What factors are associated with the provision of assistive technologies: the Bogotá D.C. case

Abstract

Aim: To examine what demographics and clinical factors are associated with the provision of assistive technology (AT) devices in a low-income country. Method: Retrospective cross-sectional exploratory study design including 15 of the 20 localities across Bogotá D.C., Colombia, a city with 6 776 009 inhabitants. Results: The type of AT device provided was significantly dependent (p < 0.001) on the client’s diagnosis, impairment, age, and socio-economic strata, whether the client has a care giver, the geographical zone in which the client lives, the year of the AT provision, and the total number of AT delivered. In contrast, the client’s gender (p > 0.05) and the client’s affiliated type of healthcare service had no effect. In addition to that, the client’s age, the client’s socio-economic strata, the number of AT devices provided to the client, and the diagnostic type were the factors with the strongest level of association with the type of AT device provided. Conclusions: Our research showed that the provision of AT in Bogotá D.C. prioritizes both people who are at the highest levels of vulnerability, and as many people as possible with the budget. That is, the low socio-economic strata, younger and older people, and the provision of at least one AT device.

Implications for Rehabilitation

• Provision of AT is intended for equal opportunities for the social participation of people with a disability. Also, people with disabilities have the right to access AT regardless of the type of limitation, gender, race, age or region where they live.

• Research regarding AT in developing countries is scarce; thus, there is a need to conduct studies in such contexts. This study provides scientific evidence to support the development of models, approaches and strategies of AT provision in low-income countries where resources for rehabilitation are scarce.

• Assistive device
• assistive technology
• assistive technology device classification
• assistive technology service
• disability and health
• HAAT
• low-income countries

Acknowledgements

The authors thank Professor Albert Cook for his invaluable advice in preparing this article. They also thank Oliver Jarvis for proof-reading. The authors assume overall responsibility for the manuscripts.

Supplimentary materials available online

Supplementary Tables A1–A5.

Notes

*This article analyzes why some factors have determined the provision of different types of AT devices in a low-income country. It also analyzes these factors' associations that could result in inequality and discrimination against people with disabilities. Policy-makers, decision-makers, and organizations of people with disabilities can improve public policy for AT provision.

¹According to STROBE methodology it is strongly advised to report all “candidate variables considered for statistical analysis, rather than selectively reporting only those included in the final model”. Please read Analyses on Method section for more details [50].

²In spite of the most recent model of disability used being the International Classification of Functioning, Disability and Health (ICF), we did not use it owing to this information being unavailable in our data source.