Publications

KEnya paper

Type

Journal Paper

Themes

Assistive & Accessible Technology
The Kenyan assistive technology ecosystem: a network analysis

Emma M. Smith, Catherine Holloway

The objective of this research was to describe the assistive technology ecosystem in Kenya through descriptive information about key stakeholder organizations, and a network analysis demonstrating the nature and strength of relationships between organizations. An assistive technology ecosystem is an interconnected community of actors, including government, civil society, and the private sector who work together or in parallel to deliver assistive products and services to the people who need them. Using the network analysis, we aimed to demonstrate the degree to which key stakeholder organizations within the ecosystem did (or did not) interact, which will provide policy makers with data from which to further develop collaborations within the ecosystem

Taylor & Francis Online; 2024

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Abstract

The Kenyan assistive technology ecosystem: a network analysis

Background

Assistive technology is central to the realization of the rights of persons with disabilities. However, there remains limited access to assistive technology throughout much of the world, with particularly poor access in lower- and middle-income countries. Evaluating stakeholder engagement in assistive technology networks has been used as a successful strategy to understand and address gaps in the assistive technology ecosystem.

Objective

The objective of this research was to provide an overview of the Kenyan Assistive Technology Ecosystem, including available assistive products and related services, and an understanding of the nature and strength of relationships between stakeholders

Methods

In this study, we employed an online qualitative stakeholder survey (2021) with representatives of organizations involved in assistive technology in Kenya.

Results

The assistive technology network in Kenya is distributed, with Government Ministries and Agencies and Organizations of persons with disabilities central to the network. The strength of relationships is concentrated on awareness and communication, with fewer organizations actively collaborating. Innovation training organizations are not yet well integrated into the network.

Conclusions

Improving access to assistive technology in Kenya will benefit from greater collaboration amongst all assistive technology stakeholders.

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The Kenyan assistive technology ecosystem: a network analysis

To cite this article:

  1. Emma M. Smith, Stephanie Huff, Rose Bukania, Bernard Chiira, Catherine Holloway & Malcolm MacLachlan (2024) The Kenyan assistive technology ecosystem: a network analysis, Global Health Action, 17:1, DOI: 10.1080/16549716.2024.2302208


The Kenyan assistive technology ecosystem: a network analysis

Type

Journal Paper

Themes

Assistive & Accessible Technology

Research Group

Local Productions
Repair strategies for assistive technology in low resource settings

Ben Oldfrey, Cathy Holloway, Julian Walker, Steven McCormack, Bernadette Deere, Laurence Kenney, Robert Ssekitoleko, Helen Ackers & Mark Miodownik

This paper focuses on the local repair of assistive products in low resource environments. We review the existing literature on the repair of assistive products in low resource settings, and briefly discuss the “Right to Repair” movement.

Disability and Rehabilitation; 2023

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Abstract

Repair strategies for assistive technology in low resource settings

Abstract

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.

Results

Three major models of repair practice emerged from the data: “Individual or Informal Repair in the Community”; “Local Initiatives”; and “Specialist AT Workshop Repair”. Additionally, the wider impact on the participants’ lives of “Problems & Concerns with Repair”; “Experiences of Breakages & Frequencies of Repair” and the “Impact of Broken Devices” are explored.

Conclusions

The results of this analysis demonstrate the paramount importance of community-based repair of devices, and how despite this importance, repair is often overlooked in the planning and design of assistive products and services. There is a need to further incorporate and support these informal contributions as part of the formal provision systems of assistive device.

