The Sustainable Development Goals (SDGs) aspire to "leave no-one behind". Universal access to assistive products is a critical link between the realization of the SDGs and those most likely to be left behind. However, assistive technology provision in many countries, particularly low- and middle-income countries, has traditionally been conducted through small-scale local providers, manufacturing products of varying degrees of quality at a limited price range. An effective way to scale these production and provision enterprises to the required level is needed to close the gap between available and required assistive technology. We argue that better access to assistive technology will only be realized through the adoption of a far stronger systems thinking and market shaping approach. We undertook a rapid literature review to explore the relationship between market shaping and assistive technology. Based on our review, we present an emergent framework for conceptualizing intersections between systems thinking and market shaping for assistive technology-the SMART (Systems-Market for Assistive and Related Technologies) Thinking Matrix.

Assisting Living and Learning Institute Maynooth University Maynooth Co Kildare W23 F2K8 Ireland

Centre for European and Eurasian Studies Maynooth University Maynooth Co Kildare W23 F2K8 Ireland

Centre for Rehabilitation Studies Faculty of Medicine and Health Sciences Stellenbosch University P O Box 241 Cape Town 8000 South Africa

Department of Law New House South Campus Maynooth University Maynooth Co Kildare W23 F2K8 Ireland

Department of Psychology John Hume Building North Campus Maynooth University Maynooth Co Kildare W23 F2K8 Ireland

Global Disability Innovation Hub UCL at Here East 8 9 East Bay Lane Queen Elizabeth Olympic Park London E15 2GW UK

Olomouc University Social Health Institute Palacký University Univerzitní 22 Olomouc 771 11 Czech Republic

The Alliance for Health Policy and Systems Research World Health Organization 20 Avenue Appia 1211 Geneva Switzerland

UCL Interaction Centre University College London 66 72 Gower Street London WC1E 6EA UK

Zobrazit více v PubMed

United Nations General Assembly . Resolution Adopted by the General Assembly on 25 September 2015. Transforming our World: The 2030 Agenda for Sustainable Development. United Nations General Assembly; New York, NY, USA: 2015.

Seventy-First World Health Assembly Improving Access to Assistive Technology. [(accessed on 12 November 2018)]; Available online: http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_R8-en.pdf?TSPD_101_R0=eaa3b8aaf23929227e06a54f6857f5acl0d0000000000000002bb914e6dffff00000000000000000000000000005bb5df7f00167cf4da.

Tebbutt E., Brodmann R., Borg J., MacLachlan M., Khasnabis C., Horvath R. Assistive products and the Sustainable Development Goals (SDGs) Glob. Health. 2016;12:1–6. doi: 10.1186/s12992-016-0220-6. PubMed DOI PMC

World Health Organization (WHO) Assistive Technology. WHO; Geneva, Switzerland: 2018.

Senge P.M. The Fifth Discipline: The Art & Practice of the Learning Organization. revised ed. Doubleday; New York, NY, USA: 2006.

Arnold R.D., Wade J.P. A definition of systems thinking: A systems approach. Procedia Comput. Sci. 2015;44:669–678. doi: 10.1016/j.procs.2015.03.050. DOI

MacLachlan M., Scherer M.J. Systems thinking for assistive technology: A commentary on the GREAT summit. Disabil. Rehabil. Assis. Technol. 2018;13:492–496. doi: 10.1080/17483107.2018.1472306. PubMed DOI

Latour B. Reassembling the Social: An Introduction to Actor-Network-Theory. Oxford University Press; Oxford, UK: 2007.

Latour B. Aramis, or, the Love of Technology. Harvard University Press; Cambridge, MA, USA: 1996.

Velho R. Ph.D. Thesis. University College London; London, UK: 2017. Fixing the Gap: An Investigation into Wheelchair Users’ Shaping of London Public Transport.

Richards E. (Un)Boxing the monster. Soc. Stud. Sci. 1996;26:323–356. doi: 10.1177/030631296026002006. DOI

Haraway D. Simians, Cyborgs, and Women: The Reinvention of Nature. Routledge; New York, NY, USA: 2013.

Bailie R., Matthews V., Brands J., Schierhout G. A systems-based partnership learning model for strengthening primary healthcare. Implement. Sci. 2013;8:1–12. doi: 10.1186/1748-5908-8-143. PubMed DOI PMC

De Savigny D., Adam T., editors. Systems Thinking for Health Systems Strengthening. World Health Organization; Geneva, Switzerland: 2009.

Midgley G. Systems thinking for the 21st century. Int. J. Knowl. Syst. Sci. 2004;1:63–69.

Midgley G. Systems thinking, complexity and the philosophy of science. Émerg. Complex. Organ. 2008;10:55–73.

Herlin H., Pazirandeh A. Nonprofit organizations shaping the market of supplies. Int. J. Prod. Econ. 2012;139:411–421. doi: 10.1016/j.ijpe.2011.04.003. DOI

Clinton C., Sridhar D. Governing Global Health: Who Runs the World and Why? Oxford University Press; New York, NY, USA: 2017.

United States Agency for International Development (USAID) Market Shaping Primer. USAID; Washington, DC, USA: 2014.

Khasnabis C., Mirza Z., MacLachlan M. Opening the GATE to inclusion for people with disabilities. Lancet. 2015;386:2229–2230. doi: 10.1016/S0140-6736(15)01093-4. PubMed DOI

International Organization for Standardization (ISO) Assistive Products for Persons with Disability—Classification and Terminology (ISO 9999:2016) ISO; Geneva, Switzerland: 2016.

International Organization for Standardization (ISO) Guide for Addressing Accessibility in Standards (ISO/IEC Guide 71:2014) ISO; Geneva, Switzerland: 2014.

