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CRPD jurisprudence on Assistive Technologies through Concluding Observations: An analysis from Global South perspectives

INTERNATIONAL DISABILITY ALLIANCE (IDA)
GLOBAL DISABILITY INNOVATION HUB (GDI)
October 2023

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States parties have several obligations with regard to assistive technologies under the CRPD under Article 4, including undertaking and promotion of research and development of or new technologies, incorporating information and communications technologies, mobility aids, devices and assistive technologies that are suitable for persons with disabilities. It also prioritizes technologies at an affordable cost. States are also to provide accessible information to persons with disabilities about mobility aids, devices, and assistive technologies, including new technologies, as well as other forms of assistance, support services and facilities. This obligation is further elaborated in other Articles of the Convention, which may explain why the CRPD Committee has not focused observations around assistive technology related to this Article

Inclusive Design and Accessibility in Medellín, Colombia. AT2030 Inclusive Infrastructure Case Studies

PATRICK, M
MULDOWNEY, A
ARRUBA PALACIO, M
AGUIRRE, M
McKINNON, I
August 2023

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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

Medellín, Colombia is the sixth and final case study city under the Global Disability Innovation Hub (GDI Hub) led and UK Aid funded AT2030 Inclusive Infrastructure sub-programme. Colombia’s second largest city, Medellín is well-known for its progress in urban development in the last 20 years, moving forward from its violent history. Medellín has been designated a district of innovation and is known for innovative urban projects such as its cable cars and electric escalators that connect higher altitude, low-income communities on the peripheries of the city. This case study explores the current state of accessibility and inclusion in the city for persons with disabilities and helps understand whether such urban innovations are inclusive for all the city’s residents.

Medellín is home to nearly 80,000 persons with disabilities and Colombia does have strong legal frameworks in place to support persons with disabilities. However, this case study found that the numerous laws and regulations are not always well implemented and there is also a need to consider more diverse disabilities in city planning and design.

The research took place in 3 phases between December 2022 and May 2023, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk-based research and interviews. Phase 2 captured the lived experience of persons with disabilities through interviews, photo diaries and co-design activities. Phase 3 then synthesised the findings, running multiple in-person workshops to validate and create actions towards the creation of more inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life for persons with disabilities including, poverty, transport, housing, healthcare, public spaces and recreational activities. Quotes from participants are interwoven throughout the report and strengthen the concluding actions. The report recognises what has worked in Medellin as well as areas for improvement.

Wheelchair provision guidelines

WORLD HEALTH ORGANISATION (WHO)
June 2023

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These Wheelchair provision guidelines aim to support improved access to appropriate wheelchairs, for all those in need, including children, older persons, people with mobility disabilities, and those with chronic health conditions. They are relevant for all countries and apply to all wheelchair users and types of wheelchairs. They emphasize that the best outcomes in wheelchair access occur when wheelchair users have the benefit of an individual process of assessment, fitting, training, and follow up, provided by trained personnel. Their purpose is to ensure that wheelchair users have timely access through wheelchair services that are people-centred and responsive to their needs. Target audiences are those with a role in planning, delivery, monitoring and evaluation of wheelchair provision. This includes policy-makers, wheelchair service personnel, and wheelchair user representative organizations

Inclusive Design and Accessibility of the Built Environment in Nairobi, Kenya

PATRICK, M
MULDOWNEY, A
KILIMANJARO BLIND TRUST AFRICA
TANUI, G
BUKACHI, V
CAMPBELL CLAUSE, J
McKINNON, I
October 2022

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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

This case study, funded through UK aid AT2030 programme, explores the current situation of inclusive and accessible environments for people with disabilities living in Nairobi. The research findings detailed in this report describe the current challenges and opportunities for embedding inclusive design in Nairobi’s future, providing priority recommendations and forward-thinking next steps.