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Repair strategies for assistive technology in low resource settings

Ben Oldfrey, Cathy Holloway, Julian Walker, Steven McCormack, Bernadette Deere, Laurence Kenney, Robert Ssekitoleko, Helen Ackers & Mark Miodownik (2023) Repair strategies for assistive technology in low resource settings, Disability and Rehabilitation: Assistive Technology, DOI: 10.1080/17483107.2023.2236142

Repair strategies for assistive technology in low resource settings

Image of an empty street in Korea, with vibrant shop signs

Type

Journal Paper

Themes

Assistive & Accessible Technology

Research Group

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

Jamie Danemayer & Myung-Joon Lim

Korea is a rapidly ageing country, with its population over 65 years old increasing from 5% in 1990 to 17% in 2021. Comparatively, the global population over 65 has increased from 6% in 1990 to 9% in 2019 ]. As populations age and functional difficulties become more prevalent, the importance of assistive technology (AT) provision becomes more pronounced. Disparities in access to AT within a population can indicate inequities in healthy aging trajectories that will widen as the overall population ages, if clusters of limited access are not identified and addressed.

Taylor & Francis Online; 2023

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Abstract

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

Purpose

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.

Materials and methods

Using data from Korea’s 2017 NDS, surveying 91,405 individuals, we extracted and calculated AP access indicators, including needing, having, using and being satisfied with 76 unique APs, by functional difficulty and product type. We compared satisfaction and unmet need between the National Health Insurance System (NHIS) and alternative provision services.

Results

Prosthetics and orthotics had high rates of under-met need, and lower satisfaction rates, from 46.9% to 80.9%. Mobility APs overall had higher rates of under-met need. There was either low (<5%) or no reported need for most digital/technical APs. Among main products, those provided through the NHIS had lower unmet need (26.4%) than through alternative providers (63.1%), though satisfaction rates were similar (p < .001).

Conclusions

The Korean survey findings align with global averages calculated in the Global Report on Assistive Technology. Low reported needs for certain APs may reflect low awareness about how these products could benefit users, emphasizing the importance of data collection at each stage of the AP provision process. Recommendations to expand access to APs are given for people, personnel, provision, products, and policy.

Implications for rehabilitation

  • Access to assistive products (APs) is an essential part of physical and occupational therapy services and rehabilitation. Monitoring population-level data on disability and AP access can inform policymakers about a key aspect of population health and healthy ageing, and demonstrate the need to expand access by including APs and associated services in primary/universal healthcare packages.
  • Stratifying findings about AP access by type of functional difficulty and further by specific device helps identify the populations for whom needs are not being met. These domain-level and device-level indicators inform efforts to support specific groups within the population of people with disabilities, which has implications for how rehabilitation services are provisioned, targeted and made more accessible.

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

Jamie Danemayer & Myung-Joon Lim (2023)

Assistive technology in Korea: Findings from the 2017 National Disability Survey, Disability and Rehabilitation: Assistive Technology,

DOI: 10.1080/17483107.2023.2225565

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

Type

Report

Themes

Assistive & Accessible Technology
Assistive Technology Changes Lives: an assessment of AT need and capacity in England

This report was prepared by Global Disability Innovation (GDI) Hub for the Disability Unit in the Cabinet Office His Majesty’s Government (HMG). The report presents findings from a Country Capacity Assessment (CCA) of AT access in England. Findings illustrate a complex state of AT in England. While delivery systems tend to provide quality products that have a strong, positive impact on people’s lives, processes are often slow and stressful for users and providers alike. Startlingly, there is also an AT access gap of 31% of disabled people not having the assistive products they need to flourish, thrive, or even participate in daily life.

The Cabinet Office; 2023

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Abstract

Assistive Technology Changes Lives: an assessment of AT need and capacity in England

The aim of this research was to undertake a Country Capacity Assessment (CCA) to inform a more integrated approach to Assistive Technology (AT) provision in England. The results aim to support policymakers in identifying actions to strengthen service delivery to better meet disabled people’s needs, improving outcomes for AT users and reducing inefficiencies in the current approach.

The research was undertaken from November 2022 to March 2023 and led by the Global Disability Innovation (GDI) Hub, which is the World Health Organization (WHO) Global Collaborating Centre on AT access, using WHO tools in the Assistive Technology Assessment (ATA) suite.

