Persons with disabilities, including persons with deafblindness, have a right to access affordable assistive devices and technologies, which are assistive, adaptive, or rehabilitative tools designed to specifically help persons with disabilities with daily tasks. They also have a right to affordable accessible technologies, which are technologies and digital tools aimed at a wider audience, but can be useful for persons with disabilities, including persons with deafblindness[i]. Persons with disabilities who have access to assistive devices and technologies, or accessible technologies are better able to maintain or improve their functioning and independence, thus improving their well-being[ii]. Although assistive devices and technologies can lead to greater independence, they should not be seen as a replacement for live assistance, such as interpreter-guide/Deafblind interpreting services.
Very few countries have a national assistive technology policy or programme, and even in high-income countries, assistive products are expensive and often rationed or not included in or difficult to obtain through health and welfare schemes, leading to high out-of-pocket payments. In many low-income countries, persons with disabilities rely on donations and/or lower-quality products that may not be suitable for the individual[iii]. In addition to access to these devices and technologies, regular maintenance, parts (such as batteries), and ongoing adjustments to properly fit the device or to make it work for the person as they adjust to it and as their condition changes over time are barriers, especially in middle and low-income countries.
Furthermore, persons with deafblindness often need to purchase assistive technologies to add to existing technology available to everyone. For example, computers are usually not built with screen reading software. People who require screening reading technology often have to purchase screen reading software separately, uninstall the operating system, and install a new operating system that is compatible with the screen reading software.
Persons with deafblindness are diverse, and therefore, the range of assistive devices and technologies and accessible technologies that they require vary considerably. Most commonly, these devices and technologies aid in communication, information, mobility, and/or memory. Some examples include wheelchairs, hearing aids, spectacles, red and white canes, screen reading software, smartphone technologies, Braille displays and notetakers, sensory toys for children, etc. There is also the potential to expand the range of devices and technologies for persons with deafblindness with new and emerging technologies that are available but are not currently being utilised for persons with deafblindness.
WFDB’s quantitative data analysis revealed that access to assistive devices is very low for children with deafblindness. Across the 36 countries in the MICS analysis, 6% of children used hearing aids, 5% used glasses, and only 1% used both glasses and hearing aids. Access to assistive devices was highest in upper middle-income countries. For the complete data table, see Table 2 in Annex 1.
In WFDB’s survey, respondents commonly stated that assistive devices and technologies are unaffordable or unavailable with very few choices and only limited training on how to use them. Many social protection schemes do not cover the costs of assistive devices and technologies and do not recognise them as a necessity or as an extra cost due to disability[iv].
[i] Convention on the Rights of Persons with Disabilities, A/RES/61/106, 13 December 2006, Articles 4.g, 4.h, 9.2.h, 19.b, 20, 26, and 32.d.
[ii] World Health Organisation, Assistive technology, https://www.who.int/news-room/fact-sheets/detail/assistive-technology, 18 May 2018.
[iii] Ibid.
[iv] World Federation of the Deafblind, At risk of exclusion from CRPD and SDG implementation: Inequality and Persons with Deafblindness, https://wfdb.eu/wfdb-report-2018/, September 2018, p. 19.
“Addressing the unmet need of assistive products is crucial to achieve the Sustainable Development Goals, to provide Universal Health Coverage (UHC), and to implement the CRPD”[i]. WHO’s Global Cooperation on Assistive Technology (GATE) initiative, which aims to assist governments to access assistive technology as part of UHC, sets out good practices across five interlinked areas, which is adapted below to apply to persons with deafblindness:
PEOPLE
Involve persons with deafblindness in decision-making about assistive devices and technologies and a person- / user-centred approach that addresses the diverse needs of persons with deafblindness
POLICY
Develop national policies and programmes with minimum standards to ensure that persons with deafblindness can access assistive products, including a sustainable financing mechanism and universal access
PRODUCTS
Identify the priority products for persons with deafblindness and enhance production, procurement, and service provision and support the innovation of new and emerging technologies for persons with deafblindness
PROVISION
Develop a model for free and affordable service provision that integrates assistive devices and technologies into health and / or rehabilitative services or specialist referral centres, making it easier to access services from a single point
PERSONNEL
Ensure training for professionals on how to use assistive devices and technologies and on how to advise persons with deafblindness on their use, including on maintenance and repairs.
[i] World Health Organisation, Assistive technology, https://www.who.int/news-room/fact-sheets/detail/assistive-technology, 18 May 2018.
Governments