The research took place in three phases between July 2021 and January 2022, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk research and interviews, phase 2 captured the lived experience of people with disabilities utilising interviews, photo diaries and co-design activities. Phase 3 then synthesised findings, running multiple workshops to create actions towards inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life, poverty, transport, housing, sanitation, public spaces and recreational activities. Quotes from participants are interwoven into this report, and strengthen the concluding actions towards inclusion.

 

SDG-CRPD Resource Package

OFFICE OF THE HIGH COMMISSIONER FOR REFUGEES (OHCHR)
December 2020

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OHCHR developed a package of resources to support realizing the Sustainable Development Goals for persons with disabilities. These include resources on policymaking (Policy Guidelines for Inclusive SDGs; Training Materials and Videos) and resources on monitoring (Human Rights Indicators on the Convention on the Rights of Persons with Disabilities and a Data Sources Guidance).

 

SDGs:

The Policy Guidelines on inclusive Sustainable Development Goals set out the main actions that should be used to develop policies to achieve the goals for persons with disabilities. Training Materials complementing the guidelines include tools to develop in-person and online trainings. The videos mirror the guidelines and can be used for training and awareness-raising activities.

 

There are Policy Guidelines, Training Materials and Videos for SDG goals 10, 16, 17, 1, 3, 4, 5, 8 and 11. There are thematic briefs for SDG goals 2, 6, 13, 8, 11, 9 and 17.

 

CRPD:

Presented article by article, the indicators are key to facilitating understanding and implementation of the Convention’s provisions. They provide guidance on actions to measure implementation of the CRPD and to track progress over time. Data sources guidance mirrors the human rights indicators and provides examples of different sources of data to inform the outcome indicators.

 

There are indicators and data sources guidance for articles: 1-4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 and 17, 16, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33.

Barriers and Facilitators for Wheelchair Users in Bangladesh: A Participatory Action Research Project

ALDERSEY, Heather
QUADIR, Mohammad Morshedul
AKTER, Soniya
MOZUMDER, Rabiul Hossain
NAZNEEN, Nayma
NURI, Reshma Parvin
2018

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Purpose: People who use wheelchairs face a range of physical, social, and economic barriers to regular participation in their communities. These barriers may be more acute in countries such as Bangladesh which are affected by poverty and often lack the physical infrastructure or resources necessary to create inclusive or accessible environments. This research aimed to identify: (a) the barriers and facilitators to accessibility faced by wheelchair users in Bangladesh; (b) how these barriers affect the inclusion of wheelchair users in Bangladeshi society; and (c) what could be done to improve accessibility and inclusion for wheelchair users in Bangladesh.

 

Methods:  This participatory action research (PAR) project used Photovoice and semi-structured interviews to identify barriers and facilitators to accessibility for people who use wheelchairs in Bangladesh.

 

Results: Participants mentioned a number of barriers in public spaces, such as roads, missing or inadequate ramps, inaccessible restrooms, and negative attitudes. There were also participants who had made their home environments more accessible with accommodations such as ramps, arrangement of space, and low countertops/work spaces. Women wheelchair users seemed to face greater barriers to access, as compared to men, in a range of community spaces and activities. Participants’ recommendations for improvement targeted government stakeholders and included greater focus on road infrastructure, particularly during flooding in the rainy season, and modifications to the public transportation system.

 

Conclusion: A key goal of the study was to identify barriers and facilitators, and use the information gathered to promote social change on the ground. Future research and action should encourage more people to get involved in removing barriers for people with disabilities, in Bangladesh as well as globally

Making cities inclusive: safe mobility for persons with disabilities in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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A policy brief concerning safe and inclusive urban mobility is presented. Safe and inclusive mobility is not currently a universally recognised concept in international human rights instruments and development framework. The relationship of various global legal & policy frameworks with safe and inclusive urban mobility is discussed including:

  • The UN Convention on the Rights of Persons with Disabilities
  • The 2030 Sustainable Development Goals
  • The New Urban Agenda
  • The UN Road Safety Decade of Action

