Harmonising Assistive Technology Assessment Data: A Case Study in Nepal

Introduction

Assistive technology (AT), including products like hearing aids and glasses, is essential for independence and well-being among people with disabilities and the elderly. However, AT access remains inadequate and uneven across and within countries, with limited efforts to monitor coverage, which impedes evidence-based decisions. Improving AT data is crucial, and recent population-based surveys focusing on AT have advanced this aim. As AT gains attention in national health agendas, countries are including AT needs in routine data collection, though gaps and inconsistent data remain.

The GDI Hub is addressing this by mapping datasets and developing methods to better use available data. The recent Global Report on Assistive Technology highlights the importance of population-level data for evidence-based decision-making, where data harmonisation can play a key role in integrating disparate datasets for unified insights.

Method

GDI Hub identified Nepal for a case study on data harmonisation due to existing partnerships and multiple relevant surveys. Nepal's National Policy and Plan of Action (2007) supports AT access, but coverage remains limited, with only 1 in 8 people with disabilities having access. This study used data from the Living Conditions Studies (LCS), Multiple Indicator Cluster Surveys (MICS), and the rapid assistive technology assessment tool (rATA). Harmonisation defined key outcome variables, such as total need, under-met need, and unmet need, to ensure comparability across surveys. Key demographic adjustments were also applied to align data.

Results

Harmonisation led to significant data cleaning, with 39% of LCS, 11% of MICS, and 30% of rATA data removed for consistency. The harmonised dataset showed trends in AT use, such as a rise in glasses use but limited hearing aid adoption. High rates of disability, especially hearing difficulty, were reported in younger populations. Harmonised datasets help validate AT needs and identify unmet needs, especially where data collection efforts differ.

Validation

Harmonisation methods allowed for cross-validation within the dataset, showing close estimates across different definitions of unmet need, particularly for vision and hearing. The harmonisation process demonstrated reliable results, useful for further analyses and policy planning.

Discussion

Harmonisation of AT data in Nepal highlighted the potential for consistent, comparable insights across surveys, despite limitations. Although some anomalies, such as high hearing difficulty prevalence, require further study, harmonised data benefits policymakers and innovators by clarifying population needs and potential demand for AT products. This method may support efforts to standardise AT data collection globally, offering insights to policymakers and market opportunities for developers.

Conclusion

The AT sector’s fragmented data landscape requires harmonisation to provide a clearer picture of global needs. This case study in Nepal demonstrates the potential of harmonising AT data for policy-making, indicating high demand for further harmonisation efforts in other regions.