DEVELOPMENT OF A NATIONAL PRIORITY ASSISTIVE PRODUCT LIST IN LOW- AND MIDDLE-INCOME COUNTRIES

J. Shad¹, A. Pupulin¹, J. Gosling¹, S. Mishra¹

Background: At the low and middle-income country (LMIC) level, the assistive technology (AT) sector is underdeveloped and only one in 10 people in need have access to assistive products (APs), such as wheelchairs, hearing aids and spectacles [World Health Organization, USAID & International Disability Alliance. (‎2016)‎. Priority assistive products list: improving access to assistive technology for everyone, everywhere]. A National Assistive Products List (APL) is a set of APs identified as highest priority and should be accessible to everyone in the country. The list enables a country to focus on the procurement and provision of the most needed products, thus optimizing the use of resources.

Purpose: The aim of the study is to discuss the process of developing an APL in Tajikistan to set an example that other LMICs can follow in developing their own APL.  

Methods: The research was conducted over four months and consisted of
1) a rapid survey,
2) focus group discussions and
3) a systems analysis [World Health Organization.
Regional Office for Europe. (‎2019)‎. Assistive Technology in Tajikistan: Situational Analysis]. The rapid survey was a modified version of the Assistive Technology Assessment tool with 200 people with disabilities throughout Tajikistan participating. Supported by non-governmental organizations, the survey assessed the following: the need for AP, impact on quality of life, barriers to access, and quality of products and service. Twelve focus groups with persons with disabilities and older adults captured personal experiences with AT. The systems analysis questionnaire collected information on AT policies, provision, products and personnel from AT stakeholders. In April 2018, a consensus meeting between key stakeholders (including disabled persons' organizations, the government and AT professionals) was held in Dushanbe to decide which APs should be included on the national APL.

Results: Through the consensus meeting, stakeholders agreed on 30 priority APs for the APL. The research paved the way for essential products to be provided, with five of the top 10 most needed APs now included on the APL. In addition, the collaboration on the assessment and consensus meeting provided a platform for strengthening ties between stakeholders and constituted a working group for furthering the AT agenda. The research revealed weaknesses in the AT system including barriers to access, low quality APs and associated services and underserved rural areas as well as gave recommendations on how the system could be strengthened. To address the challenges in access to AT, a 1 stop AT service provision project in Tajikistan is underway.

Conclusion(s): Development of an APL in LMICs can follow a process similar to Tajikistan through use of a rapid survey, focus group discussions, system analysis questionnaire and consensus meeting. This methodology may provide decision-makers with critical information of which devices to include in the APL.

Implications: The approach used in Tajikistan has shown how an APL can be developed efficiently on a low budget without compromising on a person-centered participatory approach. Achieving universal health coverage should incorporate rehabilitation and AT.  

Funding, acknowledgements: WHO’s work in Tajikistan is ongoing and financially supported by USAID.

Keywords: Assistive Products, Assistive Technology, Tajikistan

Topic: Globalisation: health systems, policies & strategies

Did this work require ethics approval? No

Institution: WHO

Committee: N/A

Reason: The abstract was based on the previously published situational analysis from WHO-MOHSP on assistive technology in Tajikistan.