology (AT). Previous studies have rarely examined how disability stigma may be shaped through factors endemic to social interactions, including how the use of assistive technology itself may precipitate or alleviate disability stigma. Through two strands of work, we address this gap. Via a series of focus groups with Kenyans without disabilities (Study 1) and secondary data analysis of consultations with Kenyans with disabilities and their allies (Study 2), we identify shared and divergent understandings of what shapes disability stigma and discrimination. Specifically, Kenyans with and without disabilities were cognizant of how religious/spiritual interpretations of disability, conceptions of impairments as “different” from the norm, and social stereotypes about (dis)ability shaped the experience of stigma and discrimination. Moreover, both groups highlighted assistive technology as an influential factor that served to identify or “mark” someone as having a disability. However, whereas participants without disabilities saw assistive technology purely as an enabler to overcome stigma, participants with disabilities also noted that, in some cases, use of assistive technologies would attract stigma from others. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

19 pages, 341 KiB

Open AccessArticle

Provision of Assistive Technology for Students with Disabilities in South African Higher Education

by Sibonokuhle Ndlovu

Int. J. Environ. Res. Public Health 2021, 18(8), 3892; https://doi.org/10.3390/ijerph18083892 - 8 Apr 2021

Cited by 16 | Viewed by 6793

Abstract

This paper used the Critical Disability Theory (CDT) to analyse the provision of assistive technology (AT) and assistive devices at an institution of higher education in South African. In this empirical study, data were collected through interviews with students with disabilities and Disability [...] Read more.

This paper used the Critical Disability Theory (CDT) to analyse the provision of assistive technology (AT) and assistive devices at an institution of higher education in South African. In this empirical study, data were collected through interviews with students with disabilities and Disability Rights Centre staff members. The paper sought to explore the effectiveness of the provision of AT and assistive devices, in terms of enabling students with disabilities’ learning. The provision was deemed inadequate, and a specific AT and assistive device was inaccessible to one category of disability, consequently limiting learning. The paper concludes that the provision of assistive devices at the institution enabled students with disabilities’ learning, however, there was a need for improvement by way of the Universal Design for Learning (UDL). The UDL will help all diverse students, including students with disabilities in all their categories of disability, to be assisted to learn through the provision of AT and assistive devices. It is hoped that the paper will contribute to contemporary debates on the provision of AT and assistive devices for people with disabilities in low-resource settings, from a South African context specifically, and in higher education broadly. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

16 pages, 774 KiB

Open AccessArticle

Perspectives of Multidisciplinary Professional Teams during Assessment Processes for ATD Selection in the Japanese Public Provision System

by Jun Suzurikawa, Yuki Sawada, Miwa Sakiyama, Motoi Suwa, Takenobu Inoue and Tomoko Kondo

Int. J. Environ. Res. Public Health 2021, 18(5), 2697; https://doi.org/10.3390/ijerph18052697 - 8 Mar 2021

Cited by 2 | Viewed by 2385

Abstract

Selection of assistive technology devices (ATDs), which are imperative for persons with disabilities to improve their quality of life, requires collaboration of users and multidisciplinary professionals. However, it is still unknown how to design and implement an adequate collaborative work flow and a [...] Read more.

Selection of assistive technology devices (ATDs), which are imperative for persons with disabilities to improve their quality of life, requires collaboration of users and multidisciplinary professionals. However, it is still unknown how to design and implement an adequate collaborative work flow and a professional team. Under Japanese governmental ATD provision system, based on the application by clients, ATDs are mainly selected through collaborative processes with the clients and health professionals in public organizations, rehabilitation counseling centers (RCCs). By employing qualitative study methods in this study, we investigated the ATD selection process in which health professionals in RCCs collaboratively assess clients with physical disabilities so as to support them in selecting the adequate ATDs. To identify the perspectives required for ATD selection completely, the assessment processes were recorded and analyzed with a pseudo setting in two RCCs. Content analysis of the conversations between the client and professionals revealed the characteristics of the information exchanged in the assessment processes. A total of 760 assessment items were identified, thus indicating a broad array of interest. Despite the richness of information collected for the assessment, half of the assessment items did not have corresponding items in the documents that were employed during the prescription process. Thematic analysis of the interviews that followed revealed the common values and collaborative processes in ATD selection, which were shared and elaborated among the staff in daily social interactions. To facilitate implementation of ATD provision in various areas with few resources, it may be effective to convert this tacit-to-tacit knowledge sharing into a more explicit sharing by promoting analyses of good practices. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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15 pages, 343 KiB

Open AccessArticle

More Than Just Assistive Devices: How a South African Social Enterprise Supports an Environment of Inclusion

by Zara Trafford, Erna van der Westhuizen, Shona McDonald, Margi Linegar and Leslie Swartz

Int. J. Environ. Res. Public Health 2021, 18(5), 2655; https://doi.org/10.3390/ijerph18052655 - 6 Mar 2021

Cited by 14 | Viewed by 3696

Abstract

Appropriate assistive technology has the potential to considerably enhance quality of life, access to health and education, and social and economic participation for people with disabilities. Most disabled people in the world live in low- and middle-income countries where access to assistive devices [...] Read more.

