Improving access to assistive technology
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Improving access to assistive technology
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Improving access to assistive technology
- 1. Improving access to assistive technology Agenda item 5(a) 63rd Session of the WHO Regional Committee for the Eastern Mediterranean 36 October 2016, Cairo
- 2. Outline • WHO definition of assistive technology • Why assistive technology? Why health? • Regional situation • WHO response • Proposed resolution and plan • Conclusion 2 Improving access to assistive technology
- 3. Improving access to assistive technology WHO defines assistive technology as “A subset of health technology, that refers to assistive products and related systems and services for people to maintain or improve functioning thereby promoting well- being ”. 3
- 4. Globally: 1 billion now, 2 billion by 2050 4 Improving access to assistive technology
- 5. To ensure access, ministries of health should lead • Responsible for ensuring the health and well-being of their populations. • Infrastructure for integrated service provision, including at primary health care levels, that can be used for wide- scale provision of assistive products. 5 Improving access to assistive technology
- 6. Regional challenges 1. Lack of national policies and programmes • No adequate information on existing legislation, policies or programmes on assistive technology • Rehabilitation services particularly in lowmiddle income countries are provided by the private sector, nongovernmental organizations, donors and international institutions 6 Improving access to assistive technology
- 7. 2. Inability to properly assess needs and provide services to different groups • Needs not fully known • Regional data on disability, ageing, noncommunicable diseases and injuries can be considered a proxy measure of market size of required products • Needs are even higher in emergency situations 7 Improving access to assistive technology
- 8. Proxy measures of regional market size 8 • Disability – Over 97 million estimated to be living with disabilities – Country prevalence of disability between 0.7% and 4.6% • Ageing population – Projected to double from 7% (2015) to 15% (2050) of regional population • Noncommunicable diseases – Highest diabetes prevalence (13.7%) among adults 18+ in the world. Lower limb amputation rates 10 to 20 times higher than among the general population • Injury – Second highest road traffic death rate worldwide. – For every death, there are at least 20 more non-fatal injuries with possible permanent disabilities Improving access to assistive technology
- 9. Emergency situations • Over 62 million people affected in the Region • Humanitarian needs in Syria, 2016 • Earthquakes: Bam (2003) and Kashmir (2005) 9 Improving access to assistive technology
- 10. 3. Inadequate rehabilitation services, including skilled personnel and assistive products • In many low- and middle- income countries, only 515% of people requiring assistive products have access to them • Inadequate production, poor quality of some assistive products, and prohibitive costs 10 Improving access to assistive technology
- 11. WHO response Global cooperation 11 Product PersonnelProvision Policy Assistive technology policy framework Priority assistive products list Single-window service provision Training package Improving access to assistive technology
- 12. Proposed resolution: Regional action plan Policy and financing Service provision Products Personnel 12 Health sector leadership in coordination with others Integrated national policy Adequate financing Data on needs for planning National priority assistive products list Essential service delivery component AT in emergency preparedness and response National standards for assistive technology National/regional collaboration and coordination for manufacturing Appropriate and adequate human resources at all levels of health service delivery Specialized assistive technology professions Improving access to assistive technology
- 13. Conclusion 13 • Assistive technology is essential to maintain and improve functioning, reduce need for caregivers and rationalize costs • Ministries of health are key to ensure universal access to assistive technology, even where others carry the main responsibility • Access to assistive technology is as important as access to medicines, vaccines and medical products • Integration of assistive technology in universal health coverage and in emergency preparedness and response is essential Improving access to assistive technology
- 14. Thank you 14 “[Assistive technology] has been supporting me for almost 20 years, allowing me to do what I love every day. [It] has the potential to improve the lives of disabled people around the world and is leading the way in terms of human interaction and the ability to overcome the …boundaries that once stood in the way”. Professor Stephen Hawking, 2014 Improving access to assistive technology
Editor's Notes
