Rural AT Access in Developing Countries
By Rosita Njeumi
Background
Assistive Technology (AT) refers to assistive products and services and the support systems enabling the effective provision and use of such products and services. Assistive products can be either physical or digital. Many populations benefit from the use of these technologies, notably elderly people, children and adults with disabilities, and those with long-term health conditions. AT products, services, and systems provide greater autonomy for users and make it possible for them to participate in daily activities like education, employment, fitness, and leisure [7].
The WHO and UNICEF's Global Report on Assistive Technology demonstrates considerable inequity in access to assistive technology. As few as 3% of people in some low-income countries were reported to have access to the assistive products they need, in comparison to 90% in some high-income countries. There are some barriers to access, such as low awareness, high costs, and limited physical access [7]. This unmet need highlights the disparity between rural and urban populations around the world. Accessing assistive technologies is necessary to provide a more equitable future for those who need them.
Asia and the Pacific
Access to AT remains highly uneven, particularly in rural areas of low-income countries and small-island states. While countries like China, India, Japan, and the Republic of Korea have stronger production and export systems, a number of countries face weak and unbalanced AT value chains. Naturally, those in small-island states do not have the extensive advanced technology that larger, more developed countries in Asia and the Pacific have. Those with disabilities cannot as easily work in the dominating workforces of agriculture and informal work that persist in these areas. Access to AT that supports the participation of persons with disabilities in these sectors is essential, especially in rural and under-resourced areas where few alternative income-generating opportunities exist. As a result, those who have disabilities will be more likely not to work or gain income due to their inability to work. Women with disabilities, youth, and rural inhabitants with disabilities experience higher rates of unemployment or economic inactivity and are at greater risk of vulnerable employment and insufficient social protection [4].
Accessing AT is only made more complicated by barriers like weak supply chains, limited financing, lack of awareness, and high costs. Though technological advancements have been happening across Asia, those who live in rural, underserved, and poverty-stricken areas are unable to utilize these technologies for the improvement of their own lives. For instance, in Japan, OriHime robots, developed by OryLab in Japan, are assistive service avatars that enable persons with complex physical disabilities to work and socially connect by remotely operating robots in settings such as cafés, restaurants, and nursing homes. This technology could be adapted for use by job coaches, enabling them to remotely assist a larger number of persons with intellectual and developmental disabilities in employment [4].
In China the Fuhong Society of Macau integrates both high- and low-tech assistive technologies into its vocational training programs to support persons with intellectual disabilities, autism, and psychosocial disabilities in developing skills and independence. This technology is data-driven and relies on user feedback to ensure continued improvement and adaptation to individuals' needs. Those living in low-resource and rural areas cannot access technology like this [4]. There is a need for more products, services, and technologies to reach those of low economic stature so they can better participate in everyday activities, especially employment, to improve their economic status.
India is one of the developing countries that does have some governance in place to provide assistive technologies. One of the largest government financial aid programs for procuring AT is through the Assistance to Disabled Persons for Purchasing/Fitting of Aids/Appliances (ADIP) scheme. The biggest agency implementing the ADIP scheme is the Artificial Limbs Manufacturing Corporation of India (ALIMCO), a public sector undertaking. ALIMCO provides a range of AT products. Products are provided through various fitting centers and donations through camps run in the rural and semi-urban areas of India. Recent developments include new products and capacity-building efforts, which will positively impact product and service quality [6]. These efforts made in India are one of the better programs in the developing world to combat the growing need for assistive technologies and services to access them.
Africa
Difficulties in accessing assistive technologies in Africa are compounded by dependence on imported products, limited local production capacity, and poorly structured supply chains. Users who are in dire need of assistive technologies cannot access them due to distance, costs, and unawareness. The differences in tax regimes, customs procedures, and international classification of goods hinder both trade monitoring and the implementation of policies aimed at expanding access to these technologies [6].
Gender disparities documented in Nigeria, Rwanda, Uganda, Sierra Leone, and South Africa show that young women face additional financial dependency, caregiving expectations, and normative barriers that reduce helpseeking and access to appropriate AT. Age-related effects observed in Nigeria and Malawi demonstrate that delayed recognition and support in early childhood increase later needs and cost. Assistive technologies could be implemented when users are younger, but the cultural and social norms prevent many from having access to them. Low educational attainment, rural residence, and limited digital literacy compound these barriers across multiple settings [5].
Cultural stigma in some African countries sees disabilities as a curse, punishment, or misfortune, resulting in shame or abuse of those with disabilities. Those who face intellectual disabilities are usually hidden or excluded due to such strong stigma. The use of assistive technologies would make them more exposed to the outside world; thus, they cannot access it due to their own families barring their use to keep a face and not call attention to their perceived misfortune [1].
