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Seeking information about assistive technology: Exploring current practices, challenges, and the need for smarter systems

DANEMAYER, Jamie
HOLLOWAY, Cathy
CHO, Youngjun
BERTHOUZE, Nadia
SINGH, Aneesha
BHOT, William
DIXON, Ollie
GROBELNIK, Marko
SHAWE-TAYLOR, John
September 2023

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Assistive technology (AT) information networks are insular among stakeholder groups, causing unequal access to information. Participants often cited fragmented international marketplaces as a barrier and valued info-sharing across industries. Current searches produce biased results in marketplaces influenced by commercial interests and high-income contexts. Smart features could facilitate searching, update centralised data sources, and disseminate information more inclusively.

 

International Journal of Human - Computer Studies, Volume 177, September 2023, 103078

https://doi.org/10.1016/j.ijhcs.2023.103078

The global birth prevalence of clubfoot: a systematic review and meta-analysis

SMYTHE, Tracey
ROTENBURG, Sarah
LAVY, Chris
August 2023

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Estimates of the birth prevalence of clubfoot in low and middle income settings range from 0.5 to 2 per 1000 births. However, there is currently no estimate of global birth prevalence of clubfoot.

A systematic review of studies was carried out reporting the birth prevalence of clubfoot across all countries and regions worldwide in the last 10 years. Africa Wide Information, EMBASE, CINAHL, Global Health, LILACS and Medline databases were searched for relevant studies from January 1st 2012 to February 9th 2023. Pooled prevalence estimates were calculated using the inverse variance method, and a random effects model was applied to account for heterogeneity between studies.

 

eClinicalMedicine,  Vol 63 September, 2023

DOI:https://doi.org/10.1016/j.eclinm.2023.102178

Using a community-based participatory research (CBPR) approach to explore economic empowerment for youth with disabilities in rural Uganda

GREENWOOD, Margo
BECHANGE, Stevens
EMONG, Paul
KYOSABA, Winnie
NSSAJA, David
THE PEERS RESEARCHER TEAM
August 2023

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This paper presents findings from a community-based participatory study exploring the lived experiences and key livelihood changes post-intervention of a vocational skills training for young people with disabilities in rural Uganda. Twenty-four youth with disabilities (13 female, 11 male) who had previously taken the vocational training were trained to become peer researchers and conducted 72 in-depth interviews with a more recent cohort of youth with disabilities. 

 

Social Sciences & Humanities Open, Volume 8, Issue 1, 2023, 100647

https://doi.org/10.1016/j.ssaho.2023.100647

Repair strategies for assistive technology in low resource settings

OLDFREY, Ben
HOLLOWAY, Cathy
WALKER, Julian
McCORMACK, STEVEN
DEERE, Bernadette
KENNEY, Laurence
SSEKITOLEKO, Robert
ACKERS, Helen
MIODOWNIK, Mark
July 2023

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Purpose: To  investigate the  practices of  repair that  exist for  users of  mobility assistive products in  low resource settings, as  well  as  the  psychosocial impact that  the  repair, or  non-repair, of  these devices has on users’ lives.

Materials and Methods: This article collates data on repair practices and the responses from participants on  the  topic of  repair from studies conducted by  the  authors across four  different low  resource settings in  Kenya, Uganda, Sierra Leone, and  Indonesia. This  data was  then analyzed to  identify the  common themes found across geographies

 

DISABILITY AND REHABILITATION: ASSISTIVE TECHNOLOGY

https://doi.org/10.1080/17483107.2023.2236142 

Assistive technology in Korea: Findings from the 2017 National Disability Survey

DANEMAYER, Jamie
LIN, Myung-Joon
July 2023

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Explicitly monitoring the need, use and satisfaction of assistive product (AP) provision is essential to support population health and healthy longevity in ageing/aged countries, like Korea. We present findings from the 2017 Korea National Disability Survey (NDS) on AP access and compare them to international averages, introducing Korea’s data into the wider coherence of global AP research.

