Assistive technology use and human rights enjoyment: a cross-sectional study in Bangladesh

Abstract

BackgroundAbout half a billion people with disabilities in developing countries have limited access to assistive technology. The Convention on the Rights of persons with Disabilities requires governments to take measures to ensure provision of such technologies. To guide implementation of these measures there is a need for understanding health outcomes from a human rights perspective. The objective of this study was therefore to explore the relation between assistive technology use and enjoyment of human rights in a low-income country.MethodsData was collected in eight districts of Bangladesh through interviews of people with hearing impairments using and not using hearings aids, and people with ambulatory impairments using and not using manual wheelchairs (N = 583). Using logistic regression, self-reported outcomes on standard of living, health, education, work, receiving information and movement were analyzed.ResultsThe adjusted likelihood of reporting greater enjoyment of human rights was significantly higher among people using hearing aids compared to non-users for all outcomes except working status. Compared to non-users, users of wheelchairs reported a significantly higher adjusted likelihood of good ambulatory performance and a significantly lower adjusted likelihood of reporting a positive working status. Further analyses indicated that physical accessibility to working places and duration of wheelchair use had a statistically significant impact on the likelihood of reporting positive work outcomes.ConclusionsThe findings support the notion that assistive technology use increases the likelihood of human rights enjoyment, particularly hearing aid use. Physical accessibility should always be addressed in wheelchair provision.

What predicts the proxy-reported health-related quality of life of adolescents with cerebral palsy in Bangladesh?

“…Previous studies from LMICs have indicated a relationship between motor function and physical wellbeing dimensions of HRQoL, although no relationship has been consistently reported regarding other associated impairments [7]. Whilst the impairments themselves may not typically be modifiable, address of social stigma in the case of hearing impairment [32], and provision of hearing aids or implementation of nonverbal communication methods [33] may assist to improve outcomes in these dimensions. Cognitive impairment was associated with reduced scores on numerous CPQoL-Teens dimensions, however this was not predictive.…”

Unmet Needs and Use of Assistive Products in Two Districts of Bangladesh: Findings from a Household Survey

“…Assistive products (AP) like wheelchairs, white canes, hearing aids, communication products, visual products and many others, can transform lives by facilitating independence and participation in community life, preventing further disability, promoting early childhood development, and reducing poverty [1,2,3]. Access to an appropriate product or technology solution can be a ‘mediator or moderator’ to attaining the Sustainable Development Goals, and is therefore central to the principle of ‘leaving no-one behind’ [1].…”

“…Despite growing interest in AP in health, disability and social sectors, little is known about unmet needs and patterns of access [6]. Previous work has emphasized individual product types, rather than understanding relative access to different product categories [7,8,9] and explored AP as a mediator of rights [2], but has not explored unmet needs for AP overall.…”

“…Previous work in Bangladesh has demonstrated that AP use is associated with greater attainment of basic rights [2], but affordability is a major barrier to AP use [6]. To inform effective strategies to scale up AP services, reliable information is needed about how people can access AP, who is at risk of missing out on the services they need, and market barriers to access.…”

A conceptual framework to assess effectiveness in wheelchair provision

“…Wheelchairs are key assistive products that help improve the quality of life of people with disabilities (Shore & Juillerat 2012 ; World Health Organization 2016 ). Their use encourages community participation (Mortenson et al 2012 ; Salminen et al 2009 ), increases access to education (Dudgeon, Massagli & Ross 1997 ) and provides better opportunities of employment (Borg et al 2012 ) for people with disabilities. These life-changing products could decrease healthcare expenditures and influence national and global economies (Bray et al 2014 ; Greer, Brasure & Wilt 2012a ).…”