China is the world’s largest domestic market and a key global manufacturing hub for assistive products. According to recent estimates, a significant proportion of assistive products available globally are manufactured in China. For instance, over 50 per cent of global spectacles exports and over 60 per cent of global hearing aids are made in China [1] [2]. Furthermore, China’s overall rehabilitation assistive products market has been growing 9.4 per cent year-on-year since 2015, which is estimated to be higher than global average [3]. The AT market growth in China is driven by two critical factors:
Figure 1: Market size of China’s rehabilitation assistive product 1 industry from 2015 to 2020 (Unit: 1 bn RMB, equivalent to US$140 mn) [3] [9]
China is home to thousands of manufacturers producing across 10,000 different types of assistive products [9]. According to the China Association of Assistive Products, from 2016 to 2020, the number of Chinese wheelchair companies grew by 51.3 per cent, those producing or selling hearing aids by 142.5 per cent and those producing or selling prostheses by 85.8 per cent [10]. By 2020 the total number of companies in these three segments exceeded 25,000 — a fivefold increase from 2010. Several global leading companies have manufacturing plants in China such as EssilorLuxottica (spectacles), Ottobock (prostheses) and GN (hearing aids).
1. Definition of “Rehabilitation assistive product” in China can be found at “China Catalogue of Rehabilitation Assistive Products (2023 Edition)”. It includes both rehabilitation devices and assistive products. ↩︎
In total, 90 suppliers responded to the survey, 66 of whom supply the five priority assistive products (9 supply digital AT, 12 for vision aids (including spectacles), 16 for hearing aids, 20 for prostheses, 31 for wheelchairs and the rest mainly for walking aids and sickbeds). 2
7This report focuses on five priority assistive products. Moreover, the report focuses on assistive products that meet WHO assistive product specifications [11]. This excludes low- quality products, which are prevalent in LMICs.
8Figure 2: Number of LMICs exported to by survey respondents
Table 1: Top 10 LMIC sales destinations for the survey respondents
Table 2: Quality management of different assistive products in China 3
12Table 3: The international certifications held by survey respondents
In addition, China is strategically upgrading its AT innovation capabilities, transitioning from its historical concentration on low-to-mid product models. A study in 2023 shows that most Chinese AT suppliers used to have few patents, with many copying products they previously manufactured for global brands [12]. This resulted in low product differentiation, intense price competition, and low brand awareness in the global market.
13Table 4: Examples of assistive technology innovation events in China
14Table 5: Examples of assistive product innovation hubs in China
15| Institute for Accessibility Development, Tsinghua University | |
| Zhejiang University | |
| University of Science and Technology of China |
The expansion of assistive product exports faces several technical and procedural challenges related to standards, certification, and verification processes. In China, some assistive products are subject to compulsory national standards (GB), while others follow voluntary standards (GB/T), allowing for broader market access but resulting in varying degrees of adherence [27]. Product inspection mechanisms, such as spot checks, are in place but may not always reflect the full scale of production. Internationally, while certifications like CE and ISO are widely used, the credibility of certification bodies can vary, and there may be gaps between certified distributors and their upstream manufacturers. Differences in technical standards, classification systems, and certification expectations between China and other countries—particularly regarding medical device designation—can also create complexities for export, often requiring
16suppliers to obtain additional documentation such as ““Certificate of Free Sale 4 ” or certification tailored to each market.
4. A Certificate of Free Sale (CFS) is used to certify that the aforementioned products can be freely sold in its country of origin. It applies to customs clearance in the importing country, registration with the competent authorities in the importing country and verifying whether the product has legitimate manufacturing procedures. ↩︎
5. China's Belt and Road Initiative (BRI) is a strategy initiated by the People's Republic of China since 2013 that seeks to connect countries globally with the aim of improving regional integration, increasing trade and stimulating economic growth. ↩︎
China’s annual export for hearing aids was around 14 million units in 2022, with a total export value of approximately US$350 mn [28]. From 2018 to 2022, the market size increased 7 per cent year-on-year [29]. The top 5 global hearing aid suppliers (Demant A/S, GN Group, Sonova, Starkey and WS Audiology), which totally account for over 90 per cent of the global market share, all have China as one of their key manufacturing hubs.
Hearing aids are classified as Class II medical devices in China. 6 To obtain a license, producers must submit their quality inspection reports and other required documents. The manufacturers with medical-certified hearing aids will be listed on the National Medical Products Administration (NMPA) official website. For a range of products, including hearing aids, the clinical trial procedure is waived to accelerate their market availability [30]. According to the China NMPA website in October 2024 a total of 96 Behind-the-ear (BTE) hearing aids 7 are certified as medical devices in China 8 , produced by 60 manufacturers [31]. Of these 60 manufacturers, 51 are local Chinese companies that registered 70 BTE products. The remaining manufacturers are local production facilities established by foreign brands.
