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- Ekman, Björn, et al.
(author)
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Sustainable and equitable provision of wheelchairs in low- and middle-income countries : an economic assessment of the models for wheelchair provision in Tajikistan
- 2021
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In: Disability and Rehabilitation: Assistive Technology. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 16:8, s. 865-870
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Journal article (peer-reviewed)abstract
- Introduction: Reaching universal coverage of assistive technologies remains a challenge in many low- and middle-income countries. Tajikistan has recently adopted several policies and national strategies to strengthen the rights of people with disabilities and improve the provision of assistive products. However, Tajikistan faces a number of challenges, including ensuring sustainable funding for the provision of wheelchairs in the medium and long term. Methods: This study presents the results of a recent analysis of the economic aspects of the provision of wheelchairs in Tajikistan to inform policy making in other low- and middle-income countries. The study draws on several sources of information, including local cost data, consultations with national and international experts and stakeholders, and reviews of the existing evidence. Results: Countries are advised to adopt an incremental approach to wheelchair provision. In the short term, countries may wish to import wheelchairs to move towards universal coverage. In the medium-to-long term, countries may wish to invest in national capacities for local production. Conclusion: Countries will need to continue implementing strategies to ensure universal access to wheelchairs without the risk of financial hardship for users, regardless of the approach to provision that has been chosen.Implication for Rehabilitation Reaching universal coverage of assistive technologies remains a challenge in many low- and middle-income countries. Countries are advised to adopt an incremental approach to wheelchair provision. The model of wheelchair importation may be a realistic model over the short- to medium-term for many LMICs countries to ensure effective and equitable provision of wheelchairs. In this article, we identify that sufficient funding needs to be allocated to the provision of wheelchairs regardless of the model of provision.
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| 2. |
- Mishra, Satish, et al.
(author)
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National priority assistive product list development in low resource countries : lessons learned from Tajikistan
- 2021
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In: Disability and Rehabilitation: Assistive Technology. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 16:8, s. 857-864
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Journal article (peer-reviewed)abstract
- Introduction: Developing a national assistive products list is an important part of an assistive technology policy and requires knowledge of total population need, and product costs and benefits; information is not always readily available in low-income countries. Our experience in Tajikistan of developing a national assistive products list provides guidance for others. Methods: Two hundred people with disabilities participated in a survey on self-reported need for assistive products, user experiences and barriers to access; 12 focus groups, of over 100 people with disabilities and older adults, conducted discussions on assistive technology. Major providers of assistive technology (government, nongovernmental organizations, local producers) were interviewed. Results: These results were presented at a meeting with government and other stakeholders, which led to a consensus on 30 assistive products for the national assistive products list. Conclusion: We identified the essential stakeholders responsible for developing the assistive products list, and discussed the data needed (total need, cost-effectiveness, unmet need, resources, barriers, system analysis) to make an informed decision on which products to include. This work can be used as a case study for developing an assistive products list quickly on a small budget without compromising on a user-centred approach or active participation of stakeholders.Implications for Rehabilitation Incorporating rehabilitation and assistive technology in universal health coverage. Establishing and strengthening networks and partnerships in rehabilitation and building on existing resources (stakeholders, knowledge, government policy documents) to strengthen rehabilitation and assistive technology particularly in low- and middle-income countries. Developing a national assistive products list is an important part of an assistive technology policy. Creating a national assistive products list requires knowledge of population need, and product costs and benefits; information that is not always readily available in low-income countries. In this article, we identify the essential stakeholders responsible for developing the assistive products list and the data needed for informed decisions. We demonstrate that developing an assistive products list can be carried out quickly and on a small budget.
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