Publications

screenshot of article's first page
Demographic, socioeconomic, and social barriers to use of mobility assistive products: a multistate analysis of the English Longitudinal Study of Ageing

Assistive technology, such as canes, walkers, and wheelchairs, is essential for independence and social participation for people with disabilities. However, access remains limited, even in high-income countries. For example, over 30% of people with disabilities in England have unmet needs for assistive devices.

Factors like age, gender, location, and socioeconomic status influence access to assistive technology. While much research focuses on devices like glasses and hearing aids, mobility aids (e.g., wheelchairs) often receive less attention despite growing demand. Understanding these access disparities is crucial for identifying the groups most in need of support and guiding better policies.

Long-term data on assistive technology use is limited, but by combining data on disability and device use, we can identify gaps in access—especially for individuals who may not identify as disabled but still face significant functional limitations. Examining the links between demographic, social, and economic factors with unmet needs can help improve access and ensure more inclusive support for those most need it.

The Lancet; 2024

Download Visit publisher

Abstract

Demographic, socioeconomic, and social barriers to use of mobility assistive products: a multistate analysis of the English Longitudinal Study of Ageing

Background

Cross-sectional evidence suggests that access to essential mobility assistive products (MAPs) might be dependent on non-clinical factors. However, MAP use is better understood as a dynamic process wherein individuals pass through different states of MAP need and use. We aimed to test associations of demographic, socioeconomic, and social factors with transitions between MAP need and use states.

Methods

For this multistate modelling study, data were drawn from 13 years (May, 2006, to July, 2019) of the English Longitudinal Study of Ageing, a prospective cohort study. We included respondents aged 50–89 years who participated in at least two waves of data collection. We used multistate models to examine associations of demographic, socioeconomic, and social factors, including age, sex, education, employment, wealth, marital status, and help with activities of daily living (ADL), with transitions between three main states: no need for MAPs, unmet need for MAPs, and use of MAPs.

Findings

We used data collected from 12 080 respondents (6586 women and 5494 men). During follow-up, 5102 (42·2%) of participants had unmet MAP need and 3330 (27·6%) used MAPs. Women were more likely than men to transition from no need to unmet need (hazard ratio [HR] 1·49, 95% CI 1·38–1·60) and less likely to transition from unmet need to use (0·79, 0·72–0·86). We found an increase in risk of transitioning from no need to unmet need for each 1-year increase in age (1·06, 1·06–1·07), for those with low education level (1·34, 1·23–1·45), those with help with ADL (1·32, 1·16–1·49), and who were not employed (1·22, 1·07–1·40) or disabled (3·83, 2·98–4·93). Similarly, we found an increase in risk of transitioning unmet need to use for each 1-year increase in age (1·06, 1·05–1·06), for those with low education level (1·20, 1·10–1·31), and those with help with ADL (1·25, 1·13–1·38). Increasing wealth was associated with a reduced risk of transitioning from no need to unmet need (0·78, 0·74–0·81) and from unmet need to use (0·94, 0·89–0·99). Single people were more likely to transition from unmet need to use than partnered people (HR 1·21, 95% CI 1·10–1·33).

Interpretation

Women might be disproportionately likely to have unmet MAP needs, whereas other demographic, socioeconomic, and social factors are associated with high MAP need overall. Our findings directly support efforts towards expanding access to assistive products and identifying groups that could particularly benefit. As the first study of its kind to our knowledge, replication with other longitudinal datasets is needed.

Funding

UK Aid.

Demographic, socioeconomic, and social barriers to use of mobility assistive products: a multistate analysis of the English Longitudinal Study of Ageing

Cover of playbook

Type

Report
A Mentoring Playbook for Disability Innovation

Daniel Hajas, Thomas Hørdam, Tigmanshu Bhatnagar, Shantosh Cumarasurier, Clare Casson

Today, as we mark the International Day of Persons with Disabilities, we want to focus on innovation’s vital role in creating a more inclusive world for people with disabilities.

On International Day of Persons with Disabilities, we are delighted to share a new playbook designed to support organisations in launching and managing mentoring programmes for early-career researchers and start-ups in the disability innovation sector. This playbook, informed by insights from the TIDAL Accelerator, Attvaran Accelerator, and We Love Mentors, provides a practical framework for overcoming the unique challenges of assistive technology (AT) ventures. The TIDAL Accelerator supports early-career researchers in disability innovation, while the Attvaran Accelerator aids start-ups and entrepreneurs through mentorship and business training.

