Socio-demographic factors influencing the use of assistive technology among children with disabilities in Malawi

  • International Journal of Environmental Research and Public Health, Volume 18, No. 6, Year 2021

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Study Justification:
– The study aims to address the information gap on the influence of socio-demographic factors on access and utilization of Assistive Technology (AT) among children with disabilities in Malawi.
– It contributes towards the realization of the recommendations of the UN Convention on the Rights of Persons with disabilities.
– It contributes to the development of a framework for creating an effective national AT policy.
Highlights:
– The study used two statistically matched datasets, the 2017 survey on Living conditions among persons with disabilities in Malawi and the 2015-16 Malawi Demographic and Health survey.
– Logistic regression and structural equation modeling techniques were utilized to assess the influence of socio-demographic factors on the use of AT among children with disabilities.
– The results indicate a high level of unmet need for AT among young children aged 2 to 9 and those living in urban areas.
– Children with multiple disabilities have lower odds of using AT for personal mobility compared to children with a single functional difficulty.
– The study highlights the need to specifically target younger children and those with multiple disabilities when developing policies on AT.
Recommendations:
– Develop policies that specifically target younger children and those with multiple disabilities to address the high level of unmet need for AT.
– Increase access to AT for children living in urban areas.
– Improve awareness and education about the benefits of AT among parents, caregivers, and healthcare professionals.
– Strengthen collaboration between government agencies, NGOs, and other stakeholders to ensure the availability and affordability of AT.
Key Role Players:
– Ministry of Health
– Ministry of Education
– Ministry of Gender, Children, Disability, and Social Welfare
– National Statistics Office
– Non-governmental organizations (NGOs) working in the field of disability rights and services
– Disability advocacy groups
– Healthcare professionals and therapists specializing in assistive technology
Cost Items for Planning Recommendations:
– Research and data collection
– Training and capacity building for healthcare professionals and therapists
– Awareness campaigns and educational materials
– Development and implementation of policies and guidelines
– Procurement and distribution of assistive technology devices
– Monitoring and evaluation of AT programs and services

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study utilized two statistically matched datasets, which allows for greater validity and generalization of the findings. The use of logistic regression and structural equation modeling techniques adds to the strength of the analysis. However, the sample size of children using assistive technology is relatively small (1.9%), which may limit the generalizability of the results. To improve the strength of the evidence, future studies could aim to increase the sample size of children using assistive technology and include a wider range of assistive devices in the survey questions.

This paper aims to address the information gap on the influence of socio-demographic factors on access and utilization of Assistive Technology (AT) among children with disabilities in Malawi. Thus, it contributes towards the realization of the recommendations of the UN Convention on the Rights of Persons with disabilities and the development of a framework for creating an effective national AT policy. The paper used two statistically matched datasets, namely, the 2017 survey on Living conditions among persons with disabilities in Malawi and the 2015-16 Malawi Demographic and Health survey. Logistic regression and structural equation modeling techniques were utilized to assess the influence of socio-demographic factors on the use of AT among children with disabilities. The results indicate that there is a high level of unmet need for AT among young children aged 2 to 9 and those living in urban areas. The results further indicate that children with multiple disabilities have lower odds (OR = 0.924) of using AT for personal mobility compared to children with a single functional difficulty. These results entail that AT needs for children with multiple disabilities are not adequately addressed. Therefore, when developing policies on AT, younger children and those with multiple disabilities need to be specifically targeted.

