Assistive technology usage, unmet needs and barriers to access: a sub-population-based study in India

Senjam, Suraj Singh; Manna, Souvik; Kishore, Jugal; Kumar, Anıl; Kumar, Rajesh; Vashist, Praveen; Titiyal, Jeewan S; Jena, Pratap Kumar; Christian, Donald S.; Singh, Udaybir; Kamath, Ramachandra

doi:10.1016/j.lansea.2023.100213

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Digital health interventions are being increasingly adopted and being provided for those in need by healthcare providers through the existing and the healthcare levels and systems in India [ 18 ]. However, the challenge faced currently is in enhancing the efficiency of the systems through which providers of DHI deliver care to those in need rather than addressing the gaps in barriers to accessing primary care [ 18 ]. There is not much information available on factors that influence this strategy for effective, safe and good quality primary care delivery using DHI in the country [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Digital health interventions for improving access to primary care in India: A scoping review

Vasanthan,

Natarajan,

Babu

et al. 2024

PLOS Glob Public Health

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Access to quality healthcare remains a challenge in low-and middle-income countries. Vulnerable populations with unmet needs face the greatest challenge in accessing primary care for appropriate and timely healthcare. The use of digital technologies can not only strengthen health systems but also improve access to health care, particularly for the vulnerable. This scoping review aims to assess the various digital health technologies and interventions available for improving access to primary care for the vulnerable in India. This scoping review employed the Joanna Brigg Institute’s (JBI) guidelines and Arksey and O’Malley’s methodological framework. The literature search was conducted in Medline/PubMed, Embase, Web of Science—Core Collection, Scopus, AgeLine, PsycINFO, CINAHL, ERIC, Cochrane CENTRAL, and Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register databases, using the keywords, such as ‘Access’, ‘Healthcare’, ‘Assistive technology’, ‘Digital health’ ‘Vulnerable’, ‘India’ and ‘Healthcare technology’. A two-staged screening of titles and abstracts, followed by full-text was conducted independently by two reviewers, using the Rayyan software. Subsequently, the data was extracted from selected studies using a pre-designed and approved extraction form. The data was then synthesised and analysed narratively. The protocol for this review has been registered with open science forum (OSF) registries (https://osf.io/63pjw/). The search yielded about 3840 records, 3544 records were eligible for screening of titles and abstracts. We included seven studies after a two-round screening and identified seven different technological innovations developed to bridge gaps in access to primary care. The commonly used digital health interventions for improving access to primary care were virtual tele-health systems and mHealth applications in-built within an android smartphone or a tablet. Digital health interventions was either used as a standalone tele-health aid or a collaborative system for community workers, primary care physicians as well as the health service users. The purpose of these innovations was to increase awareness and knowledge to access support for specific aspects of healthcare. Virtual primary health care with the specialist in the hub supporting general physicians at the primary health centres in blocks and districts was another such model used for improving access to primary care. Digital health interventions was also used for mass community screening of disabilities, such as persons with hearing disability. To re-imagine a digitally empowered health systems in India, also inclusive of the vulnerable, it is important to inclusively conceptualise, systematically develop and rigorously evaluate any public health interventions including those that are enabled by digital health interventions to bridge the gaps in access to primary care in India. Such a strategy could address the paucity of evidence in public health interventions and provide sustainable strategies to strengthen health systems in India. Trial registration: Open Science Framework—Registration Link: https://osf.io/63pjw/.

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Section: Introductionmentioning

confidence: 99%

Digital health interventions for improving access to primary care in India: A scoping review

Vasanthan,

Natarajan,

Babu

et al. 2024

PLOS Glob Public Health

View full text Add to dashboard Cite

show abstract

“…Assistive technologies are being increasingly adopted and being provided for those in need by healthcare providers through the existing and the healthcare levels and systems in India [18]. However, the challenge faced currently is in enhancing the efficiency of the systems through which providers of AT deliver care to those in need rather than addressing the gaps in barriers to accessing primary care [18]. There is not much information available on factors that influence this strategy for effective, safe and good quality primary care delivery using AT in the country [19].…”

Section: Introductionmentioning

confidence: 99%

Assistive technology for improving access to primary care in India: a scoping review