 

Disability and Rehabilitation: Assistive Technology

https://doi.org/10.1080/17483107.2023.2225565 

 

Who is disabled? On whether the functional definition of disability targets the same individuals as the subjective definition

Judith Baart
Willem Elbers
Alice Schippers
May 2023

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With the increased attention to disability as a vulnerability criterion in the Sustainable Development Goals, international organizations and NGOs within the international development sector have started to pay explicit attention to persons with disabilities, including the collection of data on persons with disabilities. The Washington Group Short Set of Questions, which focuses on functional limitations, has been gaining popularity as an assessment tool for disability. This set of questions reflects a categorization of disability that does not necessarily correspond with subjective disability assessments, such as the yes/no question (“do you have a disability?”) which many development actors have used in their assessment tools when they collect disability data This study compares the subjective and the functional limitations assessment tools for disability to answer the question: do they identify the same individuals as persons with disabilities? Based on a survey carried out amongst persons with disabilities in Cambodia, we included both the Washington Group Short Set and a subjective question asking respondents to self-identify their disability type. We find that, although all respondents self-identified as disabled, not all respondents would be considered disabled according to the Washington Group Short Set of questions. In addition, there is little overlap between specific disability types according to a subjective classification method and the domains of functioning measured through the Washington Group methodology. Our findings affirm that categorization as abled or disabled depends on the tool used. This is important, as the assessment approach chosen by those collecting disability data can shape the design choices of policies and programs, and determine who benefits.

Assistive technology: The current perspective in India

SENJAM, Suraj S
MANNAM, Hasheem
May 2023

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Despite many challenges, India needs to formulate evidence-based AT policy, planning within the purview of the healthcare delivery system in collaboration with various government and nongovernment sectors, including industries. This article explores the need, access, and potential challenges associated with AT services in India. Finally, we discussed various initiatives on AT in the country and possible recommendations to improve AT services across.

 

Indian J Ophthalmol. 2023 May; 71(5): 1804–1809.

doi: 10.4103/IJO.IJO_2652_22

Assistive technology access in longitudinal datasets: a global review

DANEMAYER, Jamie
MITRA, Sophie
HOLLOWAY, Cathy
HUSSEIN, Shereen
March 2023

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Functional limitations become more prevalent as populations age, emphasising an increasingly urgent need for assistive technology (AT). Critical to meeting this need trajectory is understanding AT access in older ages. Yet few publications examine this from a longitudinal perspective.

This review aims to identify and collate what data exist globally, seeking all population-based cohorts and repeated cross-sectional surveys through the Maelstrom Research Catalogue (searched May 10, 2022) and the Disability Data Report (published 2022), respectively. Datasets incorporating functional limitations modules and question(s) dedicated to AT, with a wave of data collection since 2009, were included.

 

International Journal of Population Data Science; 2023

Vol. 8 No. 1 (2023): IJPDS Standard Issue
 https://doi.org/10.23889/ijpds.v8i1.1901

Experiences of lower limb prosthesis users in Kenya: a qualitative study to understand motivation to use and satisfaction with prosthetic outcomes

MATTICK, Kate
OLDFREY, Ben
DONOVAN-HALL, Maggie
MAGOMERE, Grace
GAKUNGA, Joseph
HOLLOWAY, Catherine
December 2022

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An estimated 1.5 million people undergo limb amputation each year [1]. Low- and middle-income countries (LMICs) are projected to have a rapid increase in people living with an amputation in the coming years due to prevalence of non-communicable disease, trauma and conflict. This paper explores the personal and system factors that motivate and enhance outcomes for patients accessing a prosthetic service and using a lower-limb prosthesis within a low resource setting.

This study employed a qualitative approach to explore the motivations and satisfaction of individuals with lower limb loss engaging with a prosthetic service in Mombasa, Kenya. In-depth interviews were conducted over Microsoft Teams with 10 lower limb prosthesis users and thematic analysis was applied.