Recommendations for improved policies and actions are made:

  • Recommendation 1: Recognise safe and inclusive mobility as a transversal issue for realising the Sustainable Development Goals and human rights
  • Recommendation 2: Agree strong political and financial commitments to improve the safety of roads with a focus on vulnerable road users
  • Recommendation 3: Provide safe and accessible urban mobility infrastructures applying universal design approach, all along the mobility chain
  • Recommendation 4: Enhance participatory and evidence-based policy-making for a better governance of road safety, mobility management and urban planning

Developing product quality standards for wheelchairs used in less-resourced environments

MHATRE, Anand
MARTIN, Daniel
MCCAMBRIDGE, Matt
REESE, Norman
SULLIVAN, Mark
SCHOENDORFER, Don
WUNDERLICH, Eric
RUSHMAN, Chris
MAHILO, Dave
PEARLMAN, Jon
2017

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Background: Premature failures of wheelchairs in less-resourced environments (LREs) may be because of shortcomings in product regulation and quality standards. The standards published by the International Organization for Standardization (ISO) specify wheelchair tests for durability, safety and performance, but their applicability to products used in the rugged conditions of LREs is unclear. Because of this, wheelchair-related guidelines published by the World Health Organization recommended developing more rigorous durability tests for wheelchairs.


Objectives: This study was performed to identify the additional tests needed for LREs.


Methods: First, a literature review of the development of ISO test standards, wheelchair standards testing studies and wheelchair evaluations in LREs was performed. Second, expert advice from members of the Standards Working Group of the International Society of Wheelchair Professionals (ISWP) was compiled and reviewed.


Results: A total of 35 articles were included in the literature review. Participation from LREs was not observed in the ISO standards development. As per wheelchair testing study evidence, wheelchair models delivered in LREs did not meet the minimum standards requirement. Multiple part failures and repairs were observed with reviewed field evaluation studies. ISWP experts noted that several testing factors responsible for premature failures with wheelchair parts are not included in the standards and accordingly provided advice for additional test development.


Conclusion: The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies.

Development of wheelchair caster testing equipment and preliminary testing of caster models

MHATRE, Anand
OTT, Joseph
PEARLMAN, Jonathan
2017

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Background: Because of the adverse environmental conditions present in less-resourced environments (LREs), the World Health Organization (WHO) has recommended that specialised wheelchair test methods may need to be developed to support product quality standards in these environments. A group of experts identified caster test methods as a high priority because of their common failure in LREs, and the insufficiency of existing test methods described in the International Organization for Standardization (ISO) Wheelchair Testing Standards (ISO 7176).


Objectives: To develop and demonstrate the feasibility of a caster system test method.


Method: Background literature and expert opinions were collected to identify existing caster test methods, caster failures common in LREs and environmental conditions present in LREs. Several conceptual designs for the caster testing method were developed, and through an iterative process using expert feedback, a final concept and a design were developed and a prototype was fabricated. Feasibility tests were conducted by testing a series of caster systems from wheelchairs used in LREs, and failure modes were recorded and compared to anecdotal reports about field failures.


Results: The new caster testing system was developed and it provides the flexibility to expose caster systems to typical conditions in LREs. Caster failures such as stem bolt fractures, fork fractures, bearing failures and tire cracking occurred during testing trials and are consistent with field failures.


Conclusion: The new caster test system has the capability to incorporate necessary test factors that degrade caster quality in LREs. Future work includes developing and validating a testing protocol that results in failure modes common during wheelchair use in LRE.

Leaving no-one behind: using assistive technology to enhance community living for people with intellectual disability

OWUOR, John
LARKIN, Fiona
MacLACHLAN, Malcolm
April 2017

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The transformation of community care for people with intellectual disabilities (ID) through enhanced access to assistive technology (AT) is discussed. The problems associated with lack of access to AT and the extent to which these occur are reported. Issues in lack of AT provision, including lack of global standards, are discussed. A call to action is made with reference to the appropriate parts of CRPD.   