6. In China, medical devices are categorized into three classes (I, II, and III) based on their risk level, with Class I representing the lowest risk. ↩︎
7. Given that the WHO recommends the behind-the-ear (BTE) hearing aid model for LMICs, this supplier landscape analysis will primarily focus on mapping suppliers that offer BTE products. Source: Preferred profile for hearing-aid technology suitable for low- and middle-income countries, WHO, [https://www.who.int/publications/i/item/preferred-profile-for-hearing-aid-technology-suitable-for-low-- and-middle-income-countries]. ↩︎
Table 6: Top 5 cities with the highest number of certified medical-grade BTE hearing aid suppliers
| City | Province | Percentage |
|---|---|---|
| Shenzhen | Guangdong | 26% |
| Xiamen | Fujian | 16% |
| Zhongshan | Guangdong | 11% |
| Suzhou | Jiangsu | 7% |
| Hangzhou | Zhejiang | 5% |
| Total: | 65% |
Table 7: Survey respondents with medical-certified BTE products and presence in LMICs
| Company | Introduction | LMIC presence | Quality |
|---|---|---|---|
| Acosound (Hangzhou) | |||
| Austar (Xiamen) | |||
| Newsound (Xiamen) |
China’s 2022 export volume of manual wheelchairs reached 9.2 million units, with an export value of approximately US$736 mn [32]. From 2017 to 2022, export volume grew 6 per cent year-on-year, while export value grew at 8 per cent.
Known for price competitiveness, China serves as a contract manufacturer for international NGOs and social enterprises such as Motivation, UCP Wheelchairs and LDS Charities. Global brands such as Rehasense and Ottobock have manufacturing plants in China. The average export price for manual wheelchairs (including transport wheelchairs) in 2022 was around US$80 per unit, a figure that has remained steady since 2017 [32].
The Chinese wheelchair industry is fragmented with low market concentration, with the majority being small-scale businesses. According to the survey, a significant number of manufacturers report low sales volumes, with around 80 per cent of suppliers having annual sales of less than US$5 million. This high level of market fragmentation creates pressure on suppliers to remain cost-competitive, which may lead to varied approaches in product design, materials, and production processes as companies seek to differentiate themselves and expand their market share [33].
Table 8: Top 5 cities with the highest number of medical-grade manual wheelchair suppliers.
| City | Province | Percentage |
|---|---|---|
| Foshan | Guangdong | 19% |
| Tianjin | Beijing-Tianjin-Hebei Region | 12% |
| Hengshui | Beijing-Tianjin-Hebei Region | 8% |
| Danyang | Jiangsu | 4% |
| Langfang | Beijing-Tianjin-Hebei Region | 4% |
| Total: | 47% |
Table 9: Survey respondents with medical-certified manual wheelchairs and footprints in LMICs
25| Kangyijian (Hengshui) | |||
| New Century (Hengshui) | |||
| Xiangrun (Hengshui) | |||
| Zhongjin (Changzhou) |
Four publicly listed medical equipment companies also have medical-certified manual wheelchairs.
Table 10: Public listed companies with medical-certified manual wheelchair business segments
27| Intco (Zhenjiang, Jiangsu) [35] |
| Yuwell (Danyang, Jiangsu) [36] |
Table 11: Other wheelchair manufacturers identified with all three CE, FDA and ISO certifications
29According to the most recent estimates, there are currently over 600 various types of prostheses and orthoses manufacturing, assembly and fitting institutions in China [37]. In 2023, China’s prostheses sales market size in China is RMB787 million (~US$110 mn), with an annual production volume of approximately 130,000 units and around 70 per cent are lower limb products [38].
In China prostheses used to be classified as medical devices. However, certain below- knee (BK) prostheses were removed from the national medical device list in 2015, and certain above-knee (AK) prostheses were removed in 2020 [39] [40]. As a result, relevant products are no longer regulated or monitored by NMPA. Quality control for prostheses is now regulated only by the SAMR.
The National Rehabilitation Technical Aids Quality Supervision and Test Centre, under the Ministry of Civil Affairs, is assigned by SAMR to issue quality certifications and to conduct mandatory spot inspections [41]. For lower limb prostheses, the centre has established the national standard GB/T 18375, which leverages global prostheses standards, such as ISO 10328, and is used as the gold standard certification in domestic sales.
