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A glimpse into smartphone screen reader use among blind teenagers in rural Nepal

SANKHI, Prakash
SANDNES, Frode Eika
2020

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Purpose

Access to appropriate assistive technology is a challenge worldwide and especially in low GDP-per-capita countries. Nepal is one example of a country with several coinciding challenges: some claim having a high rate of blindness in the general population, a low-GDP-per capita and some studies claim it has a low literacy rate, especially in rural areas. Without appropriate assistive technology, some disabled youth may not get full access to education.

 

Methods

To gain insight into assistive technology use in rural Nepal, five blind teenagers in a mixed secondary school with disabled and non-disabled students in rural Nepal were interviewed about their daily smartphone use.

 

Results

The results show that all the participants used screen readers on donated smartphones. None of the participants had received formal training in using smartphone screen readers and therefore lacked knowledge about basic and essential operational aspects of the devices as well as misguided expectations about the technology.

 

Conclusions

One implication of the findings is that smartphone accessibility features training material needs to be made easily available to schools and all disabled youth worldwide, as smartphones are increasingly becoming available in low-income remote regions with low literacy rates. The built-in accessibility features of smartphones promise disabled youth a non-stigmatizing platform for social participation and access to the information society.

Disability Inclusive Development - Jordan Situational Analysis

THOMPSON, Stephen
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Jordan?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Jordan. It will be helpful for anyone interested in disability inclusion in Jordan, especially in relation to stigma, employment, education, health, and humanitarian issues.

Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

Systems thinking for assistive technology: a commentary on the GREAT summit

MACLACHLAN, Malcolm
SCHERER, Marcia J
2018

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The area of assistive technology has a long history of technological ingenuity and innovation. In order to ensure that the benefits of assistive technology are equitably distributed across the population and life course, it is necessary to adopt a systemic approach to the area. We describe examples of systems thinking and non-systems thinking across 10 Ps. These Ps are People (or users, as the primary beneficiaries of assistive technology), Policy, Products, Personnel, Provision (as key strategic drivers at systems level); and Procurement, Place, Pace, Promotion and Partnership (as key situational factors for systems). Together these Ps should constitute a framework for an “open” system that can evolve and adapt, that empowers users, inter-connects key components and locates these in the reality of differing contexts. The adoption of a stronger systems thinking perspective within the assistive technology field should allow for more equitable, more resilient and more sustainable assistive technology across high, middle- and low-income contexts and countries.

Developing product quality standards for wheelchairs used in less-resourced environments

MHATRE, Anand
MARTIN, Daniel
MCCAMBRIDGE, Matt
REESE, Norman
SULLIVAN, Mark
SCHOENDORFER, Don
WUNDERLICH, Eric
RUSHMAN, Chris
MAHILO, Dave
PEARLMAN, Jon
2017

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Background: Premature failures of wheelchairs in less-resourced environments (LREs) may be because of shortcomings in product regulation and quality standards. The standards published by the International Organization for Standardization (ISO) specify wheelchair tests for durability, safety and performance, but their applicability to products used in the rugged conditions of LREs is unclear. Because of this, wheelchair-related guidelines published by the World Health Organization recommended developing more rigorous durability tests for wheelchairs.


Objectives: This study was performed to identify the additional tests needed for LREs.


Methods: First, a literature review of the development of ISO test standards, wheelchair standards testing studies and wheelchair evaluations in LREs was performed. Second, expert advice from members of the Standards Working Group of the International Society of Wheelchair Professionals (ISWP) was compiled and reviewed.


Results: A total of 35 articles were included in the literature review. Participation from LREs was not observed in the ISO standards development. As per wheelchair testing study evidence, wheelchair models delivered in LREs did not meet the minimum standards requirement. Multiple part failures and repairs were observed with reviewed field evaluation studies. ISWP experts noted that several testing factors responsible for premature failures with wheelchair parts are not included in the standards and accordingly provided advice for additional test development.


Conclusion: The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies.

Effect of wheelchair design on wheeled mobility and propulsion efficiency in less-resourced settings

STANFILL, Christopher J.
JENSEN, Jody L.
2017

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Background: Wheelchair research includes both qualitative and quantitative approaches, primarily focuses on functionality and skill performance and is often limited to short testing periods. This is the first study to use the combination of a performance test (i.e. wheelchair propulsion test) and a multiple-day mobility assessment to evaluate wheelchair designs in rural areas of a developing country.


