Devices that help people function in every day life are costly in Africa: here’s why

 

More than 200 million Africans need at least one assistive device. Lucian Coman/Shutterstock

Tolu Olarewaju, Keele University; Aoife Healy, Staffordshire University, and Nachiappan Chockalingam, Staffordshire University

Everyone has a right to certain products and devices that can help them function in everyday life. This is the stance of the World Health Organisation (WHO), which has published a list of the most important of these devices. It includes things like walking aids, wheelchairs and braille displays.

But assistive technologies, as they are called, are difficult to access in many parts of Africa. This is a huge problem because the prevalence of disabilities on the continent is estimated at 15.6%. With a population of more than one billion, the number of people in need of at least one assistive product in Africa stands at over 200 million, and that figure is projected to double by 2050.

The WHO estimates that only about 15% to 25% of those in need of assistive technology products in Africa currently have access to them.

Our research sought to find out why and to offer solutions to this problem.

Human rights

Assistive technologies are functional, adaptive, and rehabilitative devices. Not only does the WHO support a global commitment to making them more easily available, the United Nations also regards them as a basic human right. This is because some people need them in order to exercise their rights.

Without access to the assistive technology they need, people can face exclusion and are at risk of poverty. They may also be perceived as a burden to their families and society. The positive impact of assistive technology products goes far beyond improving the health and well-being of users. There are also the socio-economic benefits of reducing direct health costs and having a more productive labour force, indirectly stimulating economic growth.

The 2006 UN Convention on the Rights of Persons with Disabilities and its optional protocol was negotiated quickly and well supported by member states. It was also the first human rights convention to be open for signature by regional integration organisations. But its implementation has been shaky, particularly in Africa.

We believe this is best explained by the idea of economic and political institutional voids. These are basically gaps in political and economic systems, trade policies and markets. An absence of specialised intermediaries, regulatory systems and contract enforcing mechanisms creates higher transaction costs for doing business or even entering markets.

Seeing the problem in this way also helps to show how to solve it and achieve fair access to assistive technologies.

Institutional voids

First, there is little production of assistive technologies in Africa because the parts are generally expensive to make. Many indigenous producers use crude and unstandardised materials.

Second, assistive technologies that are not produced locally are expensive to import. There are no unified tariff structures for them within the continent. This means that costs vary widely from country to country. Often, when assistive technologies do get imported despite high tariffs, they might need to be adapted for the local environment. This increases the costs even further.

Third, assistive technologies are mostly excluded from health financing and insurance schemes on the continent. They are not often included in central medical store catalogues.

Fourth, there aren’t enough people at all levels of the health system with the required knowledge and skills to provide assistive technology services and products.

Fifth, and most crucially, there is no unified governance framework for assistive technologies on the continent. And there’s a widespread lack of awareness about why they are needed and how they can improve the lives of people who need them.

Most African countries do not have national assistive technology policies or programmes. As a result, access to assistive products is difficult and many are left behind.

Solutions

African governments need to provide leadership, coordination and resources to plan and implement policies that increase access to assistive technologies.

Acting on the WHO African regional framework is a good place to start. The framework has modest aims. For instance, it calls for 40% of African member states to have assessed their assistive technology situation and developed a national strategy to improve access by 2024. This will help 40% of the population in Africa that needs assistive products to get them without suffering financial hardship.

The African Union can learn from the European Union. The European Parliamentary Research Service has commissioned and published an in-depth report of assistive technologies. The report covers economic, political and socio-ethical perspectives and it tries to implement the declarations that assistive technologies are a basic human right. Such a focused and thorough evaluation is missing in Africa.

To produce technologies on the continent, the African Union should develop a market strategy. The current market is one where the players are left to fend for themselves, and so face high operating costs. These costs ultimately make assistive technologies expensive.

Producers should also embrace frugal innovation – the process of reducing the complexity and cost of an item and its production, usually by removing nonessential features.

Qualified personnel are another part of the solution.

Finally, but maybe most importantly, there is a need for a structured enquiry to highlight the gaps in economic, political, scientific, and clinical knowledge for assistive technology development and deployment in Africa – and a unified approach to solving the problems.

