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Themes: Assistive & Accessible Technology

Working on data and evidence to unlock investment into assistive technology

Everyone from governments and health ministers, to innovators and entrepreneurs, must decide where to focus their efforts and investments into assistive technology (AT). Data and evidence is needed so that these decisions can be made, but it is often not available. GDI Hub Academic Professor Director Cathy Holloway is overseeing the data and evidence cluster of AT2030 to support meaningful investment in AT in the future.

A graphic image of a world map. Some countries are coloured in Purple representating collated data

Only one in 10 people in need have access to AT, according to the World Health Organization (WHO). This is a compelling figure, and other organisations have found it to be largely accurate through their work too. The reason for poor AT access is due to a lack of availability, high costs, lack of awareness and a lack of products that meet the specific needs of individuals.

Yet for people making decisions for governments on how to meet AT needs, or for innovators wanting to design products to help disabled people, this figure alone does not provide the information they need to help. Rigorous, reliable and more specific data and evidence is needed in order to unlock investment and meaningful decision making in this field.

Tackling data and evidence deficits

In response to this, one of the four clusters of AT2030 is data and evidence, overseen by GDI Hub Academic Director Professor Cathy Holloway.

“If you’re a Minister of Health, you become acutely aware that AT is a sector of sectors, it might include speech and language services, communication aids, wheelchairs and prosthetic devices, walking sticks, eyeglasses, hearing aids and more. Everyone has a limited budget – some ministers are faced with a decision such as building sanitation in a slum, or giving out prosthetics. But if little evidence exists about what AT is actually needed, it’s unlikely it will be invested in.”

Cathy is overseeing a number of research projects and PhD students to improve the ability to collect and share data and evidence about AT. This includes the development of the AT2030 insights portal, which combines population health data sets with information retrieval processes, to give policymakers and funders oversight of trends and gaps. This is a key way that the future of AT provision can be improved. In addition to this, there are also ongoing projects to develop a mobile screening tool, and to use storytelling as a way to collect evidence and information.

The team also undertakes systematic reviews on elements such as innovation systems, data need and market shaping – which all feeds into the data and evidence available to decision makers. From the work done in this cluster so far, the team has delivered the WHO-UNICEF Global Report on Assistive Technology, and improved rapid Assistive Technology Assessment (rATA) surveys so that better evidence can be collected.

“Once rATA has been completed in a country, you immediately have a better understanding of what the AT need is,” Holloway said. “For example, you might find a high proportion of children in a specific geography need eyeglasses. We can then feed in the relevant parts of the other clusters we’re working on, such as innovations that help screen children for visual impairments.”

This rATA data sits in the AT2030 data portal, and an artificial intelligence (AI) strand is also in progress to help make sense of it, and add in predictive features. This means that even if rATA surveys were completed a few years ago in specific locations, the system can still give an indication of AT need.

Next steps

While several projects are ongoing in the data and evidence cluster, Cathy is committed to the rigorous approach the GDI Hub takes to this area of work. In Sierra Leone the country capacity assessments is supporting the country’s ability to deliver AT and inclusive design in informal settlements.

“My job is to make the connections between projects and make sure they’re supported,”

One such example is innovative upper limb prosthetics company, Koalaa. Following civil war, there is a significant need for upper limb prosthetics in Sierra Leone. GDI Hub has supported Koalaa through a country based trial. “To gain high quality research, we were able to put a team together around Koalaa, introduce them to partners such as the Clinton Health Access Initiative, and do all the proper levels of evidence building and community engagement.”

As an unexpected result of the work, the team found that there was a high desire for subtle non-tool based prosthetics, aligned to skin tones and inconspicuous in appearance for public occasions such as attending church, the mosque or for social gatherings. Functional aids were desirable for doing things around the home, such as cooking. “No prosthetist in the world would give someone an arm that doesn’t do anything,” Cathy explained. “But gathering evidence and stories from communities like this helps to empower them.”

Cathy says that making real change for disabled people takes some careful navigation around the issues. “Disabled people, especially those in low resource settings, have very limited agency in how much change they can make, and they often don’t have a platform or a voice”. “We want to take a bottom up approach to enable and empower disabled people in AT, but to get everyone listening, both the bottom up and top down is important for making meaningful change at all levels.”