Objectives: Test the feasibility of using wheel-mounted accelerometers to document bouts of wheeled mobility data in rural settings and use these data to compare how patients respond to different wheelchair designs.


Methods: A quasi-experimental, pre- and post-test design was used to test the differences between locally manufactured wheelchairs (push rim and tricycle) and an imported intervention product (dual-lever propulsion wheelchair). A one-way repeated measures analysis of variance was used to interpret propulsion and wheeled mobility data.


Results: There were no statistical differences in bouts of mobility between the locally manufactured and intervention product, which was explained by high amounts of variability within the data. With regard to the propulsion test, push rim users were significantly more efficient when using the intervention product compared with tricycle users.


Conclusion: Use of wheel-mounted accelerometers as a means to test user mobility proved to be a feasible methodology in rural settings. Variability in wheeled mobility data could be decreased with longer acclimatisation periods. The data suggest that push rim users experience an easier transition to a dual-lever propulsion system.

Pilot testing of 3D printing technology for transtibial prosthesis in complex contexts (Togo, Madagascar and Syria)

CONICAVE, Jerome
TAN, Daniele
2017

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In January-October 2016, Handicap International carried out a pilot testing of 3D printing technology for transtibial prosthesis in Togo, Madagascar and Syria. The aim of the study was to explore and test how physical rehabilitation services can be more accessible to people living in complex contexts via innovative technologies (such as 3D printing, treatment processes that use Internet technology and tools) and decentralised services by bringing them closer to the patients. This scientific summary provides the context, the objectives, the methodology, the results of the study, and perspectives for the future.

A number of technical appendices are available

RS/05

Exploring the impact of wheelchair design on user function in a rural South African setting

VISAGIE, Surona
DUFFIELD, Svenje
UNGER, Mariaan
2015

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Background: Wheelchairs provide mobility that can enhance function and community integration. Function in a wheelchair is influenced by wheelchair design.

 

Objectives: To explore the impact of wheelchair design on user function and the variables that guided wheelchair prescription in the study setting.

 

Method: A mixed-method, descriptive design using convenience sampling was implemented. Quantitative data were collected from 30 wheelchair users using the functioning every day with a Wheelchair Scale and a Wheelchair Specification Checklist. Qualitative data were collected from ten therapists who prescribed wheelchairs to these users, through interviews. The Kruskal-Wallis test was used to identify relationships, and content analysis was undertaken to identify emerging themes in qualitative data.

 

Results: Wheelchairs with urban designs were issued to 25 (83%) participants. Wheelchair size, fit, support and functional features created challenges concerning transport, operating the wheelchair, performing personal tasks, and indoor and outdoor mobility. Users using wheelchairs designed for use in semi-rural environments achieved significantly better scores regarding the appropriateness of the prescribed wheelchair than those using wheelchairs designed for urban use (p = <0.01). Therapists prescribed the basic, four-wheel folding frame design most often because of a lack of funding, lack of assessment, lack of skills and user choice.

 

Conclusion: Issuing urban type wheelchairs to users living in rural settings might have a negative effect on users’ functional outcomes. Comprehensive assessments, further training and research, on long term cost and quality of life implications, regarding provision of a suitable wheelchair versus a cheaper less suitable option is recommended.

Conduct an accessibility audit in low and middle income countries

NOUVELLET, Hugues
June 2014

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This guide aims to assist professionals in conducting an accessibility audit, and is aimed at Handicap International professionals who have responsibility for developing, implementing or analysing accessibility activities. Within the framework of inclusive local development, an accessibility audit is a complex, substantial and technical process to implement involving a large number of different stakeholders, increase time preparation and technical specialised skills for making recommendations to remove barriers. An accessibility audit is a participatory democracy exercise which can be used as the basis to form relationships between stakeholders in a municipality accessibility commission or even a municipality commission for inclusive development, who will have responsibility for suggesting, studying, organising and implementing actions to improve accessibility

Effective use of assistive technologies for inclusive education in developing countries : issues and challenges from two case studies

