User involvement in service delivery predicts outcomes of assistive technology use: a cross-sectional study in Bangladesh.

Johan Borg,Per-Olof Östergren,Nazmul Bari,Stig Larsson,Asm Atiqur Rahman,Ahm Noman Khan

doi:10.1186/1472-6963-12-330

Abstract

BackgroundKnowledge about the relation between user involvement in the provision of assistive technology and outcomes of assistive technology use is a prerequisite for the development of efficient service delivery strategies. However, current knowledge is limited, particularly from low-income countries where affordability is an issue. The objective was therefore to explore the relation between outcomes of assistive technology use and user involvement in the service delivery process in Bangladesh.MethodsUsing structured interviews, data from 136 users of hearing aids and 149 users of manual wheelchairs were collected. Outcomes were measured using the International Outcome Inventory for Hearing Aids (IOI-HA), which was adapted for wheelchair users. Predictors of user involvement included preference, measurement and training.ResultsUsers reported outcomes comparable to those found in other high- and low-income countries. User involvement increased the likelihood for reporting better outcomes except for measurement among hearing aid users.ConclusionsThe findings support the provision of assistive technology as a strategy to improve the participation of people with disabilities in society. They also support current policies and guidelines for user-involvement in the service delivery process. Simplified strategies for provision of hearing aids may be explored.

Highlights

Knowledge about the relation between user involvement in the provision of assistive technology and outcomes of assistive technology use is a prerequisite for the development of efficient service delivery strategies
Available studies from lowand lower-middle-income countries indicate that the use of hearing aids is beneficial for language development and education, and is effective in enhancing participation, that the use of leg prosthesis facilitate mobility, work and sports, and that the use of manual wheelchairs
In order to explore the relation between outcomes of assistive technology use and user involvement in the service delivery process in a low-income country, crosssectional data from users of hearing aids and manual wheelchairs in Bangladesh was analyzed using logistic regression

Summary

Introduction

Knowledge about the relation between user involvement in the provision of assistive technology and outcomes of assistive technology use is a prerequisite for the development of efficient service delivery strategies. Experts have recommended that users in low-income countries should be involved in the delivery of services, that individual assessments should be made, and that users should receive relevant training in order to benefit from using assistive technology [6,7]. This user-centered approach is favored in well-resourced countries where the concern – besides positive outcomes – is not so much whether people will be able to access assistive technology or not, but whether they will use or abandon the products once they have got them [8,9,10,11]. The same study found that feeling that personal needs were not assessed led to lower satisfaction and that lack of user involvement in the decision making process resulted in somewhat greater rates of abandonment

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