Repair strategies for assistive technology in low resource settings

Abstract

Purpose

To investigate the practices of repair that exist for users of mobility assistive products in low resource settings, as well as the psychosocial impact that the repair, or non-repair, of these devices has on users’ lives.

Materials and Methods

This article collates data on repair practices and the responses from participants on the topic of repair from studies conducted by the authors across four different low resource settings in Kenya, Uganda, Sierra Leone, and Indonesia. This data was then analyzed to identify the common themes found across geographies.

Results

Three major models of repair practice emerged from the data: “Individual or Informal Repair in the Community”; “Local Initiatives”; and “Specialist AT Workshop Repair”. Additionally, the wider impact on the participants’ lives of “Problems & Concerns with Repair”; “Experiences of Breakages & Frequencies of Repair” and the “Impact of Broken Devices” are explored.

Conclusions

The results of this analysis demonstrate the paramount importance of community-based repair of devices, and how despite this importance, repair is often overlooked in the planning and design of assistive products and services. There is a need to further incorporate and support these informal contributions as part of the formal provision systems of assistive device.

IMPLICATIONS FOR REHABILITATION

• A lack of available specialist repair services in low resource settings hinders the potential impact of assistive technology provision systems.

• Community-based repair is the major route by which assistive devices are repaired in low resource settings.

• Appropriate community-based repair strategies should be incorporated into and supported by the formal assistive technology provision models in order to optimise outcomes.

• A lack of data on outcomes across the lifecycle of assistive products hinders progress on improving focus on follow-up services – in particular repair & maintenance.

• By supporting community-based repair, repairs that are inappropriate for that approach could be better directed to specialist repair services.

Keywords:

• repair
• community
• assistive technology
• wheelchairs
• prosthetics
• informal settlements

Acknowledgements

The researchers wish to thank all of the interviewed participants for taking the time to share their insights on their experiences using assistive technology, as well as the mediators and translators who made those interviews possible.

Disclosure statement

The author(s) declared no potential conflict of interest with respect to the research, authorship, or publication of this article.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This research was funded by Foreign, Commonwealth and Development Office (FCDO, formerly Department for International Development (DFID)), grant number GB-GOV-1-300815 Award date: 28 January 2019. This work was also supported by the UK Government Global Challenges Research Fund through the Engineering and Physical Sciences Research Council and the National Institute for Health Research under Grant (EP/R013985/1), and with additional support from Knowledge For Change.