ACAT, the African Community on Assistive Technology refers to itself as a 'Community of Practice’ supporting access to AT in Africa. The African region has an extensive unmet need for assistive technology and is fast becoming a focus for exciting new innovations in sustainable AT development, which ACAT looks to share and discuss among its membership and beyond.
ACAT was an initiative founded during the GReAT summit in 2017 led by Dr Natasha Layton and Dr Diane Bell, part of the WHO Global Cooperation on Assistive technology (GATE) community. It was accepted under the administration of The Centre for Disability and Rehabilitation Studies, Stellenbosch University, South Africa in October 2020. It has taken less than 3 years for this community to grow to over 120 members from 22 countries, cutting across the spectrum of stakeholders from AT users and providers to researchers and policymakers. This was made possible thanks to the dedication of volunteers Natasha Layton, Diane Bell, Nicky Seymour, Surona Visagie. In 2020 ACAT has, as Dr Visagie describes, 'blossomed like a flower opening up.'
One of the latest developments in 2020 has been the creation of a subgroup on the WHO GATE mednet platform for ACAT communications and information management and the development of a representative governing body, which will hopefully help facilitate ACAT becoming a member of the Global Alliance of Assistive Technology Organisations (GAATO) in the future. This step will open the gate to expert AT knowledge exchange for the African region with colleagues around the world.
From initial WHO studies, some countries in Africa have as little as 2% access to the assistive products and services they need. With the additional support of the WHO regional offices and national governments, the lives of over a billion people and their communities can be transformed. GAATO is excited to be connecting with ACAT and looks forward to supporting its endeavours in 2021 and beyond.
One of the outstanding benefits of connecting ACAT with a broader global community of AT is the transfer of knowledge and the emboldening of regionally specific research in an African context. Below are three examples of ACAT members in their own words describing some of the projects that have been undertaken in the domains of mobility and vision.
1. Developing Outcome Measures for Wheelchair Provision
While doing research in Kenya to obtain data to enable wheelchair manufacturers to improve the effectiveness of their chairs in low-resource settings, it was found that it was important to discriminate between different aspects of function. For example, a wheelchair could be durable and in good condition, but not appropriate for its current user. Or the seating was adequate, but the chair did not roll well on surfaces commonly encountered. In addition, wheelchair users have a different point of view than do wheelchair professionals, but both are essential. Therefore four outcomes tools were developed and validated.
All were wheelchair specific and designed so that feedback was explicit enough to spark beneficial changes to the design of wheelchair parts. Two of the tools were completed by wheelchair users: The Wheelchair Satisfaction Questionnaire and Aspects of Wheelchair Mobility. The other two were professional report tools: The Wheelchair Interface Question enabled informed professional data on how suitable a wheelchair was to its user’s needs; the Wheelchair Components Questionnaire enabled feedback on the maintenance condition of a wheelchair. The hope is now that the outcomes tools will enable feedback to improve wheelchair design and services globally. These outcomes are available open source on-line along with supporting research papers at www.letu.edu/wheels and on the Assistive Technology Catalyst website www.atcatalyst.org
(Contribution from Karen Rispin, Manager of the Assistant Technology Catalyst Project and formerly PI of the LeTourneau University Wheels Project.)
2. Positioning for Inclusion: 24 hours a day - Shonaquip Social Enterprise
The following paragraph is partly derived from the abstract for a GAATO@RESNA conference session.
When Shona McDonald’s of SSE's daughter, Shelly, was born with Cerebral Palsy, their family faced challenges most families have never had to consider. Unable to sit up or move around independently, with no available devices, Shona drew on her sculpting background to design Shelly’s first mobility device. The customized 24 hour postural support made Shelly’s care safer and easier and opened new possibilities for fun and learning.
24 hour positioning is the practice of using specialized equipment or everyday objects (like pillows, blankets, tables) to assist someone with a mobility impairment to experience and adopt various positions through the course of each day whether during activities or at rest.
The provision of assistive technology not only helps the person to sit better, but it can also prevent secondary health complications and much more. Providing a holistic approach to positioning has the power to remove stigma, improve a child’s self-esteem, and enable meaningful participation and inclusion. SSE was founded in 1992, with two team members working from a garage, is now one of Africa’s leading ISO9001 certified pediatric AT providers.
3. Seeing for the First Time – Philip Hoare (IAPB)
This young girl received new spectacles from KCCO this year (2020) after a bilateral cataract operation. She is now able to see for the first time.
The International Agency for the Prevention of Blindness (IAPB) is a peak body for the global eye care sector. It has over 150 members worldwide drawn from NGOs and civil society, corporate organisations, professional bodies and research and eye care institutions. Founded in 1975 to lead international efforts in blindness prevention activities, they work towards a world where no one is needlessly visually impaired, in which everyone has access to the best possible standard of eye health, and eye care is a core part of Universal Health Coverage.
IAPB Africa office works closely with stakeholders and member organisations in sub-Saharan Africa. The Kilimanjaro Centre for Community Ophthalmology (KCCO) based in Tanzania and South Africa provide low vision services in 8 African countries and provides low vision courses.
December 2020 - A busy month
At the start of December 2020 AfriNEAD hosted its 6th conference virtually from Cape Town, South Africa with the theme: Disability Unplugged – Beyond Conventions and Charters, what really matters to People with Disabilities in Africa? This year several leading international figures in AT such as Chapal Khasnabis of the WHO and Mac MacLachlan of the All Institute, spoke alongside ACAT members and the growing number of regional academics, adding strength to the growing evidence being delivered by practitioners across the continent on disability, ageing and the importance of strengthening assistive technology ecosystems.
The vision of AfriNEAD is to become a significant contributor to and facilitator around the needs of people with disabilities in Africa, by assisting in translating existing and new disability research into meaningful evidence-based advocacy, practice, products and policy.
