Karki Jiban, Rushton Simon, Bhattarai Sunita, De Witte Luc
School of Health and Related Research, The University of Sheffield, Sheffield, UK.
Department of Politics and International Relations, The University of Sheffield, Sheffield, UK.
Disabil Rehabil Assist Technol. 2023 Jan;18(1):8-16. doi: 10.1080/17483107.2021.1892843. Epub 2021 Mar 2.
The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified.
This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020. A descriptive, qualitative exploratory study design was followed. A quality assessment framework was used to structure the analysis and interpret the findings.
AT service provisions are poorly developed in all three countries. On all quality indicators assessed, the systems show major weaknesses. AT users have very limited awareness about their rights to these services and the availability of AT services, the range of services available is very limited, and eligibility is dependent on medical criteria related to visible and severe disabilities.
Lack of accessibility, eligibility, reachability and affordability are the main barriers to access AT services for PWD in Nepal, India and Bangladesh. Increased community level awareness, increased Government funding and a community based, medically informed flexible social model of AT services is a way forward to ensure access to AT services for PWD in these countries.IMPLICATIONS FOR REHABILITATIONIncreased community awareness is necessary to increase access to Assistive Technology Services for Persons with Disabilities.Increased and flexible funding from the Government and philanthropists will improve rehabilitation.Establishment of community based Assistive Technology Services centres will increase access and improve rehabilitation.
本文旨在分析并批判性地反思尼泊尔、印度和孟加拉国残疾人获取辅助技术(AT)的情况。该分析旨在基于所确定的最佳实践,指导制定适合这些国家的情境化通用AT服务提供模式。
本文基于在尼泊尔、印度和孟加拉国进行的一项综合研究,观察了由政府以及私营和非政府组织运营的与行动能力和听力相关的AT服务提供中心,并在2019年12月至2020年2月期间对关键信息提供者进行了访谈:政策制定者(5名)、AT服务提供者(20名)和AT服务使用者(20名)。采用了描述性、定性探索性研究设计。使用质量评估框架来构建分析并解释研究结果。
在这三个国家,AT服务的提供都很不完善。在所有评估的质量指标上,这些系统都显示出重大缺陷。AT使用者对其获得这些服务的权利以及AT服务的可用性了解非常有限,可用服务范围非常有限,并且资格取决于与明显和严重残疾相关的医疗标准。
无障碍性、资格获取、可达性和可负担性的缺乏是尼泊尔、印度和孟加拉国残疾人获取AT服务的主要障碍。提高社区层面的认识、增加政府资金投入以及建立基于社区的、有医学依据的灵活AT服务社会模式是确保这些国家残疾人能够获取AT服务的前进方向。
对康复的启示
提高社区意识对于增加残疾人获取辅助技术服务至关重要。
政府和慈善家增加且灵活的资金投入将改善康复情况。
建立基于社区的辅助技术服务中心将增加获取机会并改善康复情况。