Development of Priority Assistive Product Lists in Three African Countries

National Assistive Product Lists (APLs) play an important role in improving access to assistive products (APs). Assistive products are critical to enhancing the health, well-being, and quality of life of persons with disabilities and other functional limitations, including those associated with aging. Comparing national APL development across Malawi, Liberia, and Sierra Leone may provide insight into the differences between the resulting national APLs and how to enhance AP service delivery systems. The aim of this study was to compare how the World Health Organization's 5Ps model (people, personnel, policy, provision, products) influenced national APL development across Malawi, Liberia, and Sierra Leone. To achieve this aim, we conducted a series of qualitative interviews with representatives of key government and non-state organizations (n = 12) who had been involved in the development of the APL in each of the three countries. We used directed content analysis to review and analyze the resulting data, with the 5Ps representing the 5 areas of analysis. Our results found substantial differences between the APLs of the three countries, which were substantially influenced by the needs of assistive technology users in each of the respective countries (people). This was evident in the fact that product selection criteria differed across countries, with the most critical factor being population need. Provision systems were generally fragmented and depended heavily on donors, with a lack of coordination between the public and private sectors. None of the countries had or produced a standalone AT policy in the APL development process. County-specific factors also influenced the APL differences between countries. Our research concludes that national APLs will vary substantially if they are developed collaboratively, considering the needs of the population with consideration for the country's context and existing policies and systems.