Appropriate assistive technology has the potential to considerably enhance quality of life, access to health and education, and social and economic participation for people with disabilities. Most disabled people in the world live in low- and middle-income countries where access to assistive devices and other support is severely lacking. There is little evidence that describes contextually relevant approaches to meeting these needs, particularly in African countries. We provide a detailed description of a South African organisation which has manufactured mobility and seating devices for children with disabilities since 1992. The Shonaquip Social Enterprise (SSE) also trains and builds capacity among a wide range of stakeholders (caregivers, health workers, educators, government, and communities) to acknowledge and advocate for the wellbeing of disabled children and adults, and works closely with government to strengthen existing service provisions. Using examples from the SSE, we highlight a number of useful principles to consider when trying to provide for the needs of people with disabilities, particularly in low-resource settings. While access to assistive devices is important, devices have limited capacity to improve participation if the broader environment is overly restrictive and stigmatising. Improved access to devices ought to be situated within a range of broader efforts to increase the inclusion and participation of people with disabilities. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

Review

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17 pages, 1992 KiB

Open AccessReview

Community Support for Persons with Disabilities in Low- and Middle-Income Countries: A Scoping Review

by Xanthe Hunt, Melissa Bradshaw, Steyn Lodewyk Vogel, Alberto Vasquez Encalada, Shanice Eksteen, Marguerite Schneider, Kelly Chunga and Leslie Swartz

Int. J. Environ. Res. Public Health 2022, 19(14), 8269; https://doi.org/10.3390/ijerph19148269 - 6 Jul 2022

Cited by 10 | Viewed by 4534

Abstract

Over the life course, persons with disabilities require a range of supports to be integrated into their communities, to participate in activities that are meaningful and necessary, and to have access, on an equal basis to persons without disabilities, to community living. We [...] Read more.

Over the life course, persons with disabilities require a range of supports to be integrated into their communities, to participate in activities that are meaningful and necessary, and to have access, on an equal basis to persons without disabilities, to community living. We conducted a scoping review of the peer-reviewed and grey literature on community support for persons with disabilities in low- and middle-income countries (LMICs). The main findings of this review concern the following: there are gaps in access to community support for persons with disabilities in LMICs; there are barriers to the provision of such support; formal and informal strategies and interventions for the provision of community support exist across the life cycle and different life domains, but evidence concerning their effectiveness and coverage is limited; and the role of community-based rehabilitation and Organisations of Persons with Disabilities in the assessment of needs for, and the development and provision of, community support, needs to be more clearly articulated. Research needs a more robust theory of change models with a focus on evaluating different aspects of complex interventions to allow for effective community support practices to be identified. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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Other

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11 pages, 297 KiB

Open AccessBrief Report

A Narrative Review of the Government Wheelchair Provision System in India

by Shivani Gupta, Agnes Meershoek and Luc De Witte

Int. J. Environ. Res. Public Health 2021, 18(10), 5109; https://doi.org/10.3390/ijerph18105109 - 12 May 2021

Cited by 2 | Viewed by 4033

Abstract

Background and aim: India has had a wheelchair-delivery system in place for several years but its impact on users is inadequate. Therefore, this research reviews the system to examine how the right to personal mobility can be served better. Method: this paper undertakes [...] Read more.

Background and aim: India has had a wheelchair-delivery system in place for several years but its impact on users is inadequate. Therefore, this research reviews the system to examine how the right to personal mobility can be served better. Method: this paper undertakes a narrative review of the existing government-aided wheelchair provision system from the perspectives of legislation and implementing agencies, both governmental and non-governmental, through document review and key informant interviews. Results: the results indicate that all steps of the government-funded wheelchair provision system are executed by the same system. Manufacture and supply take place nationally, but wheelchair services are largely absent. Moreover, the right to access mobility devices is not upheld for all users. Conclusion: the established government-aided wheelchair provision system is inadequate in terms of coverage, design, production, supply, and wheelchair services. Therefore, there is a need to reconsider the system by increasing its coverage and creating partnerships between the government, non-governmental agencies, and private agencies to improve access. Full article

(This article belongs to the Special Issue Assistive Technology and Support Services for People with Disabilities in Low Resource Settings)

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