WHO–UNICEF assistive technology workshop in Nairobi.
Observations on choice, value chains, and digital inclusion from the WHO–UNICEF assistive technology workshop in Nairobi.
Dr Maryam Bandukda, attended the WHO–UNICEF Accelerating Access to Assistive Technology workshop in Nairobi this June, representing the Global Disability Innovation Hub (GDI Hub) alongside government delegations from 14 countries across the African Region. Over three days, the discussions consistently returned to a central point: the principal barriers to access are less about devices themselves than about the systems, financing and relationships that determine who is able to obtain and use them. The reflections below set out the themes I considered most significant and are offered as one participant's account rather than the workshop's formal conclusions.
The workshop was situated within existing regional and global commitments, including the African Region's 2021 framework (AFR/RC71/11), World Health Assembly resolution WHA71.8, and the WHO–UNICEF Global Report on Assistive Technology, which was co-delivered by GDI Hub. Sessions were structured around the WHO-GATE 5P framework: people, policy and finance, products, provision and personnel. In this article, I reflect on my main takeaways from the workshop.
Choice is more demanding than it appears
The framework's central focus on ‘People’ was reflected throughout the three-day workshop, with the strongest themes emerging around AT user awareness, inclusion, and empowerment, emphasising the serious commitment from funders and developmental partners. The discussions underscored the need for user-centred AT devices, policies, and service design; that offering a genuine choice is itself a form of respect; and that the apparently minor details — naming a device, customising it, selecting it — contribute materially to whether a person continues to use their AT. Choice, however, is not straightforward. It varies by context, culture and age, and it is readily claimed in principle while being designed out in practice. This is frequently where well-intentioned programmes fall short: services are organised around what is available rather than around individual need. Treating AT users as decision-makers and adequately resourcing the screening and assessment that enable product adaptation is considerably more demanding than the language of choice implies.
Why assistive technology remains costly
A recurring question concerned the persistent cost of AT. Part of the explanation, as several delegates noted, is that local value chains are not yet established. A significant proportion of procurement remains donor-driven rather than aligned with a country's needs, capacity, and product mix, and the consequences are evident. The term "wheelchair graveyard," used in one session, describes equipment that is supplied but does not fit, cannot be maintained, and is ultimately unused. Discussions traced a progression from donor-driven procurement toward programme-, product- and ultimately system-driven approaches, supported by national priority assistive product lists and deliberate financing mechanisms. This does not imply working without international partners; rather, it requires investment in local production, repair and reuse capacity, and meaningful use of the practical expertise that organisations of persons with disabilities already hold. Progress is real but uneven, and the distance still to be covered should not be understated.
Digital assistive technology offers potential, but not by default
Smartphones are emerging as genuinely useful assistive tools, consolidating magnification, screen readers and captioning into a single affordable device. GDI Hub's Mobile as Assistive Technology research in Kenya is examining how this functions in everyday life for people who are blind, partially sighted, deaf or hard of hearing, including in low-bandwidth settings. The findings are encouraging but qualified: cost, connectivity, digital literacy and device sharing all influence whether the potential benefit is realised.
It is equally important not to assume that digital tools are inherently inclusive. Speaking on the ‘People’ panel on Day 2 of the workshop, I noted that mainstream speech and AI technologies frequently fail people with non-standard speech and those who speak under-resourced languages — often the populations most likely to be excluded. GDI Hub's Centre for Digital Language Inclusion is addressing this directly by assembling non-standard speech datasets to train more inclusive speech-recognition systems, with work now underway in Kenya and building on an earlier pilot in Ghana. This remains in its early stages, and the gap is substantial.
These considerations extend upstream. Colleagues drew attention to the scale of unmet need among young children with disabilities, and to the stigma that makes children with communication difficulties more difficult to identify — a reminder that data and screening systems are themselves part of the access challenge.
Where the work now lies
My main takeaway from the workshop is that while the necessary frameworks and commitments are largely in place, the more challenging and prolonged task ahead is implementation. In my view, this depends on three key priorities:
- Investing in local value chains to ensure access is both affordable and sustainable.
- Incorporating user choice and voice into practice, rather than just in policy.
- Harnessing the potential of the widely used smartphones as digital assistive technologies to include those who are often overlooked.
GDI Hub is committed to pursuing this work in collaboration with African researchers, policymakers, organisations of persons with disabilities, and assistive technology users. We welcome engagement from those working to strengthen assistive technology systems at both regional and national levels. The direction we are heading is clear; the real challenge—and the value—lies in effective delivery.
GDI Hub is the first WHO Collaborating Centre on Assistive Technology, delivering the AT2030 programme in partnership with more than 60 countries.