Matter Rebecca A, Eide Arne H
Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Falmouth Rd., Observatory, Cape Town, 7925, South Africa.
SINTEF Technology and Society, Oslo, Norway.
BMC Health Serv Res. 2018 Oct 19;18(1):792. doi: 10.1186/s12913-018-3605-9.
Millions of people in Southern Africa are deprived of basic human rights such as the right to education and work because of the large and growing unmet demand for assistive technologies (AT). Evidence is needed to better characterize the lack of AT access.
This study serves to identify the sociodemographic factors that are associated with access to AT in two countries in Southern Africa, Botswana and Swaziland. To achieve this aim, logistics regression was applied to a subset of variables from two Living Conditions Studies, nationally representative surveys that were conducted in Southern Africa (2014 and 2010).
In Botswana, 44% of people who needed AT did not receive it, while in Swaziland the unmet need was 67%. Among the sociodemographic variables tested, the type of disability was the most important factor in determining AT access in both countries. The likelihood of AT access was highest in both countries for those who had mobility limitations (i.e., difficulty walking/climbing stairs) [Botswana: 6.4 odds ratio (OR) = 6.4., 95% confidence internal (CI) (3.6-11.3); Swaziland: OR = 3.2, CI (1.4-7.3)], in comparison to those with non-mobility types of disabilities.
These findings provide support for governments and other stakeholders in the AT sector to prioritize AT to address the large unmet demand, and expand the range of AT products provided so that people with hearing, seeing, self-care, communication and cognition difficulties have equal access to AT as those with mobility impairments. A step toward achieving these aims is to inventory AT product types that are commonly covered through the public sector in each country, and identify common gaps (e.g., daily living aids). Advancing the AT sector as a whole within Southern Africa will require large scale qualitative studies that achieve a comprehensive understanding of the bottlenecks in regional AT supply, procurement, and delivery systems.
由于对辅助技术（AT）的需求大量且不断增加，南部非洲数百万人被剥夺了基本人权，如受教育权和工作权。需要证据来更好地描述辅助技术获取方面的不足。
本研究旨在确定与南部非洲两个国家（博茨瓦纳和斯威士兰）辅助技术获取相关的社会人口因素。为实现这一目标，将逻辑回归应用于两项生活条件研究的部分变量，这两项研究是在南部非洲进行的具有全国代表性的调查（2014年和2010年）。
在博茨瓦纳，44% 需要辅助技术的人未获得该技术，而在斯威士兰，未满足的需求为67%。在测试的社会人口变量中，残疾类型是两国决定辅助技术获取的最重要因素。与非行动不便型残疾者相比，两国中行动不便（即行走/爬楼梯困难）的人获得辅助技术的可能性最高[博茨瓦纳：优势比（OR） = 6.4，95% 置信区间（CI）（3.6 - 11.3）；斯威士兰：OR = 3.2, CI（1.4 - 7.3）]。
这些发现为辅助技术领域的政府和其他利益相关者提供了支持，使其能够优先考虑辅助技术以满足大量未满足的需求，并扩大所提供的辅助技术产品范围，以便有听力、视力、自我护理、沟通和认知困难的人与行动不便者一样平等地获得辅助技术。朝着实现这些目标迈出的一步是清点每个国家公共部门通常涵盖的辅助技术产品类型，并确定常见差距（如日常生活辅助器具）。在南部非洲推动整个辅助技术领域的发展将需要大规模的定性研究，以全面了解区域辅助技术供应、采购和交付系统中的瓶颈。
