Assistive technology unmet need in Indonesia: challenges and opportunities for enhancing equitable access

Abstract

Purpose

To analyze the rapid Assistive Technology Assessment (rATA) data and identify challenges and opportunities for improving access to assistive technology products (AP) in Indonesia.

Materials and Methods

An explanatory sequential mixed-methods design consisting of a quantitative survey and a qualitative interview study was used. The rATA survey was administered to households in two randomly sampled provinces to collect data on AP met and unmet need. Descriptive statistics was used to analyze the survey data. Qualitative data were collected from unstructured videorecorded interviews with rATA policymakers. Interview transcripts were coded and analyzed using thematic analysis.

Results

On average, data from rATA respondents (n = 11,300) revealed 60% of AP unmet need. A high proportion of funding sources came from the private sector, and contributions from the government remained low. Affordability and funding were the main barriers to access. From the policymaker interviews (n = 5), four essential themes emerged, i.e., “resources and workforce”, “funding”, “laws and policies”, and “guidelines and standards”. From each theme, key challenges and opportunities were identified.

Conclusions

Affordability remained a major challenge, in part because government-sponsored funding was still inadequate, forcing people with low financial status to self-produce AP. One potential opportunity would be to localize AP production and improve local workforce training. Integrated national funding schemes and intersectoral coordination could accelerate improvement in meeting AP unmet need. This study may provide evidence of current challenges and opportunities to help improve the field of rehabilitation through enhanced access to AP services in Indonesia.

IMPLICATIONS FOR REHABILITATION

• A high assistive technology product (AP) unmet need due to low affordability and limited funding may prevent people with disabilities from receiving appropriate rehabilitation with the goal of improved quality of life.

• Evidence shows key barriers to AP service provision, and such evidence can be viewed as an opportunity for stakeholders to develop actionable strategies to improve access nationwide.

• Potential strategies such as local workforce capacity building, integrated national funding schemes, and improved government coordination may help enhance equitable access to AP for all.

Keywords:

• Assistive technology
• assistive devices
• disability
• unmet needs
• access
• survey
• interview

Acknowledgments

The authors would like to thank and acknowledge the rATA survey team and all the ministries and agencies involved.

Author contributions

SA, EP, GA, AP, and EW contributed to the conception of this work. SA and EP contributed to this work including the design of the work, the acquisition, analysis, and interpretation of data, and wrote the manuscript.

Ethical approval

The rATA survey was approved by the Health Research Ethics Commission, National Institute of Health Research and Development, Ministry of Health of the Republic of Indonesia (LB.02.01/2/KE.471/2021).

Disclosure statement

The views and opinions expressed in this publication are those of the authors alone and do not necessarily represent the decisions or policies of the World Health Organization and all stakeholders. No potential conflict of interest was reported by the author(s).

Additional information

Funding

WHO funded the rATA survey in Indonesia. However, this study was not funded by WHO, and the funder had no role in the design and writing of this manuscript or in the decision to publish it.