‘Enabling Access’: A Pilot Study on Access and Use of Assistive Products in the Northern Province, Sri Lanka

Shyamani Hettiarachchi, V Subramaniam, Emil Rajah, Paramaguru Gowritharan, Shamra Nizar, Shakeela Saleem


Purpose: The need for suitable assistive technology is growing all over the world, not only for people with disabilities but also for the ageing population with functional decline and non-communicable diseases. Access to assistive technology promotes access to education, employment and active societal participation. The aim of this study was to assess the self-reported need by persons with disabilities and by people who were 65 years and older without disabilities in the Northern Province of Sri Lanka, for assistive products; and to identify barriers to accessing these assistive products.

Method: This mixed-methods pilot study included 76 participants who were either persons with disabilities or their caregiver or persons 65 years and older, from the Northern Province of Sri Lanka, affected by the now-ended 30-year civil war.  To ascertain trends in the local need for assistive products, a translated version of the World Health Organisation’s Priority Assistive Products List of 50 items was used. In addition, semi-structured interviews with key participants were conducted, to gain some insights into the barriers to accessing assistive products. 

Results: The most widely used assistive products among persons with disabilities were connected to war-related injuries. In contrast, those used by the older age group of persons without disabilities were connected to non-communicable diseases and age-related frailty. The assistive products requested by both groups were aids to promote independence in daily activities and to support access to education and employment. The emergent themes included affordability, employment, independence in activities of daily living, stigma and psychological impact, and a lack of awareness and guidance in the use of assistive devices.

Conclusion: The findings highlight the need for policies and practices to be informed by local socio-cultural, historical and geographical realities.


Assistive products; war; priorities

Full Text:



Attanayaka S, Gunawardena N (2016). Buddhist karmic narratives of disability: A reading against the grain. Oral presentation at the Sixth International Buddhist Conference, 1st - 3rd July 2016; Buddhist and Pali University of Sri Lanka, Homagama, Sri Lanka.

Borg J, Larsson S, Ostergren P-O (2011). The right to assistive technology: For whom, for what, and by whom? Disability & Society; 26(2): 151-167. https://doi.org/10.1080/09687599.2011.543862

Borg J, Ostergren P-O. (2015). Users' perspectives on the provision of assistive technologies in Bangladesh: awareness, providers, costs and barriers. Disability and Rehabilitation: Assistive Technology; 12: 705-712.

Campbell F K (2009). Contours of ableism: The production of disability abledness. Palgrave Macmillan: UK. https://doi.org/10.1057/9780230245181

College of Ophthalmologists Sri Lanka (2017). VISION 2020 Sri Lanka [Online]. Retrieved from: https://www.cosl.lk/vision_2020.html

Disability Federation of Ireland (2016). Assistive technology for people with disabilities and older people: A discussion paper. Enable Ireland: Dublin, Ireland.

Khasnabis C, Mirza Z, MacLachlan M (2015). Opening the GATE to inclusion for people with disabilities. Lancet; 386: 2229-2230. https://doi.org/10.1016/S0140-6736(15)01093-4

Kumar P, Dixit U, Goyal V C (2009). Assistive and enabling technology needs of elderly people in India: Issues and initial results. In S. Bhatia & V.C. Goyal (Eds.), Assistive technologies - towards home-based elder care. Ambala Cantt: Associated Book Service: 978-993.

MacLachlan M, Banes D, Bell D, Borg J, Donnelly B, Fembek M, Ghosh R, Gowran RJ, Hannay E, Hiscock D, Hoogerwerf E-J, Howe T, Kohler F, Layton N, Long S, Mannan H, Gubela M, Ongolo T O, Perry K, Pettersson C, Power J, Ramos V D, Slepičková L, Smith E M., Tay-Teo K, Geiser P, Hooks H (2018). Assistive technology policy: A position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disability and Rehabilitation: Assistive Technology; 13(5): 454-466. https://doi.org/10.1080/17483107.2018.1468496. PMid:29790393

Marasinghe K M, Lapitan J M, Ross A (2015). Assistive technologies for ageing populations in six low-income and middle-income countries: A systematic review. British Medical Journal Innov; 1: 182-195. https://doi.org/10.1136/bmjinnov-2015-000065. PMid:26688747 PMCid:PMC4680721

