Priority Assistive Technology Products List of Sierra Leone
The Priority Assistive Technology Products List of Sierra Leone Report
was developed by the Clinton Health Access Initiative under the AT2030
programme's Country Investment Fund.
Executive Summary
The purpose of the Priority Assistive Products List in Sierra Leone is to help improve access to appropriate, quality Assistive Technology (AT) products at an affordable price that will help enhance the functioning and independence of persons with disabilities, while facilitating their participation and integration in society.
WHO defines AT as a subset of health technology that “refers to assistive products and related systems and services developed for people to maintain or improve functioning and thereby promote well-being, such as eyeglasses, hearing aids and wheelchairs. Assistive products maintain or improve an individual’s functioning and independence, thereby promoting their wellbeing’’. (WHO 2018).
The 2015 Population and Housing Census revealed the prevalence of disability in Sierra Leone is 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). The census reports disclosed that the major cause of disability in the country is disease or illness which accounts for 40.5% of cases of the 93,129 people with disabilities in the country. This is followed by congenital disability (16.2 %), other non-specified causes (10.5%), accidents (8.8%), and natural aging (8.1%). Other causes of disability, including traffic accidents, occupational injuries, injuries sustained in the war, and injuries that were not specified accounted for less than 5% of the total. The percentage of disabled people in Sierra Leone has been hit by the long and bloody civil war in 2002, which is a major contributor to a significant rise in disabled strata. The deadly Ebola Scourge in 2014, the devastating Freetown mudslide in 2016, and Covid19 in 2019 coupled with a weak healthcare system further added to the challenges of the PWDs.
AT products include any external product whose primary purpose is to maintain or improve an individual’s functioning and independence and thereby promote his or her well-being. They include (but are not limited to) wheelchairs, hearing aids, walking frames, spectacles, pill organizers, and prosthetic limbs, as well as assistive information and communication technology such as memory aids, specialized computer hardware and software, augmentative and alternative communication, and customized telephones. Assistive products are essential tools to compensate for an impairment/loss of intrinsic capacity, to reduce the consequences of gradual functional decline, to reduce the need for carers, for primary and secondary prevention, and to help to rationalize health and welfare costs.
This first report on the Sierra Leone Priority Assistive Technology Product List, seeks to list all AT products needed based on the Sierra Leone context. This list is based on a qualification framework, which was developed by the team; and is underpinned by the WHO ICF guidelines. This framework uses multiple assessment criteria to evaluate the AT product eligibility for priority devices for the country’s context. All the products were thoroughly evaluated and reviewed severally before finalizing the list. The list will form part of the general MoHS essential list of equipment.
The report identified 70 Priority AT Products for Sierra Leone and in doing so, makes a major contribution to the rehabilitation program in Sierra Leone in addressing gaps related to AT procurement and service provision by the MoHS. It will also go a long way in ensuring equitable access to AT products and services and ultimately improve the quality of life of persons with disabilities.
The report highlights AT market challenges in Sierra Leone including: the unmet demand of AT products, high out-of-pocket burden in accessing AT products, poor resource allocation to rehabilitation centers, a market driven by charity and donations, and more. To alleviate those challenges, the report makes strong recommendations for local manufacturing of AT products and allied services, allocation of sufficient funds for the AT program within the NRC, the development of a Management Information System (MIS) to capture delivery of assistive technology products (to the beneficiaries by the government or donors), building human resources capacity in rehabilitation and more. This calls for a systemic approach to developing system capacities from identifying the AT needs up to the delivery of quality AT services in the country and will certainly lead to improvement in assistive technology services and client satisfaction.