 

Disability and Rehabilitation Volume 45, 2023 - Issue 26

https://doi.org/10.1080/09638288.2022.2152875

Evaluating the use of a thermoplastic socket in Kenya: A pilot study

BARBARESCHI, Giulia
TEERLINK, Wesley
NJUGUNA, Josepg Gakunga
MUSUNGU, Purity
KIRINO, Mary Dama
HOLLOWAY, Catherine
October 2022

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Many people with amputations who live in low-resourced settings struggle to access the workshops where qualified prosthetists provide appropriate care. Novel technologies such as the thermoplastic Confidence Socket are emerging, which could help facilitate easier access to prosthetic services. The objective of this study was to evaluate the satisfaction and the performance of transtibial prosthesis featuring the Confidence Socket. This is a longitudinal repeated-measures design study.

 

Prosthet Orthot Int. 2022 Oct; 46(5): 532–537.

Published online 2022 Mar 25. doi: 10.1097/PXR.0000000000000130

Mainstreaming disability inclusive employment in international development

Mary Wickenden
Philip Mader
Stephen Thompson
Jackie Shaw
July 2022

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People with disabilities are under-represented in the global workforce, and this problem is often particularly acute inthe‘global south’. This is an editorial to a special issue that seeks to provide new perspectives on why this is the case. We deliberately wanted to place this collection in the Journal of International Development as a core development publication, rather than in a disability specific one, because we think it is important to ‘mainstream’ disability within development so that the international community can develop an increased understanding and awareness of disability dilemmas. The challenges faced by disabled people need to be tackled as part of all development thinking and programming.

Capability-sensitive principles for assistive technology to support young graduates with disabilities in Bangladesh and Kenya into employment

MORRIS, Lisa-Dione
ALGHAIB, Ola Abu
NORTHRIDGE, James
July 2022

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Owing to increased inclusion of young people with disabilities into the private sector in Bangladesh and Kenya, there is an urgent need to find alternative ways to support young graduates with a disability in the workplace with assistive technology solutions. The aim of the paper is to identify barriers for private workplace sectors to use assistive technology to support young graduates seeking, maintaining and retaining employment. This qualitative study adopted the research onion design of Saunders et al. Data were collected usinginterviews and focus group discussions and analysed using thematic analysis. The findings reveal that barriers are linked to seven key person-centred capability themes: the dream, external factors, internal factors, assistive technology vision,strategic design priorities and gaps and assistive actions.

 

Journal of International Development, Volume 34, No. 5

Barriers to inclusive employment for self-advocates and families

BIALIK, Kimber
MHIRI, Manel
June 2022

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This article is about the barriers to inclusive employment that people with intellectual disabilities and families face in Kenya, Uganda, Nigeria, and Bangladesh.

Through the Inclusion Works Project, we worked with our members in Kenya, Uganda, Nigeria, and Bangladesh to talk with self-advocates and family members about employment.

We had 3 consultation meetings with self-advocates and 3 consultation meetings with families – we talked to 54 self-advocates and 45 family members about access to inclusive employment in their countries.

Some of the barriers that they told us about were discrimination from employers, lack of access to education, unfair pay, issues with safety and security at work, and being pressured to choose self-employment.

This article explains some of the issues accessing inclusive employment that people with intellectual disabilities and their families told us they face in low- and middle-income countries.

The article also gives recommendations for how organisations doing work on inclusive employment can work towards addressing some of these barriers and being more inclusive.

 

 Journal of International Development, Volume 34, Issue 5

Disability inclusive employment in urban Malawi: A multi-perspective interview study

REMNANT, Jennifer
WANGGREN, Lena
HUQUE, Sarah
SANG, Katherine
KACHALI, Limbani
RICHARDS, James
June 2022

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The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with disabilities. Firstly, we find a policy-based assumption of a formalised workforce that is not representative of the predominantly informal disabled workforce. Secondly, the disruptive, intermittent and oftenreactive nature of non-governmental organisation (NGO ) interventions can limit long-term inclusivity agendas and undermine the work of disabled activists in Malawi. Lastly, we present findings on the stigmatised nature of disability in these urban centres. We find that stigma is economic: Urban workers with disabilities are discriminated against locally by employers, landlords and banks on assumptions they will not produce or earn enough to meet productivity demands, rent or repayment costs.

