Development of the national priority assistive product list in Malawi

Abstract

Purpose

In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi’s APL.

Methods

Two hundred and ninety-six persons with disabilities participated in a rapid Assistive Technology Assessment (rATA) survey. Six focus group discussions (FGDs) with people with various types of disabilities were conducted. The rATA questionnaire and FGDs collected data on assistive products (APs) participants used, APs they needed and the challenges they experienced. Data collection was done in six districts spread across the three regions in Malawi. All age groups were included in the survey. Persons with disabilities aged less than 18 participated but went with their guardians. All persons who participated in this study provided consent. Survey and FGDs results were presented at an APL consensus meeting with policymakers, service providers, disabled peoples’ organizations and development partners in the disability sector. Based on the results and further discussions, a consensus was reached on the priority APs for Malawi.

Results

More than a third of respondents used wheelchairs (32%), followed by auxiliary crutches (25%), walking sticks (13%), reading glasses (11%), prosthesis (10%), elbow crutches (9%) and orthosis (8%). There is also a high demand for products such as pull-up underwear (incontinence products) (79%), hearing aids (70%), reading glasses (59%) and diapers (63%). After intensive discussions during a consensus meeting, an agreement was reached on the 22 priority APs for Malawi.

Conclusion

There is a wide range of APs being used by people with different functional limitations in Malawi. There is also a demand for APs that are not readily available. When developing an APL, the list should include products in use, those in demand, and those recommended by service providers.

IMPLICATIONS FOR REHABILITATION

• Following the development of the priority assistive products list (APL) by WHO, member states should develop their own contextually based APL.

• The development of the APL should be based on research evidence.

• All key stakeholders including persons with disabilities and other functional limitations, government, and development partners should participate in this process.

• The APL should be part of the national health system or community services.

• The Department of Disability and Elderly Affairs in the Ministry of Gender, Community Development, being the Government of Malawi line ministry coordinating disability issues participated actively in this study including inviting participants in the stakeholders’ validation workshop.

Keywords:

• Assistive technology
• assistive products
• disability
• Malawi

Acknowledgements

The authors would like to thank the Action Research Group, composed of government, civil society, organisations for persons with disabilities and development partners for their guidance during the implementation of the APPLICABLE Project.

Ethical approval

Ethical approval was obtained from the University of Malawi Research Ethics Committee.

Disclosure statement

There are no conflicts of interest. The authors are responsible for the content and writing of this paper.

Additional information

Funding

Funding for the APPLICABLE project was obtained from the Irish Research Council.