Exploring the impact of assistive technology for people with deafblindness in Southern Africa: a Delphi study
Assistive Technology (AT) is an umbrella term for assistive products and related services, the use of which maintains or improves a person’s ability to function and be independent. AT is a key enabler of improved outcomes for people with disabilities, including those with deafblindness, in all life domains. However, tools are needed to assist people with disabilities to express needs, goals, and rights related to the use of AT, and to evaluate and measure AT-related outcomes, in order to make the case for appropriate AT provision.
Assistive products include devices, equipment, instruments, and software. AT services include assessment, product fitting, training, troubleshooting, and maintenance support, which are critical to the safe and effective use of products. AT is understood as a complex system requiring policies and markets that can deliver end to-end products and services. The application of systems thinking within the global AT community has identified five strategic drivers that are critical to realizing the full potential of AT for global citizens. Termed the ‘5 P’s’and comprising people (that is, AT users and their socialUnetworks), policy, products, personnel, and provision, these form the basis of strategic actions by the World Health Organization (WHO) Global Access to AT (GATE) team. Additional, situational factors of procurement, place, pace, promotion, and partnership have been hypothesized as other critical factors influencing AT outcomes.
Deafblindness is a unique and isolating sensory disability, resulting from the combination of both hearing and vision loss or impairment that significantly affects communication,
socialization, mobility, and daily living. Deafblind individuals use AT for the vision impaired, for example, long canes for mobility, screen, reading software, and refreshable braille displays and AT for deaf people, for example, hearing aids, and cochlear implants, as well as human supports, such as sign language interpreters and communication guides (support workers trained specifically to work one-to-one with people with deafblindness).
The Southern African Development Community (SADC) was selected as the focus of this study. Any research into AT and its impacts must be sensitive to context, and the impact of context upon capability. Reasons for selecting the SADC region included the emergence of an active Pan-African AT Community; evidence of strategic thinking about AT systems within the region, and the first Deafblind International Conference planned for Africa in 2022.
International calls for the sector-wide collection of AT outcomes data have been made for over two decades yet data is still not routinely collected, and consensus has not been reached on priority dimensions to be measured.