Repair strategies for assistive technology in low resource settings

Oldfrey, Ben; Holloway, Cathy; Walker, Julian; McCormack, Steven; Deere, Bernadette; Kenney, Laurence; Ssekitoleko, Robert; Ackers, Helen; Miodownik, Mark

Abstract

Purpose
To investigate the practices of repair that exist for users of mobility assistive products in low resource settings, as well as the psychosocial impact that the repair, or non-repair, of these devices has on users’ lives.

Materials and Methods
This article collates data on repair practices and the responses from participants on the topic of repair from studies conducted by the authors across four different low resource settings in Kenya, Uganda, Sierra Leone, and Indonesia. This data was then analyzed to identify the common themes found across geographies.

Results
Three major models of repair practice emerged from the data: “Individual or Informal Repair in the Community”; “Local Initiatives”; and “Specialist AT Workshop Repair”. Additionally, the wider impact on the participants’ lives of “Problems & Concerns with Repair”; “Experiences of Breakages & Frequencies of Repair” and the “Impact of Broken Devices” are explored.

Conclusions
The results of this analysis demonstrate the paramount importance of community-based repair of devices, and how despite this importance, repair is often overlooked in the planning and design of assistive products and services. There is a need to further incorporate and support these informal contributions as part of the formal provision systems of assistive device.

IMPLICATIONS FOR REHABILITATION
A lack of available specialist repair services in low resource settings hinders the potential impact of assistive technology provision systems.

Community-based repair is the major route by which assistive devices are repaired in low resource settings.

Appropriate community-based repair strategies should be incorporated into and supported by the formal assistive technology provision models in order to optimise outcomes.

A lack of data on outcomes across the lifecycle of assistive products hinders progress on improving focus on follow-up services – in particular repair & maintenance.

By supporting community-based repair, repairs that are inappropriate for that approach could be better directed to specialist repair services.

• Journal Article Type: Article
• Acceptance Date: Jul 5, 2023
• Online Publication Date: Jul 19, 2023
• Publication Date: Jul 3, 2024
• Deposit Date: Jul 20, 2023
• Publicly Available Date: Jul 21, 2023
• Journal: Disability and Rehabilitation: Assistive Technology
• Print ISSN: 1748-3107
• Electronic ISSN: 1748-3115
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Pages: 1-11
• DOI: https://doi.org/10.1080/17483107.2023.2236142
• Keywords: Speech and Hearing, Rehabilitation, Biomedical Engineering, Orthopedics and Sports Medicine, Physical Therapy, Sports Therapy and Rehabilitation
• Additional Information: Peer Review Statement: The publishing and review policy for this title is described in its Aims & Scope.; Aim & Scope: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=iidt20; Received: 2022-08-30; Revised: 2023-06-19; Accepted: 2023-07-05; Published: 2023-07-19