What is Assistive Tech, who is it for, and what does it enable?

When we use the term Assistive Technology (AT), we usually think about products like wheelchairs and walking sticks, hearing aids and eye-glasses, prosthetics and digital or mobile devices. However, the World Health Organisation (WHO) suggests a broad definition of assistive technology which emphasises services (diagnostics, fitting, ‘on-demand’ assistance), systems (infrastructure, processes), and products (eyeglasses, hearing aids, mobility aids).

Right now, the WHO estimates that over a billion people around the world need Assistive Technology (AT). This estimate is predicted to rise to 2 billion by 2050 [1]. 90% of these people don’t have access to assistive technology, and there are few signs of that number coming down. In low and middle income countries (LMICs) lack of access to assistive technology is amplified, which is a significant problem given that 80% of the world’s disabled people live in these regions [2].

People who identify as having a disability are also not the only people who may need and benefit from AT. Ageing can mean that all of us may need to wear glasses, hearing aids, or use mobility devices such as walking sticks at some point in our lives. Therefore, access to good quality AT is an issue which will likely affect us all at some point.

For many disabled and elderly people, access to AT represents an enabling gateway to everyday activities such as gaining an education, maintaining employment, and being an active family member and citizen. Given that AT is often necessary for people to participate in daily life, access to AT is therefore linked to achieving the delivery of the Sustainable Development Goals (SDGs), such as poverty, zero hunger, quality education, decent work, and reduced inequalities. Access to AT represents an important and impactful way to create a fairer and more inclusive society.

When we look at the market value of assistive tech, the eyewear market is worth approximately $130 Billion [3], hearing aids are worth $6 Billion [4], and prosthetics $1.3 Billion- growing at 3% each year [5]. Therefore, the AT sector is already performing well from a financial perspective. However, there is significant growth potential.

The two most common types of visual impairments are usually addressed by a type of AT which we are all familiar with. Reading glasses can be found relatively cheap ($1–2 to buy), but are often of low quality. Prescription glasses however are much more expensive, ranging from $20–150, and require diagnostic services to fit and must be replaced every 2 to 3 years. For more severe sight impairments, AT can encompass devices such as navigation canes, braille readers, and an increasing number of digital tools.

Key affordability challenge: Many customers in LMICs require affordability solutions to overcome high upfront purchasing costs of prescription glasses and other sight-related AT.

Key distribution challenge: Prescription glasses require last mile distribution to remote locations, and each paid must be tailored to each individual based on their prescription.

Some types of hearing loss can be corrected or improved through the use of a hearing aid. Hearing aids are relatively expensive, ranging from $70 to $500+ per device in LMICs, and many people require aids for both ears. Hearing aids also have on-going maintenance costs for users, including battery replacements, costing $12 to $50 annually, along with other replacement parts and servicing. Successful adoption of a hearing aid usually requires a trained professional to diagnose the need for a hearing aid and fitting and calibration to set up the device for an individual’s needs and ear shape. However, some members of the Deaf community choose to not adopt AT which aims to overcome hearing issues. Instead, these individuals will make use of sign language to communicate and therefore may require AT to aid in learning sign language, or to access interpretation services.

Key affordability challenge: Even the lowest cost hearing aids are often out of reach due to the upfront device cost and on-going cost to keep the device working.

Key distribution challenge: Hearing loss diagnosis requires expertise, and fitting and calibration may need hands-on assistance from trained professionals.

Mobility impairments can be addressed through wheelchairs, prosthetics, orthotics and canes. In LMICs, wheelchairs cost $150 to $350, with orthotics and prosthetics costing significantly more. Mobility aids require on-going maintenance, spare parts, and often must be fitted by highly trained professionals in dedicated fitting centres.

Key affordability challenge: The upfront costs associated with acquiring tailor made devices are often out of reach for low-income populations.

Key distribution challenge:Access to mobility themed AT typically requires interaction with rehabilitation services, medical institutions, and workshops which are usually centralised and few and far between.

The role of digital technologies in AT is still relatively nascent. However, digital applications are having an increasingly large role in diagnostics by significantly reducing the cost and knowledge burden to assess AT needs in hearing and eye care. We are seeing services such as on-demand video call services to aid blind people, sign language interpreters at the push of a button, and digital production of prosthetics made possible through 3D scanning and printing. Moving forward, digital technologies will become increasingly common across the value chain of AT- either as an AT in its own right, as a diagnostic tool, or even to address problems in production, distribution and financing AT.

Key affordability challenge: For end-users to adopt digital AT, they need the devices which digital ATs operate on. Low-income people may only be able to afford feature phones, or basic smartphones.

Key distribution challenge: As well as being able to afford the devices which make digital AT possible, many digital ATs depend on reliable internet connection services which are not typically available in remote locations.

Nearly all forms of assistive technology have similar challenges. In LMICs end users are often not aware that they need AT, what solutions are available, and how to access them. There is also often a lack of diagnostics and a limited supply of trained professionals who can properly diagnose, fit and support AT users. Scarcity of resources typically results in concentrated AT expertise in urban and peri-urban locations. Many AT devices incur high up-front costs for the diagnosis, fitting and provision of the product, with ongoing maintenance costs. So, even if users can reach an access point for AT, they may struggle to afford the upfront and associated costs. There are also many cultural and stigmas associated with AT, which can lead to a high degree of abandonment.

Whilst these issues may sound insurmountable, other tech sectors are already solving many of these issues. Therefore, many of the challenges can be solved by connecting to and partnering with companies across the technology ecosystem. Given the common themes across mutliple types of assistive technologies, well positioned partnerships have the potential to solve multiple problems- unlocking market opportunities in LMICs and across the world.

This blog post is a simple introduction to the world of assistive technology. The Global Disability Innovation Hub, and AT2030 programme have produced many detailed high quality publications which dive into the complexities and nuances of this exciting sector. Visit the publication library to find out more.