Who gets left behind? Prioritizing assistive technology for persons with disabilities in low-resource urban transport systems: Evidence from Greater Kumasi, Ghana

Assistive technologies (ATs) remain poorly integrated into urban public transport systems in low-resource cities of Sub-Saharan Africa (SSA), leaving many persons with disabilities (PwDs) with limited mobility and disproportionate transport barriers. This study examined the awareness, frequency of use, perceived effectiveness, and priority needs of ATs among PwDs within Greater Kumasi. Using an exploratory case study design, data were collected through interviewer-administered surveys from 100 PwDs across four disability groups: physical, visual, hearing, and speech. Chi-square tests and Fisher’s exact test based on Monte Carlo simulation were used to assess associations between disability type and assistive technology (AT) awareness and use; the Kruskal-Wallis test compared perceived AT effectiveness across groups; and the Assistive Technology Priority Index (ATPI) was developed to identify disability groups with higher AT needs. Although 72% of respondents reported awareness of at least one AT, this awareness was concentrated on personal mobility aids, with system-integrated technologies virtually unknown. Disability type was significantly associated with both AT awareness (χ2 = 19.5, p < 0.001) and frequency of use (χ2 = 43.1, p < 0.001). Perceived effectiveness varied significantly across disability groups (H = 21.9, p < 0.001), with respondents with speech impairments reporting comparatively lower perceived effectiveness. The exploratory ATPI further suggested relatively higher assistive technology needs among participants with speech and hearing impairment, though these findings are tentative signals drawn from very small subgroups (n = 11 and n = 5, respectively) and warrant confirmation in larger samples. The findings highlight the importance of equity-oriented and differentiated AT strategies that move beyond personal mobility aids to system-integrated communication and sensory support technologies within urban transport systems. Future research should validate the ATPI against observed mobility outcomes and incorporate perspectives from policymakers, transport planners, and operators.