Abstract
Appropriate assistive technology has the potential to considerably enhance quality of life, access to health and education, and social and economic participation for people with disabilities. Most disabled people in the world live in low- and middle-income countries where access to assistive devices and other support is severely lacking. There is little evidence that describes contextually relevant approaches to meeting these needs, particularly in African countries. We provide a detailed description of a South African organisation which has manufactured mobility and seating devices for children with disabilities since 1992. The Shonaquip Social Enterprise (SSE) also trains and builds capacity among a wide range of stakeholders (caregivers, health workers, educators, government, and communities) to acknowledge and advocate for the wellbeing of disabled children and adults, and works closely with government to strengthen existing service provisions. Using examples from the SSE, we highlight a number of useful principles to consider when trying to provide for the needs of people with disabilities, particularly in low-resource settings. While access to assistive devices is important, devices have limited capacity to improve participation if the broader environment is overly restrictive and stigmatising. Improved access to devices ought to be situated within a range of broader efforts to increase the inclusion and participation of people with disabilities.
Highlights
The majority of people with disabilities live in low- and middle-income countries (LMICs) [1,2]
In many LMICs, barriers to access may include a lack of dedicated resources, as well as dominant negative attitudes and widespread stigma about disability [6,7]
Though access to high quality appropriate assistive devices is indispensable, both global conversations and the overall story of the Social Enterprise (SSE) suggest that it is important to focus on a holistic approach that aims for the ultimate goal of inclusion and participation, rather than on the distribution of devices alone
Summary
The majority of people with disabilities live in low- and middle-income countries (LMICs) [1,2]. This is especially the case for people who are likely to live in already challenging environmental contexts, such as communities where access to electricity, sanitation, and safe housing is non-existent or unreliable Despite these constraints, many health workers are enterprising and often go far beyond the call of duty or use their own personal resources to address such gaps. The right kind of seating device can prevent additional spine curvature in children with certain kinds of physical impairment [49] Such devices play a critical role in facilitating disabled children’s access to and engagement in educational, social, and other public spaces, improving the likelihood of their inclusion and social participation [3,50].
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