Since the start of the war in Ukraine, demand for assistive technology products to help individuals with cognitive, communication, hearing, mobility, self-care or vision issues has increased dramatically. Yet, at the same time, disruption to transport systems and health-care services has greatly reduced their supply.
As a result, people with the most need, including those with disabilities, older people and people with chronic diseases – many of whom have been internally displaced because of the conflict – have been unable to access supportive equipment.
To help address this, the AT10 project was launched in 2022 thanks to funding from the ATscale Global Partnership for Assistive Technology and the Ukraine Humanitarian Fund. The project was led by the WHO Country Office in Ukraine with technical support from WHO/Europe in Copenhagen, Denmark.
Through the project, assistive technology kits were rapidly delivered to health facilities within 5 oblasts. Each kit consisted of 10 items of priority assistive equipment, including mobility aids such as crutches, wheelchairs, walking sticks and frames, and self-care products such as catheter kits, absorbent continence products, and toilet and shower chairs.
The 5 oblasts (Chernihiv, Dnipro, Kyiv, Sumy, Zaporizhzhia) are located in eastern Ukraine, and are considered likely departure and/or arrival points for people who have been internally displaced because of the war.
“The project represents a milestone in crisis situations, as it was the first time that assistive technology had been integrated into an emergency response,” commented Cathal Morgan, Policy Adviser with WHO/Europe’s Health Workforce and Service Delivery Team.
The initiative involved collaboration among the ministries of health and social policy, local governments in Ukraine, WHO/Europe, WHO headquarters, and the WHO Country Office in Ukraine, together with the extensive national network of assistive technology stakeholders involved in rehabilitation.
Evaluation of the AT10 project
A year after the launch of the AT10 project, WHO/Europe carried out an evaluation to measure the impacts of the first phase of implementation (2022–2023). Results and recommendations for future phases were published in “Rapid access to essential assistive technology for internally displaced people in Ukraine (AT10): lessons learned report”.
Significantly, the report shows that in the first phase of the project (up to 31 March 2023), nearly 2500 assistive products were provided by the 10 health facilities involved, meeting the assistive technology needs of just under 1500 people.
Additionally, over 90 health personnel, including rehabilitation specialists, had completed WHO’s Training in Assistive Products (TAP) course, ensuring the effective assessment of patients, prescribing of appropriate products and proper use of products by patients.
Pascal Bijleveld, Chief Executive Officer of ATscale, commented, “It is heartening to know that the AT10 project met its objective of addressing the immediate assistive technology needs of so many service users, despite the challenges of logistical difficulties, infrastructure limitations and an unpredictable health emergency in the context of an ongoing war.”
He added, “The main strength of the AT10 project was that through a process that was well coordinated, timely, acceptable to service users and sensitive to the challenges of the local context, assistive products were provided that met the needs of the population and facilitated rehabilitation, community participation and ultimately community development.”
While the project was initially designed to focus on internally displaced people, during its implementation it became clear that other groups of people had unmet assistive technology needs as well. It was therefore necessary to adjust the project to cater to these groups. This meant including displaced individuals that had since returned to their homes, those with lost or damaged products, and those who had acquired new injuries or conditions – some as a result of the war.
Personal impacts
Klym is a 14-year-old boy with cerebral palsy and spastic dysplasia, which means he cannot walk. He is one of the many individuals, young and old, who benefited from the assistive technology products distributed through the scheme. His mother, Ruslyana, was able to get a modern, height-adjustable bathroom chair and a more suitable wheelchair, which has given Klym greater mobility and independence.
Ruslyana shares, “I feel calm knowing that he is not lying in bed the whole time. He gets everything himself while I’m working. I can say that he began to live a much fuller life.”
Lyudmila is 70 years old, and before receiving a wheelchair from her local hospital as part of the AT10 project, she struggled to move around without the support of a family member. “I’d just stay at home or sit on a bench outside my building, but now I can go to the city and socialize with others,” she says.
Lyudmila also acquired a new shower chair through the project, which she describes as being much safer and more convenient to use than the wooden kitchen chair she had previously been using.
Learning from the project
As part of its evaluation, the report identified a number of key lessons that have helped determine recommendations for future phases of the project, but which might also be applied to the provision of assistive technology in any health emergency. These are grouped under the 5 Ps of people, policy, products, provision and personnel.
- People: Efforts should be made to ensure that everybody who needs assistive technologies can access them. A key part of this is ensuring that service users themselves are involved in the planning and implementation of assistive technology plans and communications. It should also be recognized that service users often have complex needs and may require more than one type of assistive product.
- Policy: Assistive technology provision should be standard practice in any emergency health response. Its integration into existing health-care services can help build the capacity of health systems, even beyond an emergency.
- Products: The design of the product is important for its uptake and acceptability among users. Before supplying products, local needs and the availability of products through existing services should be taken into account.
- Provision: Preparedness plans should be developed to ensure stocks of products are available at or near health facilities in advance, so as to avoid possible disruptions and delays in procurement, delivery and distribution.
- Personnel: Service providers need to be given product training to appropriately select, prescribe and explain to patients how to use various assistive technologies. Treating patients with dignity and respect has been shown to increase service satisfaction, and to encourage greater take-up and proper use of prescribed equipment.
An ongoing impact
Now in its second phase, the AT10 project continues to make a real difference on the ground, spurred on by additional funding from the Swiss Agency for Development and Cooperation, the Ukrainian Ministry of Health, Germany, and the European Union Directorate-General for European Civil Protection and Humanitarian Aid Operations.
To date, more than 100 health personnel from 15 health facilities in 8 oblasts have now taken the TAP course, which has enabled more than 4700 products to be provided to almost 3000 people affected by the ongoing conflict.