Systemic barriers impede equitable access:
Several structural challenges hinder the effective provision of assistive products and deepen the unmet need in LMICs:
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Fragmented procurement and financing: Assistive products are sourced via different channels like NGOs, government programmes and direct procurement by users. In
many countries, people depend heavily on NGOs because health insurance often does not cover assistive products. This results
in unequal access, especially for poorer populations. Funding is also highly fragmented, with money coming from a mix of out-of-pocket
payments, limited government budgets and donor contributions – leading to gaps in coverage, supply disruptions and a lack
of coordinated planning or large-scale procurement. This fragmentation not only limits the availability of quality products
but also constrains the ability to assess national-level demand and supply – both met and unmet.
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Funding shortfalls: Assistive products are often excluded from community health insurance schemes in LMICs. During the COVID-19 pandemic, many
governments reduced budgets for assistive technology, and although some recovery took place in recent years, funding remains
insufficient to meet growing demand. At the same time, global aid and contributions from faith-based organizations have declined.
This progress has been further disrupted by the recent United States Government (USG) stop-work order, which halted or eliminated
budget allocations for several AT programmes reliant on US funding. This sudden halt has created uncertainty for NGOs and
procurement agencies reliant on USG grants, further straining already limited resources for AT provision in LMICs.
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Market and supply chain barriers: Investment in the AT sector remains low, limiting local manufacturing and distribution capacity in LMICs. This is driven
by market uncertainty and high supply chain costs, which were further intensified by global disruptions such as the 2023-2024
Red Sea crisis, leading to increased shipping costs and delivery delays. As a result, high prices and long wait times continue
to suppress demand – especially in remote and low-income settings.
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Policy gaps: Although many countries have ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD),
few have comprehensive policies for assistive technology. Common gaps include the absence of product standards, service provider
qualifications and guidelines on service types and levels.
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Insufficient trained professionals: A shortage of trained professionals in LMICs limits awareness and access to appropriate assistive technologies. This includes
poor knowledge of emerging low-cost and context-appropriate solutions among both users and providers.11
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Low public awareness and demand generation: Overall awareness of assistive technology remains low in many LMICs, especially in rural areas. Many people, including caregivers
and frontline workers, are unaware of available products or how to access them. Without targeted outreach, demand remains
limited – even where products exist.
To address these challenges, key recommendations include the following:
(1) enhancing transparency in supply chains to improve efficiency and accountability;(2) strengthening government policies
to integrate at into health or social insurance schemes; (3) consolidating funding sources to encourage multi-stakeholder
partnerships; and (4) promoting market efficiency with supportive policies, such as tax exemptions, increased private sector
engagement and encouraging local and regional manufacturing, where feasible.
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