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Assistive & Accessible Technology

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Local Productions
A Preliminary Study to Understand How Mainstream Accessibility and Digital Assistive Technologies Reaches People in Lower- and Middle-Income Countries

Tigmanshu Bhatnagar, George Torrens, Ben Oldfrey, Priya Morjaria
Felipe Ramos Barajas, Katherine Perry and Catherine Holloway

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Access to information on digital platforms not only facilitates education, employment, entertainment, social interaction but also facilitates critical governmental services, ecommerce, healthcare services and entrepreneurship [1]. Article 9 of United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) enforces its signatories to commit to provide full accessibility to every citizen of the nation [2]. This has helped to spearhead accessibility directives such as the European Accessibility Act [3] that aims to improve the functioning of markets for accessible products and services. Such directives contribute to ensure that mainstream digital technologies (smartphones, computers etc.) are accessible for everyone and without being socially remarkable, they are able to assist in daily living. Additionally, there is evidence that improving access in mainstream technologies improves product experience and usability for everyone [4]. However, mainstream access has not been fully realized, leading to inferior opportunities for people with disabilities, a disparity which is more prominent in lower and middle-income countries [5].

RESNA Annual Conference; 2021

A Preliminary Study to Understand How Mainstream Accessibility and Digital Assistive Technologies Reaches People in Lower- and Middle-Income Countries

Young man with prosthetic arm developed at low cost

Type

Journal Paper

Themes

Assistive & Accessible Technology

Research Group

Local Productions
A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems

Catherine Holloway, Dafne Zuleima Morgado Ramirez, Tigmanshu Bhatnagar, Ben Oldfrey, Priya Morjaria, Soikat Ghosh Moulic, Ikenna D. Ebuenyi, Giulia Barbareschi, Fiona Meeks, Jessica Massie, Felipe Ramos-Barajas, Joanne McVeigh, Kyle Keane, George Torrens, P. V.M. Rao, Malcolm MacLachlan, Victoria Austin, Rainer Kattel, Cheryl D Metcalf & Srinivasan Sujatha

It is essential to understand the strategies and processes which are deployed currently across the Assistive Technology (AT) space toward measuring innovation. The main aim of this paper is to identify functional innovation strategies and processes which are being or can be deployed in the AT space to increase access to AT globally.

Assistive Technology The Official Journal of RESNA

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Abstract

A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems

It is essential to understand the strategies and processes which are deployed currently across the Assistive Technology (AT) space toward measuring innovation. The main aim of this paper is to identify functional innovation strategies and processes which are being or can be deployed in the AT space to increase access to AT globally. We conducted a scoping review of innovation strategies and processes in peer-reviewed literature databases and complemented this by identifying case studies demonstrating innovation strategies. The review includes WHO world region, publication year, AT type and a sector analysis against the Systems-Market for Assistive and Related Technologies Framework. We analyzed the case studies and interviews using thematic analysis. We included 91 papers out of 3,127 after review along with 72 case studies. Our results showed that product innovations were more prevalent than provision or supply innovations across papers and case studies. Case studies yielded two themes: open innovation (OI); radical and disruptive innovation. Financial instruments which encourage OI are needed and we recommend pursuing OI for AT innovation. Embedding AT within larger societal missions will be key to success governments and investors need to understand what AT is and their translational socioeconomic value.

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A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems

Catherine Holloway, Dafne Zuleima Morgado Ramirez, Tigmanshu Bhatnagar, Ben Oldfrey, Priya Morjaria, Soikat Ghosh Moulic, Ikenna D. Ebuenyi, Giulia Barbareschi, Fiona Meeks, Jessica Massie, Felipe Ramos-Barajas, Joanne McVeigh, Kyle Keane, George Torrens, P. V.M. Rao, Malcolm MacLachlan, Victoria Austin, Rainer Kattel, Cheryl D Metcalf & Srinivasan Sujatha (2021) A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems, Assistive Technology, 33:sup1, 68-86, DOI: 10.1080/10400435.2021.1970653

A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems

Type

Journal Paper

Themes

Assistive & Accessible Technology

Research Group

Local Productions
Additive manufacturing techniques for smart prosthetic liners

B Oldfrey, A Tchorzewska, R Jackson, M Croysdale, R Loureiro, C Holloway, M Miodownik

Elastomeric liners are commonly worn between socket and limb by prosthetic wearers. This is due to their superior skin adhesion, load distribution and their ability to form a seal. Laboratory tests suggest that elastomeric liners allow reduced shear stress on the skin and give a higher cushioning effect on bony prominences, since they are soft in compression, and similar to biological tissues [1]. However, they also increase perspiration reducing hygiene and increasing skin irritations. Prosthetic users in general face a myriad of dermatological problems associated with lower limb prosthesis such as ulcers, cysts, and contact dermatitis, which are exacerbated by the closed environment of a fitted socket where perspiration is trapped and bacteria can proliferate [2].

Medical Engineering & Physics; 2021

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Abstract

Additive manufacturing techniques for smart prosthetic liners

Elastomeric liners are commonly worn between the prosthetic socket and the limb. A number of improvements to the state of the art of liner technology are required to address outstanding problems. A liner that conforms to the residuum more accurately, may improve the skin health at the stump-socket interface. Previous work has shown that for effective thermal management of the socket environment, an active heat removal system is required, yet this is not available. Volume tracking of the stump could be used as a diagnostic tool for looking at the changes that occur across the day for all users, which depend on activity level, position, and the interaction forces of the prosthetic socket with the limb. We believe that it would be advantageous to embed these devices into a smart liner, which could be replaced and repaired more easily than the highly costly and labour-intensive custom-made socket. This paper presents the work to develop these capabilities in soft material technology, with: the development of a printable nanocomposite stretch sensor system; a low-cost digital method for casting bespoke prosthetic liners; a liner with an embedded stretch sensor for growth / volume tracking; a model liner with an embedded active cooling system.

