The Impact of Mobility
The need for rehabilitation and AT services is far-reaching and intersects with multiple development issues.
Sustainable Development Goals
The 2030 Agenda for Sustainable Development pledges to leave no one behind, including people with disabilities, and it has recognized disability as a cross-cutting issue, to be considered in the implementation of all of its 17 Sustainable Development Goals. Access to personal mobility is crucial to achieving Goal 3 (Good Health and Well Being), Goal 4 (Quality Education) and Goal 10 (Reduced Inequality).
Disability and Non-Communicable Diseases (NCDs)
Global disability prevalence is rising as people live longer, and as headway has been made in curbing infectious diseases. Though NCDs have become more recognized as a global challenge within the health sector, the global response has been largely focused on prevention. Meanwhile, NCDs such as diabetes and stroke often result in mobility impairment (amputation, limited mobility) and necessitate rehabilitation services and the use of an assistive product. As health systems confront rising levels of NCDs, services including rehabilitation and provision of AT, which focus on optimizing functioning and reducing disability, are becoming increasingly needed.
Universal Healthcare Coverage and Health Systems Strengthening
People with disabilities have more health care needs but are less likely to meet those needs. Universal health coverage (UHC) aims to ensure that everyone everywhere can access the health services they need without facing financial hardship. However, UHC can only be advanced inclusively if people are able to access rehab services and quality assistive products when and where they need them. This will require the health systems development, including increased financing of assistive products and health workforce development, needed to ensure appropriate AT provision.
When a member of a household has a mobility impairment and no access to the AT they need, it results not only in lost income and lower self-esteem of that individual and their caregivers, but also in a 50% higher risk of the household facing a “catastrophic health care cost.”
Early Intervention / Early Childhood Development
Early intervention for children with disabilities has a significant impact on their ability to learn new skills and overcome challenges, and can increase enrollment and success in school and life. It can also be the point at which service providers, families and caregivers identify the need for mobility AT. Many children with disabilities will require a wheelchair for both mobility and postural support, due to the nature of common developmental disabilities that affect children. Because of this, and because children grow and need to be re-assessed regularly, providing wheelchairs to children within the context of a sustainable service delivery system will encourage positive early childhood development outcomes.
Early access to mobility sets children on a path to inclusion in school and their communities, giving them a better chance at pursuing higher education, employment, and expressing themselves to their fullest potential. Globally, children with disabilities are still up to 10 times more likely not to attend school than their peers, and when they are enrolled in school, it is often at a lower grade than their peers. There are multiple causes for their exclusion from quality education, including lack of accessibility as well as entrenched and internalized societal stigma, but undoubtedly access to AT is a significant factor.
Women and girls with disabilities face multiple and intersecting forms of discrimination, including exploitation, violence, abuse, and lack of access to a range of services to which they are entitled. Women and girls with disabilities are more likely to be dismissed as unworthy of wheelchair services due to women’s restricted mobility overall, as well as beliefs that women’s primary role should be marriage, motherhood, and caregiving. Putting concerted effort into increasing women and girls’ access to AT contributes to gender equity within health services with ripple effects in other aspects of social protection, inclusion and empowerment.
People with mobility impairments are particularly vulnerable during natural disasters and extreme climate events. As the incidence of extreme weather events increases globally, health systems will need greater capacity for AT provision, both to be better prepared to serve people with previously existing impairments and to respond to the influx of individuals with newly acquired impairments.