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Assistive Technology Changes Lives: an assessment of AT need and capacity in England

Suggested Citation: Austin, V, Patel, D, Danemayer, J, Mattick, K, Landre, A, Smitova, M, Bandukda, M, Healy, A, Chockalingam, N, Bell D, and Holloway, C; Assistive Technology Changes Lives: an assessment of AT need and capacity in England; Cabinet Office, HMG; 2023

Assistive Technology Changes Lives: an assessment of AT need and capacity in England

Type

Journal Paper

Themes

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

Jamie Danemayer, Cathy Holloway, Youngjun Cho, Nadia Berthouze, Aneesha Singh, William Bhot, Ollie Dixon, Marko Grobelnik, John Shawe-Taylor

Paper highlights: 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; 2023

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Abstract

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

Ninety percent of the 1.2 billion people who need assistive technology (AT) do not have access. Information seeking practices directly impact the ability of AT producers, procurers, and providers (AT professionals) to match a user's needs with appropriate AT, yet the AT marketplace is interdisciplinary and fragmented, complicating information seeking. We explored common limitations experienced by AT professionals when searching information to develop solutions for a diversity of users with multi-faceted needs. Through Template Analysis of 22 expert interviews, we find current search engines do not yield the necessary information, or appropriately tailor search results, impacting individuals’ awareness of products and subsequently their availability and the overall effectiveness of AT provision. We present value-based design implications to improve functionality of future AT-information seeking platforms, through incorporating smarter systems to support decision-making and need-matching whilst ensuring ethical standards for disability fairness remain.

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

Kenyan man holding a prosthesis

Type

Journal Paper

Themes

Assistive & Accessible Technology
Evaluating the use of a thermoplastic socket in Kenya: A pilot study

Giulia Barbareschi, Wesley Teerlink, Josepg Gakunga Njuguna, Purity Musungu, Mary Dama Kirino, and Catherine Holloway

According to estimates from the World Health Organization, in 2010, there were more than 30 million people in need of prosthetic and orthotic devices across Africa, Asia, and Latin America.1 This number is likely to have grown significantly in the past decade, in line with trends recorded for the general need of assistive technology.2 For many people who undergo a lower limb amputation, access to an appropriate prosthesis is essential to restore functional mobility and ensure good quality of life.3 Ultimately, an appropriate lower-limb prosthesis (LLP) can enable people with amputation to fulfill their desired role in their family, work, and community life.4

Prosthetic and Orthotics International; 2022

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Abstract

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

Background:

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.

Objectives:

The objective of this study was to evaluate the satisfaction and the performance of transtibial prosthesis featuring the Confidence Socket.

Study design:

This is a longitudinal repeated-measures design study.

Methods:

A convenience sample of 26 participants who underwent transtibial amputation were fitted with the Confidence Socket. The performance of the socket was evaluated after a follow-up period between 1 month and 6 months using the L test of functional mobility and the amputee mobility predictor. Satisfaction with the prosthesis was measured using the Trinity Amputation and Prosthetic Experience Scales and purposefully designed 7-point Likert scales.

Results:

Ten of the 26 participants returned for follow-up. Perceived activity restriction and L test times improved significantly at follow-up, but the self-reported satisfaction with the Confidence Socket was lower at follow-up compared with that after fitting.

Conclusions:

The Amparo Confidence Socket represents a potentially viable alternative to improve access to appropriate prosthesis in Kenya, but some aspects of users’ self-reported satisfaction should be further investigated.

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

Barbareschi G, Teerlink W, Njuguna JG, Musungu P, Kirino MD, Holloway C. Evaluating the use of a thermoplastic socket in Kenya: A pilot study. Prosthet Orthot Int. 2022 Oct 1;46(5):532-537. doi: 10.1097/PXR.0000000000000130. Epub 2022 Mar 25. PMID: 35333813; PMCID: PMC9554758.

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