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A multidimensional classification of assistive technology for health system integration
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DOI：10.3389/fpubh.2026.1875576.png)
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Abstract
En 中文
standards and lists; providing a common language for ministries of health; payers; regulators and service provider (Figure 1 S1-S7. Readers are encouraged to refer to the supplementary material for complete subdimension listings; representative product examples; and domain-specific policy applications.The dimensions of this framework were derived through a structured process drawing on: (i) a review of existing international and national classification systems (ISO 9999; WHO Priority Assistive Products List; ICF-based frameworks; national essential assistive product lists); (ii) analysis of health system planning frameworks in low-; middle-and high-income countries; and (iii) iterative expert deliberation among the multidisciplinary author team; which includes scientists; rehabilitation professionals and health policy researchers. Although a formal Delphi or systematic review process was beyond the scope of this opinion article; the selection of dimensions reflects convergent evidence from policy mapping; implementation literature and practical health system experience (Table S1).The framework is anchored in functional domains that are widely recognised in AT practice: mobility; vision; hearing; communication; cognition; self-care and sports & recreations. Within each domain; assistive products are classified to similar depth; reflecting that needs; technologies and service pathways differ substantially across domains and cannot be managed through generic device lists alone. It allows decision-makers to compare; within and across domains; how different products map onto levels of impairment; service platforms and financing options (7).To our knowledge; no existing framework classifies assistive products simultaneously by functional domain; impairment severity; health-system tier; technology characteristics; user context; and financing and equity dimensions in a way that is directly usable for planning and procurement (Table S1 & Figure S1). We therefore present this as a higher-order structure that can incorporate and connect current standards; rather than replace them.The framework organises assistive products (APs) across comprehensive dimensions reflecting real-world use; health system realities and equity. Demographic dimensions include age groups (early childhood 0-5; childhood 6-12; adolescence 13-18; working-age adults 19-59; older adults 60+); gender; regional/cultural contexts (rural; urban; tribal; remote) and socioeconomic access (by HDI category; income level and digital literacy); with additional equity-relevant factors. including disability type; minority or indigenous status; humanitarian settings and longterm maintenance affordability accommodated during national adaptation (Table S2) (8). User and condition-related dimensions capture health condition trajectory (short-term; intermittent; stable long-term; progressive; permanent) and level of impairment/dependency (mild to profound); guiding whether provision should be temporary; recurrent; or lifelong and whether follow-up belongs in primary care or specialist services. (ICF) and various regulatory frameworks can be nested within the multidimensional structure; allowing countries to retain familiar product codes while gaining clarity on where and how these products fit within health-system tiers; financing schemes and equity goals (1; 2; 9). In this sense; the framework provides the "scaffolding" within which diverse AT policies; lists and programmes can be aligned.By explicitly linking AT to core health-system functions; assessment & prescription; procurement & supply; financing; service delivery and monitoring; the classification reframes AT as an essential health service rather than a discretionary add-on (10)
Keywords:
global health
Sustainable Development Goals
assistive technology
assistive product
Universal Health Coverage
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