Abstract
Few estimates are available of the need for assistive devices (ADs) in African settings. This study aimed to estimate population-level need for glasses and hearing aids in The Gambia based on (1) clinical impairment assessment, and (2) self-reported AD awareness, and explore the relationship between the two methods. The Gambia 2019 National Eye Health Survey is a nationally representative population-based sample of 9188 adults aged 35+ years. Participants underwent standardised clinical vision assessments including the need for glasses (distance and near). Approximately 25% of the sample underwent clinical assessment of hearing and hearing aid need. Data were also collected on self-reported awareness, need and access barriers to vision and hearing ADs. Overall, 5.6% of the study population needed distance glasses (95% CI 5.0–6.3), 45.9% (95% CI 44.2–47.5) needed near glasses and 25.5% (95% CI 22.2–29.2) needed hearing aids. Coverage for each AD was very low (<4%). The agreement between self-report and clinical impairment assessment for AD need was poor. In conclusion, there is high prevalence and very low coverage for distance glasses, near glasses and hearing aids in The Gambia. Self-report measures alone will not provide an accurate estimate of AD need.
Highlights
The sample sizes for these analyses were relatively small and gaps were identified, including a lack of consistency in the collection of data on assistive devices (ADs) need and disaggregation of AD need by impairment severity [6]. We address these gaps and provide further comparisons between self-report and clinical impairment assessment approaches for assessing need for glasses and hearing aids in The Gambia
This study found evidence of high need and very low coverage of two priority ADs among adults aged 35+ years in The Gambia based on clinical impairment assessment
Total need was significantly higher among females compared to males for distance glasses and hearing aids, and significantly higher among males compared to females for near glasses
Summary
The World Health Organization (WHO) estimates there are at least one billion people in need of assistive technology (AT). AT includes both assistive devices (ADs) and the systems and services related to AD delivery [1,2]. AT users can include older people, people with disabilities, and people living with chronic health conditions, noncommunicable diseases, and communicable diseases [1]. Global AT need is expected to rise to 2 billion by 2030, given population ageing and the increase in non-communicable disease prevalence; reliable data on AT need are scarce [2].
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