TIDAL N+; 2024

Download

Abstract

A Mentoring Playbook for Disability Innovation

This playbook provides a comprehensive guide for organisations seeking to launch and manage mentoring programmes aimed at early career researchers (ECRs) and start-ups in the disability innovation sector. Rooted in the experiences of the TIDAL ECR Accelerator, insights from the Attvaran Accelerator, run by GDI Hub as part of the AT2030 programme, and We Love Mentors, this playbook outlines a practical and adaptable framework for fostering mentoring in a complex, yet essential, area of innovation.

A Mentoring Playbook for Disability Innovation

Type

Conference Paper

Research Group

Local Productions
Unlocking Sustainable and Resilient Assistive Technology Innovation and Delivery Ecosystems: Personalised Co- creation of Locally Produced Prosthetics

Ben M. Oldfrey, Ram C. Thapa, Ashish Thapa, Bikash Paudel, Amit Bajracharya, Ganga Gurung, Rosemary Gowran, Pratisthit Lal Shrestha, Tigmanshu Bhatnagar, Mark Miodownik, Catherine Holloway

The World Health Organisation (WHO) reports that access to assistive products like prosthetics, wheelchairs, and hearing aids varies significantly by income level. In high-income countries, 64% of people needing these products have access, while only 33% in medium-income countries and 11% in low-income countries do.

Assistive technology (AT) encompasses assistive products (APs) and services necessary for effective use. Globalisation has facilitated the mass production of assistive products but often leads to monopolies that create barriers to local innovation and repair strategies, especially in low-income countries. The AT2030 Programme, led by the Global Disability Innovation Hub in Nepal, aims to enhance localised innovation within the global assistive product system.

In Nepal, official estimates suggest that only 2.2% of the population has a disability, but this figure is likely underestimated. Various organisations are working to provide AT and rehabilitation services, addressing local needs, such as difficult terrain and logistics.

This paper reflects on our journey within the AT2030 project, highlighting the development of a global-local community, interdisciplinary innovation teams in Kathmandu, and preliminary results from two bespoke product development cases, emphasising collaboration between global and local expertise for effective AT solutions.

Download

Unlocking Sustainable and Resilient Assistive Technology Innovation and Delivery Ecosystems: Personalised Co- creation of Locally Produced Prosthetics

Type

Report
Repair of Assistive Products in the UK: Wheelchairs. Outcomes of a 1-day workshop exploring this topic from user, community and provision system perspectives

Ben M. Oldfrey, Vikranth H. Nagaraja, Eleanor Crommentuijn-Marsha, Laurence P.J. Kenney

Our recent one-day workshop brought together a diverse group of stakeholders to examine the challenges and opportunities in wheelchair repair services. By engaging multiple perspectives, we gained valuable insights into how improved repair processes can enhance service delivery, empower users, and support sustainability efforts.

Key discussions focused on the urgent need to address data gaps in repair practices, promote user involvement, and shift towards systems that prioritise repair and maintenance. Innovative ideas, such as creating digital profiles for wheelchairs and using AI to predict breakdowns, were explored as ways to streamline repair services and improve user autonomy.

Going forward, collaboration between manufacturers, healthcare providers, and users will be essential to building a more sustainable, user-centred approach to wheelchair repairs.

Read the full report to learn more about the ideas and strategies shared during the wheelchair workshop

Download

Repair of Assistive Products in the UK: Wheelchairs. Outcomes of a 1-day workshop exploring this topic from user, community and provision system perspectives

Type

Report
Repair of Assistive Products in the UK: Prosthetics & Orthotics. Outcomes of a 1-day workshop exploring this topic from user, community and provision system perspectives

Ben M. Oldfrey a, Vikranth H. Nagaraja b, Arhym Hoonchamlong a, Laurence P.J. Kenney

Our recent one-day workshop brought together a diverse group of stakeholders to explore the critical role of repair in the assistive technology sector. Through a range of perspectives, we uncovered valuable insights into how repair can drive sustainability, improve service delivery, and empower users.

Key discussions centered on the urgent need for a systemic shift toward more repairable and modular designs alongside regulatory changes and innovative frameworks that support efficient repair services. We also highlighted the importance of better data on repair practices and the need for transparency and user engagement.

As we look ahead, the conversation must include all stakeholders, particularly the users themselves. This collaborative approach will be vital to building a more sustainable and repairable future for assistive technology.

Read the full report to learn more about the ideas and strategies shared during the P&O workshop

Download

Repair of Assistive Products in the UK: Prosthetics & Orthotics. Outcomes of a 1-day workshop exploring this topic from user, community and provision system perspectives

KEnya paper

Type

Journal Paper
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

Download Visit publisher

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.

Cite

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