 

 

Disability and Rehabilitation: Assistive Technology, 12:5, 426-428

DOI: 10.1080/17483107.2017.1312572 

Road safety : focus on vulnerable users

HANDICAP INTERNATIONAL
November 2015

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This advocacy briefing paper shows the challenges to implementing road safety, the benefits of safe roads for communities, the international legal framework that discusses road safety in policy, suggestions for what individual actors can do to increase mobility and vehicle safety, and finally how to measure the progress of road safety programmes

 

Policy paper

Policy implementation in wheelchair service delivery in a rural South African setting

VISAGIE, Surona
SCHEFFLER, Elsje
SCHNEIDER, Marguerite
2013

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Background: Wheelchairs allow users to realise basic human rights and improved quality of life. South African and international documents guide rehabilitation service delivery and thus the provision of wheelchairs. Evidence indicates that rehabilitation policy implementation gaps exist in rural South Africa.

 

Objectives: The aim of this article was to explore the extent to which wheelchair service delivery in a rural, remote area of South Africa was aligned with the South African National Guidelines on Provision of Assistive Devices, The United Nations Convention on the Rights of Persons with Disabilities and The World Health Organization Guidelines on Provision of Wheelchairs in Less-Resourced Settings.

 

Method: Qualitative methods were used. Data were collected through semi-structured interviews with 22 participants who were identified through purposive sampling. Content analysis of data was preformed around the construct of wheelchair service delivery.

 

Results: Study findings identified gaps between the guiding documents and wheelchair service delivery. Areas where gaps were identified included service aspects such as referral, assessment, prescription, user and provider training, follow up, maintenance and repair as well as management aspects such as staff support, budget and monitoring. Positive findings related to individual assessments, enthusiastic and caring staff and the provision of wheelchairs at no cost.

 

Conclusion: The gaps in policy implementation can have a negative impact on users and the service provider. Inappropriate or no wheelchairs limit user function, participation and quality of life. In addition, an inappropriate wheelchair will have a shorter lifespan, requiring frequent repairs and replacements with cost implications for the service provider.

Quantitative Exploratory Evaluation of the Frequency, Causes and Consequences of Rehabilitation Wheelchair Breakdowns delivered at a Paediatric Clinic in Mexico

TORO, M L
GARCIA, Y
OJEDA, A M
DAUSEY, D J
PEARLMAN, J
2012

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Purpose: The United Nations Convention on the Rights of Persons with Disabilities recognises assistive technology such as wheelchairs (WCs) as a tool for social inclusion for this population. In less resourced settings, organisations lack information about effective models of WC service provision. The goal of this study was to investigate the lifespan of WCs and whether they provided reliable mobility, at one clinic in Mexico.

 

Methods: Caregivers of children, who had requested replacements for their WCs from a clinic in Mexico, were interviewed in Spanish. Among others, the questions pertained to repairs/modifications, adverse events and WC usage characteristics. The owners exchanged their WCs for new ones at the clinic, and the maintenance status of each returned WC was evaluated using the WC Assessment Checklist (WAC).

 

Results: Twenty-three donated WCs, used by children aged 3 to 14 years for an average of 19 months, were evaluated. Brakes (n=18), seat and back-sling upholstery (n=11 and 7 respectively), and armrests (n=14) were the components that failed most frequently. A total of 26 adverse events due to WC failure were reported. Adverse events were significantly associated with poor WAC scores (rs=-0.544, p=0.007).

 

Conclusions: Poor WC reliability, associated with adverse events which could undermine social engagement, indicates the need for a stronger WC and for regular maintenance. For instance, brake failures which were most often associated with adjustment issues, could have been resolved with maintenance, while seat and back-sling upholstery and armrest failures suggest that the WC may not be appropriate for the environment. Future work should investigate the robustness of these WCs using standardised methods (ISO 7176), as well as the impact of maintenance interventions on WC reliability.

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