This would help millions of people in Africa to achieve their basic rights such as access to education, freedom to live, and the right to work.The Conversation

Tolu Olarewaju, Lecturer in Management, Keele University; Aoife Healy, Associate Professor of Human Movement Biomechanics, Staffordshire University, and Nachiappan Chockalingam, Professor of Clinical Biomechanics, Staffordshire University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Visualising Coordination Patterns during human movement

Featured

Here’s an introduction and highlights of our work

  • Proposed coordination pattern classification can offer an interpretation of the CA that provides either in-phase or anti-phase coordination information, along with an understanding of the direction of segmental rotations and the segment that is the dominant mover at each point in time.

Introduction to Vector Coding

  • The traditional approach of reporting time-series data from vector coding can be problematic when overlaying multiple trials on the same illustration.
  • The use of colour mapping and profiling techniques highlighted differences in coordination pattern and coordination variability data across several participants that questions the interpretation and relevance of reporting group data.

Coordinatiion Mapping

  • Colour mapping and profiling techniques are ideal reporting methods to compliment prospective multiple single-subject design studies and to classify commonalities and differences in patterns of coordination and patterns of control between individuals or trials.
  • The data visualisation approaches in the current study may provide further insight on overuse injuries, exercise prescription and rehabilitation interventions.
  • Our approach can have important implications in demonstrating gait coordination data in an easily comprehensible fashion by clinicians and scientists alike.

Key References

Needham, R., Naemi, R. and Chockalingam, N., 2014. Quantifying lumbar–pelvis coordination during gait using a modified vector coding technique. Journal of biomechanics47(5), pp.1020-1026. https://doi.org/10.1016/j.jbiomech.2013.12.032

Needham, R.A., Naemi, R. and Chockalingam, N., 2015. A new coordination pattern classification to assess gait kinematics when utilising a modified vector coding technique. Journal of biomechanics48(12), pp.3506-3511. https://doi.org/10.1016/j.jbiomech.2015.07.023

Needham, R.A., Naemi, R., Hamill, J. and Chockalingam, N., 2020. Analysing patterns of coordination and patterns of control using novel data visualisation techniques in vector coding. The Foot, p.101678.  https://doi.org/10.1016/j.foot.2020.101678

Our latest work shows that children with Cerebral Palsy have more energy to play and be physically active for longer!

Featured

 

Our research shows that the appropriate design and tailoring of splints can reduce the energy used by children with CP while increasing their speed and distance, compared with a splint which is not fine-tuned. This is something which could have a significant impact on their quality of life.

During the study, the researchers analysed the walking pattern of children with cerebral palsy at our gait laboratory and participants were assessed while barefoot and with both non-tuned and tuned splints.

Children wearing the fine-tuned splints showed improvements in several areas including hip and pelvic function and knee extension, while a non-tuned splint potentially showed a decrease in hip function.

The full research findings, which were published in the June edition of the Foot Journal, are available below:

Calling for Early career Researchers in India interested in Diabetes and Assistive Devices

Featured

The Centre for Biomechanics and Rehabilitation Technologies at Staffordshire University, UK is looking to establish a network of like-minded early career researchers in India interested in the area of rehabilitation and/or mobility assistive devices (e.g. footwear, orthoses, prostheses, wheelchairs) for people with diabetes. The goal of this network will be to establish national collaboration between early career researchers within India and international collaboration with Indian institutions and Staffordshire University.Centre for Biomechanics and Rehabilitation Technologies

Ideally you should:

· Have a PhD related to the area of rehabilitation or mobility assistive devices for people with diabete
· Be employed at an Indian University or Research based Institution.
· Be an early career researcher who is currently within their first five years of academic or other research-related employment.
· Ideally with a good range of internationally peer reviewed journal publications.
· Below the age of 40 years.

If you are interested please email Dr. Aoife Healy (a.healy(at)staffs.ac.uk) with a short resume including a list of publications or provide a link to your ResearchGate/Google Scholar profile by Monday 22nd July 2019.