Vasanthan,

Sindhu,

Babu

et al. 2023

Preprint

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IntroductionAccess to quality healthcare remains a challenge in low-and middle-income countries. Vulnerable populations with unmet needs face the greatest challenge in accessing primary care for appropriate and timely healthcare. The use of assistive technologies can not only strengthen health systems but also improve access to health care, particularly for the vulnerable. This scoping review aims to assess the various assistive technologies available for improving access to primary care for the vulnerable in India.MethodsThis scoping review employed the Joanna Brigg Institute’s (JBI) guidelines and Arksey and O’Malley’s methodological framework. The literature search was conducted in Medline/PubMed, Embase, Web of Science–Core Collection, Scopus, AgeLine, PsycINFO, CINAHL, ERIC, Cochrane CENTRAL, and Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register databases, using the keywords, such as ‘Access’, ‘Healthcare’, ‘Assistive technology’, ‘Vulnerable’, ‘India’ and ‘Healthcare technology’. A two-staged screening of titles and abstracts, followed by full-text was conducted independently by two reviewers, using the Rayyan software. Subsequently, the data was extracted from selected studies using a pre-designed and approved extraction form. The data was then synthesised and analysed narratively. The protocol for this review has been registered with open science forum (OSF) registries (https://osf.io/63pjw/).ResultsThe search yielded about 3840 records, 3544 records were eligible for screening of titles and abstracts. We included seven studies after a two-round screening and identified seven different technological innovations developed to bridge gaps in access to primary care. The commonly used assistive technologies for improving access to primary care were virtual tele-health systems and mHealth applications in-built within an android smartphone or a tablet. Assistive technology was either used as a standalone tele-health aid or a collaborative system for community workers, primary care physicians as well as the health service users. The purpose of these innovations were to increase awareness and knowledge to access support for specific aspects of healthcare. Virtual primary health care with the specialist in the hub supporting general physicians at the primary health centres in blocks and districts was another such model used for improving access to primary care. Assistive technology was also used for mass community screening of disabilities, such as persons with hearing disability.ConclusionsTo re-imagine a digitally empowered health systems in India, also inclusive of the vulnerable, it is important to inclusively conceptualise, systematically develop and rigorously evaluate any public health interventions including those that are enabled by assistive technology to bridge the gaps in access to primary care in India. Such a strategy could address the paucity of evidence in public health interventions and provide sustainable strategies to strengthen health systems in India.

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Social inequities influencing diabetes self-management among persons with disabilities: A Cross-Sectional Study from rural Tamil Nadu, India

Research,

Soundari,

Kosalram

et al. 2024

Preprint

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Background Self-management of diabetes is a crucial component of treatment. This involves diet, exercise, medications, blood sugar monitoring, reducing harmful behaviors like smoking and alcohol, and foot care. Persons with disabilities find it challenging to adopt self-management behaviors. Various social factors like age, gender, caste, and socioeconomic status further complicate this inequity in adoption of self-management behaviors. Objectives To study the social inequities influencing the adoption of diabetes self-management behaviors among persons with disabilities. Methods We conducted a cross-sectional comparative study of diabetes self-management behaviors among persons with and without disabilities in a rural block in Tamil Nadu, India. We used the Summary Diabetes Self-Care Activities (SDSCA) tool to assess the diabetes self-management practices among the study participants. We also collected information on other social factors including age, gender, caste, and socioeconomic status as estimated by the Modified Kuppusamy Scale. To study the influence of these social factors on disability we applied multivariable logistic regression analysis in SPSS version 22. We also performed a path analysis to study the potential causal pathway of how disability influences physical exercises using JAMOVI software version 2.3.21. Results We interviewed 414 persons with diabetes of whom 190 (46%) were people with disabilities. There was no difference in diabetes self-management behaviors in any of the domains between people with and without disabilities except for physical activity. Disability (OR = 3.384 (C.I. 1.282–8.930, p = 0.014)) and lower socioeconomic status (6.617 (C.I. 3.151–13.895, p = 0.000)) are independently associated with poor physical exercise behavior. The path analysis revealed that among persons with disabilities, as the difficulty in performing activities of daily living worsens (β = 5.46; p < 0.001) it affects the quality of life (β=-1.31; p < 0.001) thereby reducing adoption of physical activity behaviors (β = 0.05; p < 0.001). Conclusion Disability and socioeconomic status strongly influence diabetes self-management, especially the physical activity component. There is a need for customized interventions for people with disability to improve their physical activity and improve their diabetes self-management behaviors.

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Assistive technology usage, unmet needs and barriers to access: a sub-population-based study in India

Cited by 3 publications

References 15 publications

Digital health interventions for improving access to primary care in India: A scoping review

Digital health interventions for improving access to primary care in India: A scoping review

Assistive technology for improving access to primary care in India: a scoping review

Social inequities influencing diabetes self-management among persons with disabilities: A Cross-Sectional Study from rural Tamil Nadu, India

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