Implementation of the Assistive Product List (APL) in Malawi through development of appropriate policy and systems: an action research protocol

IntroductionAssistive technology (AT) is important for the achievement of the sustainable development goals (SDGs) for persons with disabilities (PWD). Increasingly, studies suggest a significant gap between the need for and demand for and provisions of AT for PWD in low-income and middle-income settings. Evidence from high income countries highlights the importance of robust AT policies to the achievement of the recommendations of the World Health Assembly on AT. In Malawi, there is no standalone AT policy. The objectives of the Assistive Product List Implementation Creating Enablement of inclusive SDGs (APPLICABLE) project, are to propose and facilitate the development of a framework for creating effective national AT policy and specify a system capable of implementing such policies in low-income countries such as Malawi.Method and analysisWe propose an action research process with stakeholders in AT in Malawi. APPLICABLE will adopt an action research paradigm, through developing a shared research agenda with stakeholders and including users of AT. This involves the formation of an Action Research Group that will specify the priorities for practice—and policy-based evidence, in order to facilitate the development of contextually realistic and achievable policy aspirations on AT in Malawi and provide system strengthening recommendations that will ensure that the policy is implementable for their realisation. We will undertake an evaluation of this policy by measuring supply and support for specific AT prior to, and following the implementation of the policy recommendations.Ethics and disseminationThe study protocol was approved by Maynooth University Research Ethics Committee (SRESC-2019-2378566) and University of Malawi Research Ethics Committee (P.01/20/10). Findings from the study will be disseminated by publication in peer-reviewed journals, presentations to stakeholders in Malawi, Ireland and international audiences at international conferences.

Evaluation of a New Mobility Assistive Product for the Visually Impaired

In this study we present the results of evaluating the sonification protocol of a new assistive product aiming to help the visually impaired move more safely with the help of sounds organized in different cognitive profiles. The evaluation was carried out with 17 sighted and 11 visually impaired participants. The experiment was designed over both virtual and real environments and divided into 3 virtual reality based tests. Finally, four participants became experts by means of longer and deeper training, and they participated in a real life test and in a focus group at the end of the tests. Both quantitative and qualitative results were extracted, showing that the proposed system is able to help the users understand their surroundings via sounds. However, important limitations have been found in the sample used (some important demographic characteristics are strongly linked among them, limiting segregated analysis), the usability of the most complex profile, or even the special difficulties faced by the completely blind participants as compared to the sighted and low vision participants.

The use of the ICF in the process of supplying assistive products: discussion paper based on the experience using a general Dutch prescription guideline

For many people assistive products are important to perform daily activities and to participate in society. In the process of selecting the proper assistive product for a person, it is important to describe in a uniform and transparent way his/her present functioning and wishes with respect to functioning. To indicate how the ICF (the International Classification of Functioning, Disability and Health) can be used during the supply process, we have taken as a framework a general guideline describing this process. The guideline distinguishes seven steps in the supply process and for each step an inventory is made of the actions of the client, the actions of the care professional, the instruments used, the decisions made, the data generated, relevant classifications (including the ICF) to code these data, and the results for the client. It is the aim of this discussion paper to describe the role of the ICF in the prescription and supply of assistive products and to discuss the specific data in this process that can be classified using the ICF. Although the ICF is not perfect, it is a useful tool to code important data in the process of supplying assistive products. Clinical relevance Assistive products – used worldwide by millions of people – are used to maintain or enhance functioning, rather than to cure a disease. 1 As functioning can be classified with the International Classification of Functioning, Disability and Health (ICF), it can be expected that the use of ICF terminology in the supply process of assistive products will result in a better match between the characteristics of the person and the characteristics of the assistive product.