 

Journal of International Development, Volume 34, Issue 5

https://doi.org/10.1002/jid.3678

Unemployment in women with psychosocial disabilities during the COVID-19 pandemic: Lessons from Tana River County, Kenya

IBUENYI, Ikenna D.
GITONGA, Isaiah
TELE, Albert
SUYRINA, Elena
February 2022

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In low-income settings, the informal economy is a practical alternative to work and employment for persons with disabilities. However, the COVID-19 pandemic negatively affected the informal economy. This study aimed to explore the experiences of women with psychosocial disabilities in Kenya during the pandemic. We found that the pandemic worsened their experiences of work and employment, and they did not receive any social welfare or support from the government. Our findings suggest that pandemic management must adopt inclusive and context-sensitive approaches that support persons with psychosocial disabilities. Social welfare and protection for persons with disabilities are relevant for socio-economic empowerment and inclusion.

 

Journal of International Development, volume 34, issue 5

https://doi.org/10.1002/jid.3638

Estimating need and coverage for five priority assistive products: a systematic review of global population-based research

DANEMAYER, Jamie
BOGGS, Dorothy
DELGADO RAMOS, Vinicius
SMITH, Emma M
KULAR, Ariana
BHOT, William
RAMOS-BARAJAS, Felipe
POLACK, Sarah
HOLLOWAY, Catherine
January 2022

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Assistive technology (AT) includes assistive products (APs) and related services that can improve health and well-being, enable increased independence and foster participation for people with functional difficulties, including older adults and people with impairments or chronic health conditions. This paper uses the umbrella term ‘functional difficulty’ (FD) to refer to all of these groups. This systematic review was undertaken to identify studies presenting population-based estimates of need and coverage for five APs (hearing aids, limb prostheses, wheelchairs, glasses and personal digital assistants) grouped by four functional domains (hearing, mobility, vision and cognition).

 

BMJ Glob Health. 2022; 7(1): e007662

doi: 10.1136/bmjgh-2021-007662

Translating disability-inclusive WASH policies into practice: lessons from Cambodia and Bangladesh: Study details and reports

LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE (LSHTM)
WILBUR, Jane
2022

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This is a collaborative study between the LSHTM and WaterAid, funded by the Australian Government’s Water for Women Fund. It aims to improve disability-inclusive WASH policymaking in low and middle-income countries through policy and practice guidance for governments wishing to mainstream disability-inclusive WASH at scale. Using Cambodia and Bangladesh as case studies, we answered these research questions:

  • How do Cambodia and Bangladesh’s national WASH policy and guidance incorporate disability?
  • To what extent do sub-national government officials and service providers implement these commitments to disability inclusion?
  • How does this implementation impact the WASH experiences of people with disabilities and their caregivers?

Resources available

This poster gives an overview of the study.

We conducted a policy analysis of Cambodia and Bangladesh’s WASH policies and guidance documents to explore the inclusion of disability. We published a journal article and an accessible briefing note that summarised the article.

We carried out qualitative research in Cambodia and Bangladesh that explored the implementation of commitments to disability inclusion in national policies at the sub-national level. This journal article captures our research in Cambodia, which is summarised in this briefing note. We worked with Epic Arts (an inclusive arts organisation based in Cambodia that uses art to empower and bring people with disabilities together) to develop a performance and two short films about the findings related to 'independence' and 'caregivers'. 

We wrote a research report capturing findings from Bangladesh, which is supplemented by this poster.      

We produced the Disability-Inclusive WASH Checklist for government officials and service providers to support the meaningful inclusion of people with disabilities and caregivers in national policies, guidance documents, and interventions. The Disability-Inclusive WASH Checklist is based on our study findings and co-developed recommendations. Three films introduce the checklist, give an overview of it and show how to complete it. Each film has transcripts (film 1, film 2, film 3).    