Drawing from the UNCRPD it states that it strives to put, 'the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) principles into action for a rights-based change.'
Contributors to the conference will have their work published in AJOD (African Journal of Disability) .
The African Journal of Disability, is the official journal of CRS, AfriNEAD and CEDRES, publishing papers discussing the issues and experiences of practitioners and academics studying the correlation between disability, poverty and practices of exclusion and marginalisation. It is an open-access journal which means that all content is freely available without charge to the user. Its articles yield new insight into established human development practices, evaluate new educational techniques and disability research, examine current cultural and social discrimination, and provide analysis on common issues experienced across the African region.
This is a valuable resource in a frustratingly restrictive space for African-based academics who Dr Visagie says, 'often struggle to achieve research grants or have their work published in journals'. There is a call for greater voice to be given to authors from the Global South to speak for their own region rather than being represented by academics from the Global North who win the majority of grants and have established routes to publication. GAATO is proud to be promoting this objective and this year GAATO founding member RESNA welcomed international academics, particularly those from the Global South to participate in their annual conference and will be publishing papers in its journal. (Further information on this event can be found here.)
“For many years, NGOs have been providing assistive products to Malawians; it’s now the time that we should look for an alternative instead of relying on donations. I am glad that this assessment is conducted and the findings are the true reflection on what is on the ground”— Wheelchair User & Disability Rights Activist from Malawi (Clinton Health Access Initiative (CHAI) | April 2020)
ACAT takes part in Regional consultation for the development of a WHO regional framework for assistive technology in the African Region.
WHO Regional Office Country Capacity Assessments on AT in Africa
Throughout seven counties of Africa, systems-level assessments have now been carried out by WHO regional offices. With technical support from Clinton Health Access Initiative (CHAI) and the Global Disability Innovation Hub (GDI Hub), Ethiopia, Liberia, Malawi, Nigeria, Rwanda, Sierra Leone, and Uganda have used the WHO’s Assistive Technology Capacity Assessment Tool (ATA-C) under the AT2030 programme. This has brought together national stakeholders and created momentum for further actions to improve access to AT.
The WHO is also directly supporting countries in the Africa region to improve access to AT including national data collection and policy development including the adoption of a National Priority Assistive Products List and further activities to strengthen service delivery systems and the capacity of the workforce. In addition, the WHO rapid Assistive Technology Assessment (rATA) is going to be implemented in 10 countries to collect data on need and unmet need for AT in early 2021. RATA will also help inform the Global Report on Assistive Technology and support advocacy activities and the planning of national AT programmes or interventions.
The WHO have understood the positive impact that improved access to AT across Africa will achieve and they have been instrumental in building networks and partnership building to facilitate this. Following on from the momentum built up from country capacity assessments, WHO Africa and partner organisations such as ACAT came together in late December to discuss their findings. This regional AT highlight was the first joint African regional consultation on AT and was held between 14th and 16th of December 2020 by 85 professionals from member states.
The rich cultural diversity of the African region was evident from the attendees present and recognition of the importance of culture was deemed one of the relevant keystones in a future collaborative framework. Priority strategic objectives and encompassing activities were identified for improving access to assistive technology in the WHO African region, along with clarification of the leading and supporting roles needed to achieve this. The objectives, activities, and implementing partners identified were consolidated into a draft document to define the development of the WHO regional framework of action for improving access to assistive technology in the region. In early 2021 the outcomes from this consultation will be built upon and pioneering steps will be taken to fulfil the mission and vision of this newly founded African AT community.
Some of the additional thematic areas focused upon in the WHO Africa consultation were based around concerns for the needs of an ageing population and response in disaster and conflict, two factors also prioritised by the organisation HelpAge.
In their recently published report 'Access to age-assistive technology: A resilience-building measure for older people', HelpAge ‘explores the intersection between age, gender and disability and the use of AT by older people, in emergency response and as a tool for disaster risk reduction (DRR). The report shows that AT can have a positive impact on independence, vulnerability reduction and resilience building for older women and men in humanitarian crises. This report urges sensitization and capacity building of humanitarian organizations for the inclusion and promotion of assistive product (AP) provision in humanitarian response and offers insight into key areas to enable AT provision to successfully meet the needs of older people.’
With a growing weight of evidence on the importance of mainstreaming AT across development and humanitarian programming, it is hoped that these growing global collaborations can rise to the challenge of meeting the huge unmet AT need at scale by combining their regional and global knowledge, skills and vision.
2021 and beyond
2020 has been a year for virtual meetings and conferences which has in many ways speeded up the process of international collaboration as we became accustomed to the new normal. GAATO has been born into a year that put the WHO and the issues that the GATE community highlight at the forefront of everyone's minds - how we communicate and care for ourselves and each other. This has demanded collaboration and a voice for the aged and disabled all over the globe.
ACAT is a gateway to providing assistive technology to an area of the world that is home to over 16% of our world's population, most of whom have no access to the AT they need and no conduit through which to change this. ACAT has now found a home among African-based practitioners and it is hoped that their network of members and their growing number of regional and global partners will become this channel and facilitate a huge impact upon the communities of over a billion people throughout the African continent. 2021 will be an exciting year for AT in Africa.
Upcoming African regional AT Events
Southern Africa AT Expo. (SAATE) Theme: Wake up and do it for yourself: To promote and advance local AT solutions for Southern Africa. Namibia, Windhoek. 14th - 17th September 2021
CBR world congress – Uganda, Kampala. Postponed from 2020, Date TBC FATO Conference– African federation of rehabilitation professionals. Marakesh - Morroca Postponed from 2020 to 29 March - 2 April 2022
For further information and other global events see the GAATO events page.