Assistive technology unmet need and barriers to access in Sri Lanka: a mixed-methods study (2024)

Background Assistive technology (AT) access supports functional abilities and is considered a crucial component in aged care planning. To address the research gap with respect to AT use, unmet need, and access barriers in Sri Lanka, this study was undertaken using a mixed methods approach. Methods Using WHO tools, the government of Sri Lanka undertook a country capacity Assistive Technology Assessment (ATA-C) in combination with the rapid Assistive Technology Assessment (rATA) survey in 2024. The rATA consisted of a nationally representative household survey including all household members greater than 2 years of age to estimate AT use, need, and unmet need, while the ATA-C guided qualitative data collection through 26 key informant interviews and six focus group discussions. Logistic regression tested the association of demographic variables with AT access indicators in weighted survey data, producing odds ratios and predicted prevalences. Qualitative data were analysed using reflexive thematic analysis, to understand access barriers. An adapted Delphi method was adopted to build consensus on the recommendations during the final stakeholder workshop. Findings An estimated 35.2% (95% CI 33.9–36.6) of the study population experienced functional difficulty; 18.1% (16.9–19.3) reported using AT, while 16.4.% (15.4–17.6) reported unmet AT needs, with higher unmet need among older adults, females, and rural and estate residents. Key barriers included cost, information/awareness gaps, sociocultural/environmental factors, and provision/coordination challenges, which differentially impacted groups within the population. Interpretation Age, sex, and setting were associated with AT access disparities. Their interaction and relationship to systemic barriers must be considered alongside population ageing to create equitable AT policies. Funding Asian Development Bank.