Finally, we wrote a Learning Brief, Foundations of success: driving change through successful research collaborations. This brief documents the process the Principal Investigator followed to support and mentor the research team in Cambodia remotely. The Brief captures the strengths and limitations of approaches and learning gained. It includes recommendations for organisations that remotely support non-academics to conduct ethical research in low-and middle-income countries.

Applying market shaping approaches to increase access to assistive technology in low- and middle-income countries

SAVAGE, Margaret
ALBALA, Sarah
SEGHERS, Frederic
KATTEL, Rainer
LIAO, Cynthia
CHAUDRON, Mathilde
AFDHILA, Novia
December 2021

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Development outcomes are inextricably linked to the health of the marketplace that delivers products and services to people in low- and middle- income countries (LMIC). Shortcomings in the market for assistive technology (AT) contribute to low access in LMIC. Market shaping is aimed at improving a market’s specific outcomes, such as access to high quality, affordable AT, by targeting the root causes of these shortcomings. The paper summarizes the findings of a market and sector analysis that was conducted under the UK aid funded AT2030 programme and aims to discuss how market shaping can help more people gain access to the AT that they need and what are the best mechanisms to unlock markets and commercial opportunity in LMICs.

 

Assistive Technology 
The Official Journal of RESNA
Volume 33, 2021 - Issue sup1: Companion Papers to the Global Report on Assistive Technology

https://doi.org/10.1080/10400435.2021.1991050

A Global Assessment of Eye Health and Quality of Life: A Systematic Review of Systematic Reviews

ASSI, Lama
CHAMSEDDINE, Fatimah
IBRAHIM, Perla
et al
September 2021

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More than 1 billion people worldwide have vision impairment or blindness from potentially preventable or correctable causes. Quality of life, an important measure of physical, emotional, and social well-being, appears to be negatively associated with vision impairment, and increasingly, ophthalmic interventions are being assessed for their association with quality of life.

Objective  - To examine the association between vision impairment or eye disease and quality of life, and the outcome of ophthalmic interventions on quality of life globally and across the life span, through an umbrella review or systematic review of systematic reviews.

The electronic databases MEDLINE, Ovid, Embase, Cochrane Database of Systematic Reviews, Proquest Dissertations, and Theses Global were searched from inception through June 29, 2020, using a comprehensive search strategy. Systematic reviews addressing vision impairment, eye disease, or ophthalmic interventions and quantitatively or qualitatively assessing health-related, vision-related, or disease-specific quality of life were included. Article screening, quality appraisal, and data extraction were performed by 4 reviewers working independently and in duplicate. The Joanna Briggs Institute critical appraisal and data extraction forms for umbrella reviews were used.

 

JAMA Ophthalmol. 2021;139(5):526-541

doi:10.1001/jamaophthalmol.2021.0146

Disability and Indigeneity: intersectionality of identity from the experience of Indigenous people at a global level

GILROY, John
UTTJEK, Margaretha
LOVERN, Lavonna
WARD, John
2021

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The authors of this paper have protested, fought, written extensively and represent the broader theoretical foundations of Indigenous and disability research by focusing on their standpoint perspectives informed by their ancestral spirits and knowledge. Based on our knowledge, cultures, and advocacy skills, this paper collectively explores and compares the intersections of Indigeneity and disability as an embodied identity in four countries: USA, Canada, Sweden, and Australia. This is accomplished by beginning with a brief synopsis of colonization to provide context and then examine the consequences of Western assimilation practices, including academic support of the Western status quo. The paper will then turn to the impact of both colonization and academic constructs on Indigenous epistemologies and ideas of self in disability dialogues. Finally, the paper will focus on Indigenous concepts of difference to not only advance Western disability discussions, but also as a way for Western dialogue to overcome its predilection to hierarchical binaries.

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