Of the more than 2.5 billion people globally who need 1 or more assistive products, such as eyeglasses, hearing aids, wheelchairs, and software or apps that support communication, nearly 1 billion of them lack access to these products, according to a new report from United Nations agencies.
Based on self-reported survey data collected by the World Health Organization (WHO), 31% of the global population (and about two-thirds of the global population aged 60 years or older) need assistive products, including eyeglasses. When eyeglasses are excluded, roughly 11% of people globally (900 million) need assistive products other than or in addition to eyeglasses.
A joint effort by the WHO and the United Nations Children’s Fund (UNICEF), the first Global Report on Assistive Technology notes that the need for these life-changing products is especially acute in low- and middle-income countries, where as few as 3% of those who need them can obtain them.
“Assistive technology is a life changer—it opens the door to education for children with impairments, employment and social interaction for adults living with disabilities, and an independent life of dignity for older persons,” said WHO Director-General Tedros Adhanom Ghebreyesus in a statement. “Denying people access to these life-changing tools is not only an infringement of human rights, it’s economically shortsighted.”
Assistive technology is an umbrella term for products and their related systems and services, such as wheelchairs, eyeglasses, hearing aids, prostheses, orthoses, walking devices, or continence pads, as well as software and apps that support communication, monitoring, and other functions. It also includes environmental adaptations, such as portable ramps or grab-rails, as well as services involving trained personnel to provide product-related assessment, fitting, user training, and maintenance.
Assistive products share a common purpose, which is to enable and promote “the inclusion, participation and engagement of persons with disabilities, ageing populations and people living with chronic conditions in the family, community and all areas of society, including the political, economic and social spheres,” the report notes.
Because of aging populations and disabilities related to an increasing prevalence of noncommunicable diseases globally, the number of people who will need 1 or more assistive products is likely to increase to 3.5 billion by 2050, the report said.
Findings from self-reported population surveys in 29 countries conducted by the WHO found that 10% to 69% of people reported they needed assistive products, including eyeglasses (excluding eyeglasses, about 5% to 20% reported needing such products). The proportion of people who reported access to the assistive products they needed, including eyeglasses, ranged from about 3% in poorer countries to 90% in wealthy countries; excluding eyeglasses, about 2% to 84% reported they had access to needed products.
Among all types of assistive products in all of the countries surveyed, the most-needed product was eyeglasses, followed by hearing aids and products that support mobility, including canes and crutches, walkers and wheelchairs, prostheses, and other items.
High costs, low availability, and lack of support were the most common barriers to accessing assistive products reported by survey respondents. The majority of individuals bought the assistive products they needed from the private sector and paid out of pocket, sometimes with financial support from family and friends.
Although the need for assistive technologies increases with age, the report notes that these products are important across the lifespan. For example, for the nearly 240 million children who have disabilities, access “is often the first step for childhood development, access to education, participation in sports and civic life, and getting ready for employment,” the report notes.
“Without access to assistive technology, children with disabilities will continue to miss out on their education, continue to be at a greater risk of child labor and continue to be subjected to stigma and discrimination, undermining their confidence and wellbeing,” UNICEF Executive Director Catherine Russell said in a statement.
The report presents a series of recommendations to expand availability and access to assistive technologies. It calls on governments to establish 1 or more agencies to lead and coordinate work to improve access, identify current gaps in meeting the need for assistive technologies, develop a national assistive technology roadmap, establish or integrate models for service delivery (such as mobile, tele-based, and online distribution), and implement other policies.
“Access to assistive technology is a human right, and a precondition for equal opportunities and participation,” the report notes, adding that “everyone is likely to need assistive technology during their lifetime, especially as they age.”
Published: May 31, 2022. doi:10.1001/jamahealthforum.2022.2169
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Stephenson J. JAMA Health Forum.
Corresponding Author: Joan Stephenson, PhD, Contributing Editor, JAMA Health Forum (Joan.Stephenson@jamanetwork.org).
Conflict of Interest Disclosures: None reported.
Stephenson J. Nearly 1 Billion People Globally Who Need Assistive Technologies Lack Access. JAMA Health Forum. 2022;3(5):e222169. doi:10.1001/jamahealthforum.2022.2169