Nicolson A, Moir L, Millsteed J (2012). Impact of assistive technology on family caregivers of children with physical disabilities: A systematic review. Disability and Rehabilitation: Assistive Technology; 7(5): 345-349. https://doi.org/10.3109/17483107.2012.667194. PMid:22436000

Perera A (2015). Sri Lankans disabled by war, forgotten in peace [Newspaper]. The New Humanitarian. Retrieved from: http://www.thenewhumanitarian.org/news/2015/09/16/sri-lankans-disabled-war-forgotten-peace

Ritchie J, Spencer L (1994). Qualitative data analysis for applied policy research. In A. Bryman & R.G. Burgess (Eds.). Analysing qualitative data. London: Routledge: 173-194. https://doi.org/10.4324/9780203413081_chapter_9

Samararatne D, Soldatic K, Perera B (2018). Out of the shadow: War-affected women with disabilities in Sri Lanka: Final report. Penrith, New South Wales: Western Sydney University.

Tebbutt E, Brodmann R, Borg J, MacLachlan M, Khasnabis C (2016). Assistive products and the Sustainable Development Goals (SDGs). Globalisation and Health; 12(79): 1-6. https://doi.org/10.1186/s12992-016-0220-6. PMid:27899117 PMCid:PMC5129191

United Nations (2016). Sustainable development knowledge platform: Transforming our world: The 2030 agenda for sustainable development [Online]. Retrieved from: http://sustainabledeveloment.un.org/post2015/transformingourworld

United Nations Children's Fund (2012). Progress for children: A report card on adolescents. Number 10. New York: United Nations Children's Fund.

United Nations Convention on the Rights of Persons with Disabilities - UNCRPD (2006). Retrieved from: https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html

United Nations Development Programme (2015). Sustainable Development Goals [Online]. Retrieved from: http://www.undp.org/content/undp/en/home/sustainable-development-goals.html

United Nations International Children's Emergency Fund - UNICEF - & World Health Organisation -WHO (2015). Assistive technology for children with disabilities creating opportunities for education, inclusion and participation: A discussion paper. Geneva: World Health Organisation.

Visagie S, Eide A H, Mannan H, Schneider M, Swartz L, Mji G, Munthali A, Khogali M, van Rooy G, Hem KG, MacLachlan M (2017). A description of assistive technology sources, services and outcomes of use in a number of African settings. Disability and Rehabilitation: Assistive Technology; 12: 705-712. https://doi.org/10.1080/17483107.2016.1244293. PMid:27882821

Weerasinghe I E, Fonseka P, Dharmaratne S D, Jayatilake J A M S, Gielen A C (2015). Barriers in using assistive devices among a group of community-dwelling persons with lower limb disabilities in Sri Lanka. Disability, CBR and Inclusive Development; 26(1): 79-96. https://doi.org/10.5463/dcid.v26i1.410

World Health Organisation - WHO (2001). International classification of functioning, disability and health (ICF). Geneva: World Health Organisation.

World Health Organisation - WHO (2008). Guideline on the provision of manual wheelchairs in less-resourced settings. Geneva: World Health Organisation.

World Health Organisation - WHO (2011a). Joint position paper on the provision of mobility devices in less-resourced settings. Geneva: World Health Organisation.

World Health Organisation - WHO (2011b). World report on disability. Geneva: World Health Organisation.

World Health Organisation - WHO (2016a). Health financing for universal health coverage. What is universal coverage? [Online] Retrieved from: http://www.who.int/health_financing/universal_coverage_definition/en/

World Health Organisation - WHO (2016b). Priority assistive products list: Improving access to assistive technology for everyone, everywhere. Geneva: World Health Organisation.

World Health Organisation - WHO (2017a). WHO standards for prosthetics and orthotics. Part 2: Implementation Manual. Geneva: World Health Organisation.

World Health Organisation - WHO (2017b). Global priority research agenda for improving access to high-quality affordable assistive technology. The Gate Initiative. Geneva: World Health Organisation.

DOI: https://doi.org/10.5463/dcid.v30i3.842

Copyright (c) 2020 Shyamani Hettiarachchi

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Supported by:


© Disability, CBR & Inclusive Development