Access to assistive technology in two Southern African countries

Abstract

BackgroundMillions of people in Southern Africa are deprived of basic human rights such as the right to education and work because of the large and growing unmet demand for assistive technologies (AT). Evidence is needed to better characterize the lack of AT access.MethodsThis study serves to identify the sociodemographic factors that are associated with access to AT in two countries in Southern Africa, Botswana and Swaziland. To achieve this aim, logistics regression was applied to a subset of variables from two Living Conditions Studies, nationally representative surveys that were conducted in Southern Africa (2014 and 2010).ResultsIn Botswana, 44% of people who needed AT did not receive it, while in Swaziland the unmet need was 67%. Among the sociodemographic variables tested, the type of disability was the most important factor in determining AT access in both countries. The likelihood of AT access was highest in both countries for those who had mobility limitations (i.e., difficulty walking/climbing stairs) [Botswana: 6.4 odds ratio (OR) = 6.4., 95% confidence internal (CI) (3.6–11.3); Swaziland: OR = 3.2, CI (1.4–7.3)], in comparison to those with non-mobility types of disabilities.ConclusionsThese findings provide support for governments and other stakeholders in the AT sector to prioritize AT to address the large unmet demand, and expand the range of AT products provided so that people with hearing, seeing, self-care, communication and cognition difficulties have equal access to AT as those with mobility impairments. A step toward achieving these aims is to inventory AT product types that are commonly covered through the public sector in each country, and identify common gaps (e.g., daily living aids). Advancing the AT sector as a whole within Southern Africa will require large scale qualitative studies that achieve a comprehensive understanding of the bottlenecks in regional AT supply, procurement, and delivery systems.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3605-9) contains supplementary material, which is available to authorized users.

Socio-Demographic Factors Influencing the Use of Assistive Technology among Children with Disabilities in Malawi

“…Our findings regarding the influence of place of residence on both uses of any AT and use of AT for personal mobility do not correspond to the finding of Matter, and Eide [11] in two Southern African Countries (i.e., Botswana and Swaziland). Matter, and Eide [11] found a location (urban or rural) not to be significantly associated with the use of AT.…”

“…Our findings regarding the influence of place of residence on both uses of any AT and use of AT for personal mobility do not correspond to the finding of Matter, and Eide [11] in two Southern African Countries (i.e., Botswana and Swaziland). Matter, and Eide [11] found a location (urban or rural) not to be significantly associated with the use of AT. However, the finding of the current study is supported by previous studies, which found the place of residence or location of a person with a disability to influence the use of AT [16,29].…”

“…The World Health Organization estimates that only 5% to 15% of AT needs are met in the African region [10]. Matter and Eide [11] found that 44% of persons with disabilities in Botswana who needed AT had not received it, whilst in Swaziland, 67% had an unmet need for AT. Several factors have been found to contribute to the limited availability of AT in the region.…”

“…Several factors have been found to contribute to the limited availability of AT in the region. The factors include low prioritization of AT in national legislation, policies, or strategies [12]; the high cost of AT and rehabilitation services [11]; limited awareness of the benefits of using assistive devices and the services available to ensure access to them [12]; the negative attitude of the head-teachers, teachers, support staff, and students with and without disability [8]; social stigma and being singled-out as disabled through the use of AT [13].…”

O acesso às órteses, próteses e meios auxiliares de locomoção no Sistema Único de Saúde de uma microrregião de saúde do município de São Paulo

“…Um estudo de base populacional em dois países da África Austral mostrou que dentre as pessoas com necessidade de OPM, entre 44% e 67% não as receberam e tal porcentagem tende a aumentar quando considera-se somente dispositivos que estão relacionados às necessidades de pessoas com outros tipos de deficiência que não físicas, como dispositivos para pessoas com deficiências auditivas, visuais ou intelectuais (Matter;Eide, 2018). O Inquérito de Saúde da cidade de São Paulo apontou uma estimativa de 65,9% pessoas com 12 anos ou mais com pelo menos uma deficiência referindo uso de OPM (São Paulo, 2018).…”