Developing National Priority Assistive Products Lists: experiences and lessons from six Sub-Saharan African countries

Assistive technology (AT) plays a vital role in promoting independence, inclusion, and improved quality of life for people globally [1–3]. Yet, over 1 billion people worldwide lack access to AT, particularly in low-and middle-income countries (LMICs) where access is as low as 3% [4]. In 2016, to address this large and global need, the World Health Organisation (WHO) launched the Priority Assistive Products List (APL), a model list of fifty essential assistive products [5]. Modelled after the WHO Model List of Essential Medicines, the WHO Priority APL aimed to strengthen health systems and advance Universal Health Coverage (UHC) through improved AT provision, while also mobilising resources and stimulating market competition [5,6]. The WHO APL provides a guiding framework for countries to develop National APLs, tailored to local contexts and priorities [7,8]. These National APLs can inform local policies, resource allocation, and service delivery strategies, ultimately improving access to AT not only for people with disabilities but all who benefit from AT. Research has demonstrated that increased availability of assistive products can contribute to achieving multiple Sustainable Development Goals (SDGs), including poverty reduction, improved health outcomes, and enhanced educational and employment opportunities for persons with disabilities [7]. This underscores the importance of National APLs as tools for promoting UHC and social inclusion [6]. Despite the availability of the WHO Priority APL since 2016, country-level adoption of National APLs has been limited. By 2020, no African countries had developed National APLs. Between 2021 and 2024, work was done with several governments to develop and launch the first-ever National APLs, yet many African countries have yet to initiate this process [9]. Given this, the need for knowledge sharing across the international setting regarding the process, barriers, facilitators, and learnings from implementing National APLs is key [10].
 

Purpose: This study examines the experiences and lessons learned from six Sub-Saharan African countries in developing National Priority Assistive Products Lists (APLs) between 2020 and 2024, aiming to provide insights for improving assistive technology (AT) access in low- and middle-income countries (LMICs). Materials and methods: The study employed qualitative descriptive methodology with a multi-faceted approach, including a comprehensive desktop review of documentation and publications, followed by semi-structured interviews and information review with key stakeholders (n = 9) from all six countries. Data analysis involved synthesising information to identify common themes, challenges, and best practices in APL development. Results: Key findings include the importance of multi-stakeholder engagement, challenges in data availability, varied prioritisation frameworks, and the need for local context adaptation. Countries faced common barriers, such as limited funding and regulatory challenges, however also identified facilitators like government leadership and integration with existing health systems. Conclusions: The study highlights the complex nature of developing National APLs and emphasises the importance of inclusive stakeholder engagement, data-driven prioritisation, and integration within broader health system strengthening efforts. These insights can guide other countries in developing and implementing effective APLs, ultimately improving AT access and advancing disability rights.