Citation: MAXIMO, T. and CLIFT, L., 2016. Assessing service delivery systems for assistive technology in Brazil using HEART study quality indicators.Technology and Disability, 24 (4), pp. 161 -170. Additional Information:• This is an accepted version of a paper subsequently published in the jour- Abstract. BACKGROUND: recently in Brazil, there has been investment and improvements in the service delivery system for assistive technology provision. However, there is little documentation of this process, or evidence that users are being involved appropriately. OBJECTIVE: to understand how assistive technology service provision currently functions in Belo Horizonte city, Brazil, in order to provide context-specific interventions and recommendations to improve services. METHOD: Qualitative research design, including visits to key institutions and semi-structured interviews with key stakeholders. Interview questions were divided with two purposes: 1) Exploratory, aiming to understand present service functioning; 2) Evaluative, aiming to assess staff difficulties in applying existing best practice. RESULTS: Assistive Technology services in Belo Horizonte fall under the 'medical model' definition of the service delivery system developed by AAATE. It was also found that staff lack training and knowledge support to assess user requirements and to involve them during the decisionmaking process. Additionally, there is no follow-up stage after the device is delivered. CONCLUSIONS: The study clearly defines the service provision function and the staff difficulties at Belo Horizonte city, providing information for further studies.

One of the first challenges for many children with physical disabilities is to sit independently. A floor seating positioning system enables this milestone, helping a child to maintain eye level with other children, play and learn on the floor, rectify his or her posture, and, therefore, helps to include the child within his or her social spectrum. Ciranda is the first comprehensive floor seat solution in Brazil to attend to those needs. The project collected anthropometric data from 370 children who were unable to sit without support. A sample of 37 families of these children was visited, observed, and interviewed. A project requirement compiled key insights from the field data to support a multidisciplinary team of collaborators to co-design solutions. The project resulted in two floor seating positioning systems to attend to different needs. One is a social enterprise where the children’s parents and the community build the seat while the child in need and his or her friends engage in entertainment. The other is a salable seat that helps to raise funds for the social enterprise. The model also unravels other challenges common to assistive technologies, such as access to a device and training for the use and maintenance of the device.

It is certain that smart technologies can benefit healthcare from an individual level to comprehensive healthcare services. This chapter reflects on the use of technologies in public healthcare systems and reveals some barriers encountered in the attempt to integrate the World Health Organisation wheelchair services' good practices into the Brazilian National Health Service information system. Between countries with a population larger than 100 million inhabitants, Brazil is the only to declare healthcare as a duty of the State and a civil right, providing free of charge services to its population. The service is moving from a fragmented to an integrated healthcare service on which the use of technologies plays an important role. This study shows the value of understanding the requirements of the different healthcare service stakeholders and considers the contextual factors to improve service quality. It also shows how technology can become a hurdle rather than assistance to improve healthcare provision. increasing the service offer and access and providing a bridge between primary and secondary care [15]. Each NASF team is composed of up to 19 professionals from a diverse clinical proficiencies providing support among 8-20 ESF teams. NASF personnel vary from physiotherapist, phonoaudiologist, social worker, acupuncturist, nutritionist, and psychologist, to cite a few examples. The purpose was to provide multidisciplinary care by fostering discussion of clinical cases, assessing users in its home environment, operating in the prevention and health promotion, supporting therapeutic projects and qualifying and increasing health interventions [16]. Smart Healthcare Not