Holloway C., Dawes H. Disrupting the world of disability: The next generation of assistive technologies and rehabilitation practices. Heal. Technol. Lett. 2016;3:254–256. doi: 10.1049/htl.2016.0087. PubMed DOI PMC

Velho R., Holloway C., Symonds A., Balmer B. The effect of transport accessibility on the social inclusion of wheelchair users: A mixed method analysis. Soc. Incl. 2016;4:24–35. doi: 10.17645/si.v4i3.484. DOI

Sen A. Development as Freedom. Oxford University Press; Oxford, UK: 1999.

Fraser N. Rethinking recognition. New Left Rev. 2000;3:107–120.

World Health Organization (WHO) Global Cooperation on Assistive Technology (GATE) [(accessed on 12 November 2018)]; Available online: http://www.who.int/phi/implementation/assistive_technology/en/

World Health Organization (WHO) Global Cooperation on Assistive Technology—About US. [(accessed on 12 November 2018)]; Available online: http://www.who.int/phi/implementation/assistive_technology/phi_gate/en/

World Health Organization (WHO) Priority Assistive Products List (APL) [(accessed on 12 November 2018)]; Available online: http://www.who.int/phi/implementation/assistive_technology/global_survey-apl/en/

MacLachlan M., Banes D., Bell D., Borg J., Donnelly B., Fembek M., Hooks H. Assistive technology policy: A position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disabil. Rehabil. Assis. Technol. 2018;13:454–466. doi: 10.1080/17483107.2018.1468496. PubMed DOI

MacLachlan M. China, assistive technology and market shaping re Rise of a new superpower: Health and China’s global trade ambitions. BMJ. 2018;360 doi: 10.1136/bmj.k595. PubMed DOI

Arksey H., O’Malley L. Scoping studies: Towards a methodological framework. Int. J. Soc. Res. Methodol. 2005;8:19–32. doi: 10.1080/1364557032000119616. DOI

Gilson L. Health Policy and Systems Research: A Methodology Reader; The Abridged Version. [(accessed on 12 November 2018)]; Available online: http://www.who.int/alliance-hpsr/resources/alliancehpsr_abridgedversionreaderonline.pdf.

Cooke M., Murphy E. Moving through crisis and resilience: An activity-centred CONOPs of CI organisations. In: Walls L., Revie M., Bedford T., editors. Risk, Reliability and Safety: Innovating Theory and Practice, Proceedings of The ESREL 2016, Glasgow, Scotland, 25–29 September 2016. CRC Press; Boca Raton, FL, USA: 2016. pp. 510–517.

Engeström Y. Learning by Expanding: An Activity-Theoretical Approach to Developmental Research. 2nd ed. Cambridge University Press; Cambridge, UK: 2015.

Kaptelinin V., Nardi B. Activity theory in HCI: Fundamentals and reflections. Synth. Lect. Hum. Centred Inform. 2012;5:1–105. doi: 10.2200/S00413ED1V01Y201203HCI013. DOI

IEEE Computer Society . IEEE Guide for Information Technology—System Definition—Concept of Operations (ConOps) Document (IEEE Std 1362–1998) IEEE Computer Society; Washington, DC, USA: 1998.

Mostashari A., McComb S.A., Kennedy D.M., Cloutier R., Korfiatis P. Developing a stakeholder-assisted agile CONOPS development process. Sys. Eng. 2012;15:1–13. doi: 10.1002/sys.20190. DOI

Peters D.H. The application of systems thinking in health: Why use systems thinking? Health Res. Policy Sys. 2014;12:1–6. doi: 10.1186/1478-4505-12-51. PubMed DOI PMC

Grudin J. Why CSCW Applications Fail: Problems in the Design and Evaluation of Organizational Interfaces; Proceedings of the 1988 ACM Conference on Computer-Supported Cooperative Work; Portland, OR, USA. 26–28 September 1988.

United Nations . Convention on the Rights of Persons with Disabilities and Optional Protocol. United Nations; New York, NY, USA: 2006. [(accessed on 12 November 2018)]. Available online: http://www.un.org/disabilities/documents/convention/convoptprot-e.pdf.

Ferri D. Does accessible technology need an ‘entrepreneurial state’? The creation of an EU market of universally designed and assistive technology through state aid. Int. Rev. Law Comput. Technol. 2015;29:137–161. doi: 10.1080/13600869.2015.1055660. DOI

Ferri D. ‘Subsidising accessibility’: Using EU State Aid law and policy to foster development and production of accessible technology. Eur. State Aid Law Q. 2015;14:51–67.

Kline J., Ferri D. Enabling people with disabilities through effective accessible technology policies. In: Halvorsen R., Hvinden B., Bickenbach J., Ferri D., Guillén Rodriguez A.M., editors. The Changing Disability Policy System: Active Citizenship and Disability in Europe. Routledge; New York, NY, USA: 2017. pp. 127–143.

Smith R.O., Scherer M.J., Cooper R., Bell D., Hobbs D.A., Pettersson C., Bauer S. Assistive technology products: A position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disabil. Rehabil. Assis. Technol. 2018;13:473–485. doi: 10.1080/17483107.2018.1473895. PubMed DOI

MacLachlan M. Access to assistive technology, systems thinking, and market shaping: A response to Durocher et al. N.a. Behav. 2018:1–5. doi: 10.1080/10508422.2018.1447382. DOI

Global Disability Innovation Hub AT 2030. [(accessed on 12 November 2018)]; Available online: https://www.disabilityinnovation.com/at-2030.

Implementation of a pan-European ecosystem and an interoperable platform for Smart and Healthy Ageing in Europe: An Innovation Action research protocol

Implementation of the Assistive Product List (APL) in Malawi through development of appropriate policy and systems: an action research protocol