Assistive Technology (AT) Policy and Strategic Plan 2021-25
The Assistive Technology Policy and Strategic Plan was developed by the Clinton Health Access Initiative under the AT2030 Programme Country Investment Fund.
Executive Summary
The 1991 constitution of Sierra Leone incorporates the main elements of the United Nations standard rules on equality of opportunities for persons with disabilities. It also includes the recently ratified UN Convention on the Rights of Persons with Disabilities (UNCRPD) and domesticated into the Persons with Disability Act 2011. These rules and the convention provide important framework for any policy and strategy in Sierra Leone to achieve equalization of opportunities for persons with functional difficulties. Functional difficulty is an overarching term for impairments, activity limitations and participation restrictions.
The Government of Sierra Leone is committed to implementing the Sustainable Development Goals (SDGs) which place greater emphasis on the need for greater social inclusion and equality. The pledge of the SDGs of ‘leaving no one behind’ addresses people with disabilities who are often marginalized. As recognized globally, AT has a tremendous scope of ensuring equitable achievements of the SDGs by providing products and services that alleviate impairments and barriers enabling them to actively participate as equal members of society. AT, as defined by the World Health Organization (WHO) is a subset of health technology, referring to assistive products and related systems and services developed for people to maintain or improve functioning, thereby promoting well-being. However, not everyone has access to appropriate AT. The WHO estimates that only 1 in 10 people globally have access to the AT they need1. A health condition may include a variety of circumstances such as pregnancy, ageing, stress, congenital anomaly, or genetic predisposition. AT enables people with difficulties in functioning to live healthy, productive, independent, and dignified lives; participating in education, the labor market and social life. It can reduce the burden on formal health and support services and care givers.
It is also worth noting that the population of Sierra Leone is quite young, 78% are aged between 5 and 50 years with elder population (above 50) constituting only 9%. As per the Sierra Leone Population and Housing Census (PHC) 2015, the prevalence of disability is recorded as 1.3% (93,129) of which the northern region has the highest number of persons with disabilities (32,849), which represents 35.3% of all persons with disabilities in the country. Disease or illness is the major cause of disability among the country’s disabled population. This is followed by congenital disability (16.2 %), other non-specified causes (10.5%), accidents (8.8%) and natural ageing (8.1%). Other causes of disability, including road traffic accidents, occupational injuries, and injuries sustained in the war, and injuries that were not specified accounted for less than 5% of the total number of persons with disabilities.
Therefore, policies and strategies that envision a well-functioning ecosystem with the capacity to provide quality and affordable rehabilitation and assistive technology services in a timely manner should be made a priority.
The Ministry of Health and Sanitation (MoHS) and its Agency, the National Rehabilitation Centre (NRC) are primarily responsible for ensuring quality, affordable and customized rehabilitation and assistive products and services to persons with disabilities. The policy acknowledges the fact that rehabilitation and assistive technology services should be integrated at all levels of health care delivery i.e., primary, secondary, and tertiary. In addition, policy envisages the highest degree of inter-sectoral coordination to ensure equitable access to AT services in the population through increased support and participation from non-health ministry’s/departments e.g., education, road and transport, labor, and social welfare.
The Assistive Technology Policy and Strategic Plan intends to guide the government, MoHS, intersectoral ministries, Organizations of Persons with Disabilities (OPD), development partners, donors, and private players in the development of assistive technology services for the country. Furthermore, the document developed 5 policy statements, 8 strategic objectives, and 40 activities ranging from coordination of the AT ecosystem, to raising resources and monitoring full implementation of the policy strategic plan. In doing so, we are addressing, in a holistic manner, the provision of AT products and services to PwDs at our national and regional centers. The activity of these policy statements and their allied objectives have been costed to provide a strategic level view of how much it will cost government and partners to implement these AT activities.
The document also draws attention to key activities such as creation of a disability medical board to provide necessary medical guidance on the process. Screening, evaluation, and certification of disability based on type and level of functional disability and, partnerships with regional and international technical institutions to build the in-country capacity to produce, distribute and monitor the use of AT services. A strong emphasis has been laid on on-site and online skill-based training and certification of AT professionals in the system. Special considerations should be made in promoting and rewarding professionals for their continuous skill upgradation and services in-country. The long-term vision is to develop a National Assistive Technology Program to ensure affordable, quality and equitable AT services to the population.
References
1 World Health Organization. Assistive technology factsheet. 2018 (https://www.who.int/en/news-room/fact-sheets/detail/assistive-technology, accessed 11 November 2020).