The lack of access has an impact not only for the day-to-day life of the concerned persons with disability, but also on their family and the society as a whole. In fact, without the appropriate assistive technology, the people with disabilities, who do not have the financial means, are excluded from the society and therefore trapped in the vicious circle of poverty.
To identify and answer to the urgent needs of the persons with disabilities, the WHO has established a core group, the Global Cooperation on Assistive Health Technology (GATE) in charge of the strategic research priorities. The GATE has identified five global priorities research thematic:
- Effects, costs and economic impact of assistive technology
- Assistive technology policies, systems, service provision models and best practices
- High-quality and affordable assistive technology
- Human resources development for the assistive technology sector
- Standards and methodologies for the assessment assistive technology need and unmet need
Affordable and efficient technology
In line with the GATE’s global priorities, MoveAbility is aiming to help persons with disabilities fulfill their potential. After more than 30 years of activities in the field, MoveAbility has concluded that to achieve its goal, the first step for persons with disabilities is to access products and services. Without that prerequisite, they don’t have the ways nor the means to advocate for their rights.
In low- and middle- income countries, there is an urgent need for more affordable and efficient assistive products and services. Assistive products can be defined, according to Chapal Khasnabis, as “any products […] whose primary purpose is to maintain or improve an individual’s functioning and independence and thereby promote their wellbeing”. (Khasnabis, et al, 2015) It is not only essential in helping the persons with disabilities gain or regain their mobility, but also in promoting their social inclusion.
For many years, to improve the access to devices,MoveAbility has been working with the polypropylene technology, developed by the ICRC. It is affordable, resistant and requires low maintenance. Also, measures, such as the implementation of a beneficiaries’ satisfaction and impact survey or the introduction of products from the private industry (i.e. devices for sports), have greatly improved the quality and comfort of the devices for the users. It is in fact essential to adopt a users’ centered approach in line with the WHO principles and the Article 4 of the UNCRPD. MoveAbility ensures that the persons with disabilities, through their representatives, such as the Disabled Peoples’ Organization, are involved in all stages from the formulation to the implementing of the laws and services related to them.
Inclusive social protection systems
The access to assistive devices and services is first and foremost determined by the financial means of the persons with disabilities. According to a research paper by the London School of Hygiene & Tropical Medicine, “persons with disabilities tend to be of lower socioeconomic status and to be concentrated in poorer areas and to be less likely to work.” They are therefore vulnerable and their inclusion within the context of social protection is important.
To ensure and sustain the socio-economic inclusion of persons with disabilities the current health system in the low- and middle-income countries should evolve to be more responsive to their complex needs. Starting with the fundamental necessity of a social protection program covering the common daily expenditure, such as healthcare and assistive devices.
A National Platform for coordination
MoveAbility acknowledged, after some years of technical capacity-building, that the lack of managerial capacities and of national coordination limited the impact of the measures in the long run. It indeed contributed to the improvement of the technical skills of the rehabilitation professionals, but it remained confined to a small circle of experts.
Therefore, MoveAbility operated a shift in its mindset by adopting a multi-sectoral approach, instead of focusing on the technical know-how only. It worked on the management capacity-building and included all the actors of the rehabilitation sectors in the process: from the Disabled People’s Organization to the Ministry of Health. The training sessions that were organized in most of the countries where MoveAbility operates, led to the creation of a National Platform for the physical rehabilitation sector. It created a productive space of discussion, exchange and advocacy.
In fact, disability affects a wide range of actors and crosses all sectors of the society. The success of the action plan, as the WHO underlines, “depends on an effective multi-sectoral approach, with practical mechanisms for coordination and implementation between all the key stakeholders”: the relevant ministries, the rehabilitation services, the national societies of the Red Cross/Red Crescent, the people with disabilities, represented through the Disabled People’s Organizations and all other relevant actor.
The National Platform constitutes an ideal space for the construction of a coherent and relevant social protection and inclusion policy for persons with disabilities. They are, with their family and caregivers, notably through the Disabled People’s Organizations, empowered and involved in the formulation and implementation of the policies. Their active participation and decision-making are integral to the success of habilitation and rehabilitation systems.
MoveAbility’s project to create a National Platform was successful in many countries, especially in Togo, where the members of the platform are currently working on the Terms of Reference. For the first time in Togo, the physical rehabilitation actors and the civil society are directly consulted on the social policy resolutions to facilitate the access to services and devices for persons with disabilities. The platform also contributes to raise awareness on disability issues and has placed it in the political agenda. The Togolese Ministry of Health is currently working on a revision of the social and protection policy towards persons with disabilities.
The National Platform is being extended to other countries in Africa. This concept is now proposed in all cooperation agreements with the concerned Ministries of the countries in which MoveAbility operates. It is a real step forward for the inclusion and empowerment of persons with disabilities. It demonstrates a raise of awareness of the disability issues and the willingness of the Governments in low- and middle-income countries to take the lead in the field of public policy.
Director of Operations
The ICRC MoveAbility Foundation
 WHO Global priority research agenda for improving access to high quality affordable technology: http://apps.who.int/iris/bitstream/10665/254660/1/WHO-EMP-IAU-2017.02-eng.pdf
 United Nations Convention on the Rights of Persons with Disabilities, Article 4: http://www.ohchr.org/EN/HRBodies/CRPD/Pages/ConventionRightsPersonsWithDisabilities.aspx#4
 Bernabe-Ortiz A, Diez-Canseco F, Vasquez A, et al. Inclusion of persons with disabilities in systems of social protection: a population-based survey and case–control study in Peru. BMJ Open 2016;6: e011300. doi:10.1136/
 WHO Global Disability Action Plan 2014-2021: better health for all people with disability http://apps.who.int/iris/bitstream/10665/199544/1/9789241509619_eng.pdf?ua=1