GRONLUND, Åke
LIM, Nena
LARSSON, Hannu
2010

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This article presents a study that "conducted an in-depth case study of two developing countries, Bangladesh and Tanzania, and thoroughly reviewed existing (inclusive education) IE projects around the world and other relevant literature. Three experts in the field and 18 informants of the two selected countries were interviewed in person, by phone or by email. The analysis of findings from interviews and literature review shows that obstacles to effective use of (assistive technologies) AT for IE come from three different levels - school, national, and network"
IJEDICT, Vol 6, Issue 4

Accessibility standards : a practical guide to create a barrier-free physical environment in Uganda

UGANDA NATIONAL ACTION ON PHYSICAL DISABILITY (UNAPD)
Ministry of Gender
Labour and Social Development
2010

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This guide promotes better accessibility for persons with physical disabilities in Uganda by providing information for constructors or developers to build accessible environments. It presents information about how to construct standard ramps, toilets, lifts, road in addition to wells, furniture and more. These accessibility standards are useful for Architects, policy makers and implementers on accessibility requirements during the design and implementation of construction projects

Up-scaling pro-poor ICT policies and practices

GERSTER, Richard
ZIMMERMANN, Sonja
February 2005

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This paper is the result of a literature review and discussions during a two-day workshop. It examines how ICT can make a difference in reducing poverty and reaching the MDGs. This potential contrasts, however, with the relatively modest pro-poor ICT implementation level. It asks what key barriers impede the implementation of declarations, and how can we multiply, upscale and replicate successful pilot projects. This study idenfies four "basic requirements" for successful up-scaling of poverty reduction through ICTs: an enabling ICT policy environment; a high priority assigned to ICT for poverty reduction; appropriate technology choices; and mobilisation of additional public and private resources

Revisiting the "magic box" : case studies in local appropriation of information and communication technologies (ICTs)

BATCHELOR, Simon
O’FARRELL, Clare
2003

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This book looks at the way communities and groups in developing countries are appropriating information and communication technologies (ICTs) to address their needs. It finds that ICTs are being integrated into wider community-based activities and adapted to fit different contexts. It follows on from the paper "Discovering the Magic Box". It finds that there are still few examples of community-driven and locally appropriated ICT initiatives and an absence of standards or guidelines to evaluate ICT-based projects. The book includes some analytical frameworks and indicators to identify good practice and evidence of impact A significant development has been in the growth of telecommunications, in particular mobile phones, that are relatively cheap and powerful tools for poor communities, even in remote areas. The book concludes that the power of oral communication through telephones and radio cannot be underestimated. The book proposes that the main challenge is to adapt the new, usually computer-based ICTs to the needs of poor, predominantly oral-based communities so that they can be appropriated effectively and quickly

Collecting and propagating local development content : synthesis and conclusions

BALLANTYNE, Peter
May 2002

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Drawing from a consultation process to examine how local content in developing countries is created, adapted, and exchanged, this report provides some answers to these questions. It is a synthesis of lessons; the case stories which are reproduced in an accompanying report provide details on actual experienses and lessons from the ground

The significance of information and communication technologies for reducing poverty

MARKER, Phil
MCNAMARA, Kerry
WALLACE, Lindsay
January 2002

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A study for DFID staff, and for policy consideration, about the role of ICT in development. Identifies and assess the links between information and poverty, and concludes that although spreading ICT ('bridging the digital divide') should not be an end in itself, there is enormous potential for ICTs to increase information flow and empower poor people. The study then discusses the potential role of the international community, and sets out specific recommendations for DFID. Includes several appendices containing: a bibliography; brief case studies of Chile, Costa Rica and India; and list of related DFID funded projects. The study concludes that ICT should not be viewed as an end itself but has the potential as a tool to increase information flows and empower people. It can play a part in achieving International Development Goals

Challenges and concerns

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This article follows on from several case studies presented on the Reproductive Health Outlook website. It draws together key issues based on a review of recent literature and project experiences. The main themes are around the significant financial, political, cultural and technological obstacles that affect the establishment of sustainable programmes, especially for computer-based ICTs. These obstacles have been identified as lack of affordability, lack of human capacity, lack of awareness of the benefits of ICT, lack of ability to use ICT proficiently, and lack of content suitable for local residents. ICTs that rely on access to the Internet need good-quality access to be truly useful

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