A secondary-data analysis was employed in this study, where data from two-nationally representative surveys, namely, the 2017 Living conditions among persons with disabilities (2017 LCS) and the 2015-16 Malawi Demographic and Health Survey (2015-16 MDHS) were utilized [19]. These two datasets involved larger samples that were representative of the target population and thus allowed for greater validity and generalization of the study findings. The 2017 LCS and the 2015-16 MDHS also contain substantial disability data that can be used in the development of new knowledge, however, researchers in this country always underutilize this data. The data used to examine the relationship between socio-demographic factors and the use of AT was obtained by statistically matching the 2017 LCS and the 2015-16 MDHS [19]. The 2017 LCS is a nationally representative survey that was conducted between 2016 and 2017 among households of individuals with and without disabilities. This study was a follow-up to a similar study that was conducted between 2003 and 2004. The survey was conducted to map the living conditions among persons with disabilities and to compare the living conditions of the disabled with those of the non-disabled population. The survey collected information on disability indicators that would determine any changes in the living conditions of persons with disabilities [14]. For children with disabilities, their information was collected from either the head of the household in the absence of the child or the presence of the disabled child using the UNICEF module on Child Functioning [14]. Regarding the use of assistive technologies, the 2017 LCS survey participants with various functional limitations were asked if they were using the following assistive devices or products: for personal mobility (wheelchairs, crutches, walking sticks, white cane, guide dog, standing frame); for obtaining information (eyeglasses, hearing aids, magnifying glass, enlarged print, and braille); for personal care and protection (special fasteners, bath, and shower seats, toilet seat raiser, commode chairs, safety rails, and eating aids); for communication (sign language interpreter, fax, portable writer, and portable computers); for handling products and goods (gripping tongs, aids for opening containers, and tools for gardening); in-terms of household items (flashlight on the doorbell, amplified telephone, vibrating alarm clock); for computer assistive technologies (keyboard for the blind). The assistive technologies were not differentiated in terms of low cost, improvised aids, and manufactured aids [14]. Among the 1475 children with disabilities that were sampled in the survey, only 1.9% of the sample was using any type of assistive technology. The 2015-16 MDHS, on the other hand, is a cross-sectional survey that was conducted from October 2015 to February 2016. This study was conducted by the Malawi National Statistics Office in collaboration with the Ministry of Health [20]. The survey was conducted to provide an overview of the country’s population, maternal and child health, and other health indicators including measures of nutritional status and knowledge and attitude of women and men about sexually transmitted diseases [20]. Regarding disability, the survey collected information about functional limitations or disabilities of children aged 2 to 17. This information was obtained from the respondents through a household questionnaire. The questions on disability or functional limitation included speech and language, hearing, vision, learning (cognition and intellectual development) mobility and motor skills, emotions, and behaviors [20]. Concerning assistive devices, the survey only asked about the use glasses and hearing aids.

Based on the provided information, here are some potential innovations that can be used to improve access to maternal health:

1. Mobile Health (mHealth) Applications: Develop mobile applications that provide pregnant women with access to important maternal health information, such as prenatal care guidelines, nutrition advice, and appointment reminders. These apps can also include features for tracking symptoms, monitoring fetal development, and connecting with healthcare providers.

2. Telemedicine Services: Implement telemedicine services that allow pregnant women in remote or underserved areas to consult with healthcare professionals through video calls or phone consultations. This can help overcome geographical barriers and provide timely access to prenatal care and medical advice.

3. Community Health Workers: Train and deploy community health workers who can provide maternal health education, conduct regular check-ups, and facilitate referrals to healthcare facilities. These workers can play a crucial role in reaching pregnant women in rural or marginalized communities who may have limited access to healthcare services.

4. Maternal Health Vouchers: Introduce voucher programs that provide pregnant women with subsidized or free access to essential maternal health services, including prenatal care, delivery, and postnatal care. These vouchers can be distributed through healthcare facilities, community organizations, or government initiatives.

5. Maternal Health Hotlines: Establish toll-free hotlines staffed by trained healthcare professionals who can provide information, support, and guidance to pregnant women. These hotlines can address common concerns, provide advice on healthy practices, and offer referrals to appropriate healthcare services.

6. Mobile Clinics: Set up mobile clinics equipped with basic maternal health services, such as prenatal check-ups, vaccinations, and health screenings. These clinics can travel to remote or underserved areas, bringing essential healthcare services closer to pregnant women who may have limited mobility or transportation options.

7. Health Education Campaigns: Launch targeted health education campaigns that raise awareness about maternal health issues, promote healthy practices during pregnancy, and encourage women to seek timely prenatal care. These campaigns can utilize various communication channels, including radio, television, social media, and community outreach programs.

Remember, these are just potential recommendations based on the information provided. The actual implementation and effectiveness of these innovations would require further research and consideration of local context and resources.
AI Innovations Description
Based on the information provided, the following recommendation can be developed into an innovation to improve access to maternal health:

Title: Development of a Comprehensive Maternal Health Access Program in Malawi

Description: Based on the findings of the study on socio-demographic factors influencing the use of assistive technology among children with disabilities in Malawi, it is evident that there is a high level of unmet need for assistive technology (AT) among young children and those living in urban areas. Additionally, children with multiple disabilities have lower odds of using AT for personal mobility compared to children with a single functional difficulty.

To address these issues and improve access to maternal health in Malawi, the following recommendation can be developed into an innovation:

1. Establish a National Maternal Health Access Program: Develop a comprehensive program that focuses on improving access to maternal health services for all women in Malawi, including those with disabilities. This program should be designed to address the specific needs and challenges faced by women with disabilities during pregnancy, childbirth, and postpartum.

