Abstract

ABSTRACT Humanitarian coordination systems increasingly recognize and aim to respond to the needs of people with disabilities within populations affected by crises, spurred on by the UN Convention on the Rights of Persons with Disabilities (CRPD) which was adopted in 2006. Many agencies state their aim to meet the requirements of the CRPD using a “twin track” approach: ensuring the inclusion of people with disabilities in mainstream provision, alongside targeted support for their needs, which may include the need for Assistive Technology (AT). However, there is very little evidence of AT provision in humanitarian settings, which is a specific and urgent need for many people including the elderly and people with disabilities, and an implicit requirement of Article 11 of the CRPD and World Health Assembly resolution on improving access to assistive technology. There is also little evidence of effective mechanisms for AT provision in humanitarian settings. This is despite high and growing levels of unmet AT need in crises, and despite the legally binding requirement in the CRPD to provide AT for those who need it. AT provision faces unique challenges in humanitarian settings. This paper discusses the evidence available in the literature for the scale and quality of AT provision interventions in crises, and what is known about the challenges and facilitators of provision. We conducted a search of the academic literature and retained literature that reported on any form of AT provision following crisis, where international humanitarian response was in place, published in English between January 2010 and June 2020. We found very few examples in that academic literature of systematic and coordinated AT provision at the acute stage of crisis, and even less in the preparedness and post-acute stages. However, it is difficult to assess whether this is the result of insufficient academic attention or reflects a lack of provision. The small body of academic literature that describes AT provision in humanitarian settings paints a picture of small-scale provision, specialized to single types of impairments, and delivered by predominantly by NGOs. We also conducted a search of the gray literature, using the same inclusion criteria, in two countries: Afghanistan and South Sudan (case studies forthcoming). This gray literature provided supplementary evidence of the types of AT providers and AT provision available in those protracted crises. There are very few examples of how AT services can be scaled up (from a very low baseline) and maintained sustainably within a strengthened health system. The literature also describes more examples of provision of assistive products for mobility over assistive products for other impairments. If the paucity of literature on AT provision in humanitarian settings is a reflection of the scale of provision, this implies a deficiency in humanitarian response when it comes to providing people with AT needs with the essential products and services to which they have a right, and which will enable their access to basic, life-saving assistance. We conclude by providing recommendations for urgent actions that the AT and humanitarian community must take to fill this critical gap in the provision of essential products and services for a potentially marginalized and excluded group.

Highlights

  • The UN Convention on the Rights of People with Disabilities (CRPD) represents a milestone in terms of defining the respon­ sibilities of governments and other humanitarian actors in emer­ gency response

  • Humanitarian contexts offer a particular set of challenges, including related to access, security, coordination and equity, which make setting up a functioning Assistive technology (AT) ecosystems especially challenging compared with other contexts, including low- and middleincome countries (LMICs)

  • In Afghanistan, little evidence was found of AT provision through multi-donor-supported Basic Package of Education Services pro­ gramme (some provision is theoretically described in programme documents, but informants reported that, in practice, AT services through BPHS were unlikely to be available (Anonymised Interview – International NGO Afghanistan, 2020), and financial assistance was only provided to the war-wounded) (Anonymous, 2020)

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Summary

The Official Journal of RESNA

To cite this article: Golnaz Whittaker, Gavin Adam Wood, Giulia Oggero, Maria Kett & Kirstin Lange (2021) Meeting AT needs in humanitarian crises: The current state of provision, Assistive Technology, 33:sup1, 3-16, DOI: 10.1080/10400435.2021.1934612 To link to this article: https://doi.org/10.1080/10400435.2021.1934612

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Introduction
Methodology
What is known about best practice?
What guidance on AT provision is available to humanitarian actors?
Examples of AT provision in humanitarian settings
Gaps in data and gaps in evidence on data gathering
Challenges to AT provision in humanitarian settings
Challenges within the preexisting context
Challenges caused by the crisis
Limitations of the crisis response
Challenges of AT provision
Facilitators of AT provision in humanitarian settings
Findings
Next steps
Full Text
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