Access to assistive technology in Africa: findings from evidence-informed deliberative dialogues on trade and fiscal policies.
Emiliana Maria Grando Gaiotto, Mariana Gabriel, Magali Favaretto Prieto Fernandes and 5 others
PMID 42620619WHAT IT FOUND
A facilitated policy discussion with 35 stakeholders in four African countries surfaced common barriers to assistive technology access (cost, failed tax exemptions, weak local production, workforce shortages) but provides no clinical evidence to change how you treat a patient.
Key findings
01Across all four countries, participants identified the same structural barriers: high device costs persisting even where tax exemptions exist, fragile local production and maintenance capacity, shortage of specialised professionals, and weak coordination between institutions.
02Country-specific themes differed: Mozambique emphasised geographic barriers and integration of rehabilitation into primary care; Chad focused on governance, advocacy, and building a national AT database; Egypt highlighted insurance gaps and urban–rural inequality; Kenya raised stigma, gender inequality, and cultural acceptability of devices.
03Participants converged on four policy priorities: simplifying customs and tax-exemption procedures so fiscal benefits reach end users; strengthening local production with quality standards; integrating AT into primary care, rehabilitation, and universal health coverage; and ensuring active participation of people with disabilities and their organisations.
STILL TO COME
How it was doneWhat they found
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What it does not show
This is a facilitated discussion, not a test of any intervention. No policy option was implemented and evaluated; the paper reports what participants said, not what happened. Thirty-five purposively selected stakeholders across three dialogues; findings reflect the views of those present and cannot be generalised to all of Africa or even to the four countries studied. The Republic of Congo was invited but no representatives attended, so one of the five planned contexts is absent. Coding was performed by a single researcher (reviewed by a second), which limits the breadth of thematic interpretation. Participants worked from a pre-existing evidence synthesis, so the discussion was framed by the authors' prior policy options rather than emerging entirely from participants' own priorities. All dialogues were conducted virtually, which may have shaped participation and depth of discussion.
Declared interests
The research was funded by ATscale (Global Partnership for Assistive Technology) and the publication was funded by IMREA (Instituto de Medicina Física e Reabilitação, Universidade de São Paulo). No author-level conflicts of interest beyond the funding declaration are stated.
The easy way to misread this
Do not read the participants' consensus on tariff reform, local-production incentives, or awareness campaigns as evidence that those policies improve AT access. The paper records what stakeholders discussed in a facilitated meeting; it did not implement any of the five policy options, measure access before and after, or compare countries that adopted a policy with those that did not. The themes are a starting point for policy debate, not a demonstration of effect.