2. Increase Availability of Assistive Technology: Ensure that adequate and appropriate assistive technology is available for women with disabilities who require it during pregnancy and childbirth. This includes providing assistive devices such as wheelchairs, crutches, and walking aids, as well as other assistive technologies for communication, personal care, and mobility.

3. Targeted Outreach and Education: Implement targeted outreach and education campaigns to raise awareness among women with disabilities about the importance of accessing maternal health services. This can include providing information about available services, addressing misconceptions and barriers, and promoting the rights of women with disabilities to receive quality maternal healthcare.

4. Training and Capacity Building: Provide training and capacity building programs for healthcare providers to ensure they have the knowledge and skills to provide inclusive and accessible maternal health services. This should include training on disability awareness, communication strategies, and the use of assistive technology.

5. Collaboration and Partnership: Foster collaboration and partnership between government agencies, non-governmental organizations, and disability advocacy groups to ensure a coordinated and holistic approach to improving access to maternal health services. This can include sharing resources, expertise, and best practices, as well as advocating for policy changes and funding support.

By implementing these recommendations, Malawi can develop an innovative and inclusive approach to improving access to maternal health services for all women, including those with disabilities. This will contribute to the realization of the recommendations of the UN Convention on the Rights of Persons with Disabilities and the development of a framework for creating an effective national maternal health policy.
AI Innovations Methodology
Based on the provided information, the paper aims to address the influence of socio-demographic factors on access and utilization of Assistive Technology (AT) among children with disabilities in Malawi. The methodology used in the study involves a secondary-data analysis of two statistically matched datasets: the 2017 survey on Living conditions among persons with disabilities in Malawi and the 2015-16 Malawi Demographic and Health survey. Logistic regression and structural equation modeling techniques were utilized to assess the influence of socio-demographic factors on the use of AT among children with disabilities.

To simulate the impact of recommendations on improving access to maternal health, a similar methodology can be applied. Here is a brief description of the methodology:

1. Data Collection: Collect relevant data on maternal health indicators, such as maternal mortality rates, access to antenatal care, skilled birth attendance, and availability of maternal health services. This data can be obtained from national health surveys, health facility records, and other relevant sources.

2. Identify Potential Recommendations: Conduct a comprehensive review of existing literature, policies, and best practices to identify potential recommendations for improving access to maternal health. These recommendations can include interventions such as increasing the number of skilled birth attendants, improving transportation infrastructure to ensure timely access to healthcare facilities, promoting community-based maternal health programs, and enhancing the availability of essential maternal health supplies.

3. Develop a Simulation Model: Develop a simulation model that incorporates the identified recommendations and their potential impact on maternal health indicators. This model should consider the interdependencies between different recommendations and the contextual factors specific to the target population.

4. Input Data and Parameters: Input the collected data on maternal health indicators into the simulation model. Define the parameters and assumptions for each recommendation, such as the expected increase in skilled birth attendance or the reduction in maternal mortality rates.

5. Run Simulations: Run the simulation model using different scenarios to assess the impact of the recommendations on improving access to maternal health. This can involve varying the parameters and assumptions to explore different potential outcomes.

6. Analyze Results: Analyze the simulation results to evaluate the effectiveness of each recommendation in improving access to maternal health. Identify the most impactful recommendations and their potential synergistic effects when implemented together.

7. Policy and Program Development: Based on the simulation results, develop evidence-based policies and programs to improve access to maternal health. Consider the feasibility, cost-effectiveness, and sustainability of implementing the recommended interventions.

8. Monitoring and Evaluation: Implement the recommended interventions and establish a monitoring and evaluation framework to track progress and assess the actual impact on maternal health indicators. Continuously refine and adapt the interventions based on ongoing monitoring and evaluation efforts.

By following this methodology, policymakers and stakeholders can gain insights into the potential impact of different recommendations on improving access to maternal health and make informed decisions to prioritize and implement effective interventions.


Statistics:
Citations: 2
Identifiers:
DOI: 10.3390/ijerph18063062
ISSN: 16617827
Research Areas:
Disability, Environmental, Health System and Policy, Infectious Diseases, Maternal and Child Health, Quality of Care, Social Determinants, Technology and Innovations
Study Countries:
Malawi
Study Design:
Case-Control Study, Cohort Study, Cross Sectional Study
Study Approach:
Quantitative
Participants Gender:
Male & Female
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