Accessing AT is highly centralized, urban-biased, and dependent on fragmented, donor-driven systems, leaving rural and low-income youth with limited or no pathways to obtain or maintain essential devices. Getting access to such technologies is heavily based on networking, status, location, and chance. There is a shortage of technologies in institutions or a complete absence of these technologies. There is a limited amount of specialized staff who can teach and utilize these technologies. Rural youth also face major disadvantages because workshops, rehabilitation centers, and disability units are concentrated in urban hubs; young people often cannot travel the long distances required for assessment, fitting, or repairs, leading to prolonged device downtime and interrupted participation in school or training [5].
Even if these technologies are accessed, there is still the issue of functionality. Users experienced functional difficulties with their devices despite receiving them, particularly in rural areas where information and maintenance were scarcest. Rural residents fare worse than urban ones on nearly every measure, from information to maintenance. Devices that cannot survive rural conditions and match the users' needs based on lifestyle will not be used. Country experiences show that pairing appropriate technology with a sustainable local support base is what makes provision durable. This enables the technology to be used consistently rather than thrown away immediately [2].
Local AT production exists but is uneven. East Africa hosts the most dynamic production and innovation ecosystems; Southern Africa offers stable fabrication capacity; West Africa remains early-stage; and North Africa contributes advanced technical expertise in biomedical engineering, orthotics and prosthetics manufacturing, rehabilitation robotics, digital assistive devices, and standards-based medical device production, driven by stronger university-industry linkages and engineering capacity [5]. These improvements are promising, which can lead to better localized access to assistive technologies.
Strides for improvements have been made, like the community outreach systems such as mobile clinics, CBR programs, disability hubs in learning institutions, and rural repair/refurbishment services—have reduced travel burdens, improved follow-up, and increased early identification of AT needs. The establishment of national Priority Assistive Products Lists (APLs) is strengthening procurement planning and improving availability. Some countries are investing in the rehabilitation workforce through prosthetics & orthotics training, reinstatement, community-worker upskilling, and AT literacy among educators. They are better positioned to deliver proper and equitable AT services that accommodate the diversity of youth needs [5].
Other initiatives are tackling some of the barriers associated with AT in Africa, like dependence on donor-driven supply chains, service delays, and product relevance and durability. These digital and locally appropriate innovations, including mobile-based coordination, AI-enabled AT tools, low-cost local production, and context-specific AT solutions, further expand access where connectivity and infrastructure allow [5].
Limitations
There are a plethora of developing countries not listed that also may need assistive technologies, but due to limited studies, they were not mentioned. Varying definitions of what is classified as assistive technologies vary from country to country, so some services that may be deemed essential may not even be considered for use, depending on that country's policies. Many of the countries listed may not have access to sufficiently trained personnel for utilization of assistive technologies. Most commonly referred to in these studies were assistive technologies for those facing physical disabilities.
Conclusion
It is evident that around the world there is a need for assistive technologies, and further investigation for the rural populations is needed. Though limited studies exist that cover specific countries, the evidence that is there is promising. There could be more usage of these technologies in the future as long as more awareness is brought to this issue.
References
[1] Addis, B., Britton, J., & Davies, T. (2021). Challenges and barriers to the use and provision of assistive technology in Africa: A systematic review. https://www.resna.org/sites/default/files/conference/2021/InternationallyAppropriateTechnology/90_Addis/90_Addis.pdf
[2] Diallo, A., & Silva, R. (2026). Bridging the Assistive Technology Divide: Access, Barriers, and Pathways to Equity for Persons with Disabilities in Low- and Middle-Income Countries. International Journal of Rehabilitation & Disability Studies, 2(1), 4-13. https://doi.org/10.54878/y95ry408
[3] Gaiotto EMG, Gabriel M, Fernandes MFP, Andrade OG, Hedlund Jardim N, Ramos VD, Souza NM and Aguiar BGA (2026) Access to assistive technology in Africa: findings from evidence-informed deliberative dialogues on trade and fiscal policies. Front. Rehabil. Sci. 7:1866962. doi: 10.3389/fresc.2026.1866962
[4] Social Development Division. (2025). Assistive Technology for the Economic Empowerment of Persons with Disabilities in Asia and the Pacific. United Nations Economic and Social Commission for Asia and the Pacific. https://repository.unescap.org/server/api/core/bitstreams/89e3ba52-be89-4715-b894-255f26267400/content
[5] Stellenbosch University .(2026). Assistive technology landscape in Africa. Mastercard Foundation. https://mastercardfdn.org/en/our-research/assistive-technology-landscape-in-africa/
[6] Toro-Hernández, M. L., Kankipati, P., Goldberg, M., Contepomi, S., Tsukimoto, D. R., & Bray, N. (2019). Appropriate Assistive Technology for Developing Countries. Physical Medicine and Rehabilitation Clinics of North America, 30(4), 847 - 865. https://doi.org/10.1016/j.pmr.2019.07.008
[7] World Health Organization. (2024). Assistive technology. Who.Int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/assistive-technology