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Additive manufacturing techniques for smart prosthetic liners

, Additive manufacturing techniques for smart prosthetic liners, Medical Engineering & Physics, Volume 87, 2021, Pages 45-55, ISSN 1350-4533, https://doi.org/10.1016/j.mede....

Additive manufacturing techniques for smart prosthetic liners

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

Working Paper

Themes

Culture and Participation

Research Group

Disability Interactions
Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya

Nusrat Jahan and Catherine Holloway

This working paper was developed to support the development of challenge statements for a GDI Hub innovation challenge fund call related to improving access to and retention of employment for persons with disabilities in Kenya and Bangladesh and is written by GDI Hub's Nusrat Jahan and Professor Catherine Holloway.

The issue of disability and employment has taken centre stage on the global arena in part because it is recognised across several areas of the United Nations Sustainable Development Goals, in which confrontation of extreme poverty in its many manifestations is the number one goal [2]. The World Health Organization (2011) reports about 15 percent of the world’s population has a disability [1]. In developing countries, 80 to 90 percent of people with disabilities of working age are unemployed.

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Abstract

Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya

Globally persons with disabilities have lower employment rates compared to the general population due to systemic barriers particularly in the formal sector. In developing countries, 80 percent to 90 percent of people with disabilities of working age are unemployed. There has been limited research in low-income and middle-income countries focused on the barriers to access and retain formal employment for persons with disabilities. The aim of this paper, based on desk research, is to analyse the barriers to access and retain formal employment of persons with disabilities which are framed in three categories according to where the barriers primarily manifest: 1. In the workplace among employers and co-workers without disabilities, 2. Among persons with disabilities seeking or engaged in formal employment and 3. In the wider social, physical and policy environment. Although the study mainly focuses on Kenya and Bangladesh other countries’ literature on access to and retention of employment of persons with disabilities were reviewed where relevant. In the current context where the global pandemic is breaking barriers to remote working one part of the solution will be to empower persons with disabilities with appropriate access to Information and Communication Technology, assistive devices and services, digital skills, creating more accessible and inclusive digital platforms for persons with disabilities which also hold the potential to improve working conditions and productivity for the whole workforce as well as enhancing resilience to potential future shocks.

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Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya

Jahan & Holloway, 2020, Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya, GDI Hub Working Paper Series Issue 01

Barriers to Access and Retain Formal Employment for Persons with Disabilities in Bangladesh and Kenya

Photograph of an informal settlement

Type

Journal Paper

Themes

Inclusive Design
Culture and Participation

Research Group

Disability Interactions
Bridging the Divide: Exploring the use of digital and physical technology to aid mobility impaired people living in an informal setlement

Giulia Barbareschi, Ben Oldfrey, Long Xin, Grace N. Magomere, Wyclife A. Wetende, Carol Wanjira, Joyce Olenja, Victoria Austin, and Catherine Holloway

The World Health Organisation estimate that there are approximately a billion people with disabilities who require access to appropriate assistive technology and this number is set to double by 2050 [82]. Assistive technologies (ATs) play a crucial role in the lives of people with disabilities and are necessary to be able to access essential services and participate in family and community life according to one’s aspirations [40, 62, 68, 81]. Although this is not often specifcally mentioned, the large majority of people with disabilities will routinely use more than one assistive device in their everyday lives [25, 26]. For example a person with a visual impairment is likely to use a white cane to navigate from their house to the office where they work and have a screen-reader, or an equivalent accessibility software, on their computer to be able to do their work once in the office [17].

ASSETS '20: Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility; 2020

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Abstract

Bridging the Divide: Exploring the use of digital and physical technology to aid mobility impaired people living in an informal setlement

Living in informality is challenging. It is even harder when you have a mobility impairment. Traditional assistive products such as wheelchairs are essential to enable people to travel. Wheelchairs are considered a Human Right. However, they are difficult to access. On the other hand, mobile phones are becoming ubiquitous and are increasingly seen as an assistive technology. Should therefore a mobile phone be considered a Human Right? To help understand the role of the mobile phone in contrast of a more traditional assistive technology – the wheelchair, we conducted contextual interviews with eight mobility impaired people who live in Kibera, a large informal settlement in Nairobi. Our findings show mobile phones act as an accessibility bridge when physical accessibility becomes too challenging. We explore our findings from two perspective – human infrastructure and interdependence, contributing an understanding of the role supported interactions play in enabling both the wheelchair and the mobile phone to be used. This further demonstrates the critical nature of designing for context and understanding the social fabric that characterizes informal settlements. It is this social fabric which enables the technology to be useable.

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Bridging the Divide: Exploring the use of digital and physical technology to aid mobility impaired people living in an informal setlement

Giulia Barbareschi, Ben Oldfrey, Long Xin, Grace Nyachomba Magomere, Wycliffe Ambeyi Wetende, Carol Wanjira, Joyce Olenja, Victoria Austin, and Catherine Holloway. 2020. Bridging the Divide: Exploring the use of digital and physical technology to aid mobility impaired people living in an informal settlement. In Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS '20). Association for Computing Machinery, New York, NY, USA, Article 50, 1–13. https://doi.org/10.1145/337362...

Bridging the Divide: Exploring the use of digital and physical technology to aid mobility impaired people living in an informal setlement