Table 12: Survey respondents for prostheses
| Company | Introduction | LMIC footprint | Type | Quality |
|---|---|---|---|---|
| Chonglang (Beijing) | ||||
| Fuyutiancheng (Beijing) |
| Fengxing (Beijing) | ||||
| Beijing rehabilitation hospital (Beijing) | ||||
| Linkang (Bazhou, Hebei) | ||||
| Grootre (Jinan, Shandong) |
| JBK (Beijing) | ||||
| Dongfang Resun (Beijing) | ||||
| Reborn (Danyang, Jiangsu) | ||||
| Jingbo (Beijing) |
| Ruipu (Hebei) | ||||
| Shenghe (Changsha, Hunan) |
China has over 3,000 manufacturers of spectacles and associated products. Of these, 400 have annual sales exceeding RMB20 million (approximately US$2.8 mn), and at least 600 manufacturers export their products. China is the largest exporter of eyewear to LMICs; for instance, 78 per cent of India’s eyewear imports come from China. Nigeria also relies significantly on imports, with over 90 per cent sourced from China [1]. Chinese manufacturers also produce products for several global brands such as EssilorLuxottica and Safilo and social enterprises such as Vision Spring.
The China Optometric and Optical Association publishes China’s export volume and value every year [42]. The data show a general growing trend of spectacles and its accessories from 2016 to 2023, reaching over US$7.4 bn in 2023 [43]. The export value to “BRI” 9 countries is US$2.7 bn in 2022 (37 per cent of the total), a 20 per cent increase from 2021. And the export value to ASEAN countries is US$639 mn in 2022 (9 per cent of the total), a 52 per cent increase from 2021 [44] [45].
Figure 3: China spectacles export value (Unit: US$100,000)
Spectacles are not classified as medical devices in China [46]. Therefore, no compulsory clinical trials are required. In addition, spectacles for myopia and presbyopia are also not classified as assistive products in China and not included in the national rehabilitation and assistive products list.
9. China's Belt and Road Initiative (BRI) is a strategy initiated by the People's Republic of China since 2013 that seeks to connect countries globally with the aim of improving regional integration, increasing trade and stimulating economic growth. ↩︎
specifically GB10,810 for lenses, GB13,511 for near-vision spectacles, and GB14,214 for frames [47].
Table 13: Survey or interview respondents for spectacles
| Company | Introduction | LMIC footprint | Type | Quality |
|---|---|---|---|---|
| Conant (Shanghai) | ||||
| Pilot (Wenzhou) | ||||
| Weilan (Matt optical) (Wenzhou) |
| Ouhai Glasses (Wenzhou) | ||||
| Readsun (Wenzhou) | ||||
| Select Optical (Jiangsu) | ||||
| Zhantai (Wenzhou) | ||||
| Mike Optical |
Digital assistive products manufacturers that participated in the survey are listed below:
Table 14: Survey respondents for digital AT
| Company | Introduction | LMIC footprint | Type | Quality |
|---|---|---|---|---|
| Huibang (Shenzhen) | ||||
| LL Vision (Beijing) |
| KeAn (Guangzhou) | ||||
| Qiming (Shenzhen) | ||||
| Yuanfangboai (Beijing) |
According to the WHO, digital assistive technology refers to devices or software that provide practical solutions to individuals with disabilities, enabling improved communication, time management and monitoring [52]. In alignment with this broader definition, smartphones have gained prominence due to their portability, multifunctionality, and integration of advanced accessibility features [53]. In recent years, many leading Chinese smartphone suppliers have already been making efforts to develop smartphones tailored for assistive purposes. Given the significant market penetration of made-in-China smartphones in LMICs, it would be beneficial if more persons with disabilities in these countries could access the products.
Among the Chinese smartphone suppliers available in LMICs, Huawei and Honor are leading the way in accessibility feature development. Since 2017, Huawei has introduced features such as screen readers, voice-to-text capabilities, and AI-powered tools [54].
The company announced in 2024 that its accessibility features have reached almost 8
43million users globally [55]. Honor developed several features such as “screen reading”, “AI subtitle” and “Hearing aids as earphones” and announced in their ESG report that monthly almost 1 million users access these functions. Other suppliers, such as Xiaomi, Oppo, Vivo and Transsion, are launching models or systems with accessibility features but detailed user numbers are not publicly available.
Table 16: Accessibility features introduced by Chinese smartphone suppliers
| Supplier | Year | Key accessibility features |
|---|---|---|
| Honor [56] [57] | 2022 | |
| 2023 | ||
| Huawei [58] | 2017 | |
| 2019 | ||
| 2020 [59] |
| 2023 [66] | ||
| 2024 | ||
| Xiaomi | 2018 | |
| 2020 [69] | ||
| 2021 | ||
| 2022 [70] |
Several key factors driving these competitive advantages are listed below:
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