- WHO defines AT as “A subset of health technology, that refers to assistive products and related systems and services for people to maintain or improve functioning thereby promoting well-being”. Assistive products include a variety of devices from walking canes, spectacles, hearing aids, wheelchairs and artificial legs up to the more sophisticated memory and cognitive aids or computer hard and software for different needs
- Today it is estimated that globally over 1 billion could benefit from AT. This number is projected to rise above 2 billion by 2050. This includes persons with disability, older people, people with noncommunicable diseases and mental health conditions as well as people with gradual functional decline. Despite this huge need globally only one in 10 of those in need is estimated to have access to AT. This gap will further increase as the need grows – with a huge burden on public health and socioeconomic growth. Given the impact of assistive products on functioning and health, they are key role to achieving Sustainable Development Goal (SDG) 3, in particular target 3.8 on universal health coverage. Add to this their impact on the achievement of most of the other SDGs
- In fact the health sector is best placed to ensure universal access to assistive products. MOH are responsible for ensuring the health and well being of their populations. They are in possession of the health infrastructure for integrated service provision, including PHC, for wide-scale provision of APs. Even in countries where other sectors (such as social welfare) have the main responsibility for assistive technology, MOH should have an assistive technology programme to ensure access to the whole population.
- There are some efforts and achievements in terms of AT provison across the Region. However for the sake of time and to make the case for this paper, we will present the identified regional key challenges: First there is a lack of national AT policies and programmes. In a 2005 Global survey 18 countries of the Region reported that they supply individuals with APs. However there was no adequate information on whether this was supported by an appropriate legislation, policy or instituted programme. Rehabilitation services, particularly in low- and middle-income countries, are provided by the private sector, NGOs, donors and international institutions. Many of these actors have different limitations relating to geographical coverage, focus on specific types of assistive technology or disability, financial means or capacity to develop country-wide sustainable service delivery systems. The implications for universal access to all are grave.
- The second challenge is the inability to properly assess the specific needs and provide services to different groups. Data on existing needs not fully known. Nevertheless, regional data on disability, ageing, NCDs and injury could be used as a proxy measure of market size of required products. Needs are even higher in emergency situations. The next 4 slides will show available data.
- In addition, the Eastern Mediterranean Region is facing an unprecedented scale of emergencies affecting almost each country either directly or indirectly. Over 62 million people affected by emergencies in EMR; and in need of health care. For example: - A 2016 humanitarian needs review in Syria: Around 1.5 million people with disabilities and 600 000 with chronic illness in need of humanitarian assistance, and have limited access to needed services Earthquakes in Bam (2003) and Kashmir (2005) resulted in large numbers of deaths, injuries and disabilities. Estimates indicated that both earthquakes resulted in approximately 31 000 deaths and 30 000 injuries in the Islamic Republic of Iran and over 73 000 deaths and 128 000 injuries in Pakistan. However, the response to pre-existing and emerging needs is often absent or patchy with provision of inappropriate low-quality products. This may be exacerbated by the disruption of health and other systems.
- The third challenge is the inadequate rehabilitation services including skilled personnel and products. In fact, in many low- and middle-income countries, only 5-15% of people requiring assistive products have access to them due to different reasons such as inadequate production, poor quality of some products, and prohibitive costs.
- In response to a request from the Un General Assembly in 2013 to develop and coordinate technical assistance to Member States on AT, the Secretariat established the Global Cooperation on Assistive Technology (GATE). GATE addresses four key areas. On policy, a policy framework is being developed, on products the WHO priority AP list was developed in consultation with MS, partners and users, on personnel, a training package is under development for all training needs and on service provision, a single window provision model is underway supported by a needs assessment tool.
- Along these lines, a resolution has been drafted for your review and discussion enclosing a regional action plan to improve access to AT in the Region. The focus is on MoH’s leading role in this regard in coordination with others, integrated national policies with adequate financing, inclusion of AT in UHC and emergency preparedness and response, data on needs to inform service planning, national priority products lists, and adequate human resources.
- In conclusion