Africa’s assistive technology ecosystem is becoming more coordinated, but millions of people with disabilities remain vulnerable because many countries have yet to build locally led assistive technology systems, according to a new report by South Africa’s Stellenbosch University.
The Assistive Technology Landscape in Africa Scoping Review, commissioned by the Mastercard Foundation, analysed 523 sources, including 185 peer-reviewed scientific studies and 338 policy documents, organisational reports, and other materials spanning all 54 African countries.
It found that assistive technology policy activity has accelerated since 2016, with at least 38 countries adopting national strategies aligned with the World Health Organisation and United Nations frameworks. But most policies remain aspirational because they lack adequate financing and monitoring systems to support implementation, leaving Africa “policy-rich but implementation-poor.”
The report said East and Southern Africa have built more resilient assistive technology ecosystems by strengthening links between governments, universities, and civil society. By contrast, West and Central Africa remain more reliant on donors and international partners, with weaker institutional integration limiting the development of sustainable systems.
The findings come as more than 200 million Africans require at least one assistive product, while only 10% to 25% of that need is being met across most countries. Demand is projected to double to 400 million people by 2050, according to the World Health Organisation, driven by the continent’s youthful population and rising rates of chronic disease and injury.
Without stronger domestic financing and coordination, the report warns, many African countries will struggle to meet that growing demand as donor support becomes less certain.
The report said that weak financing remains one of the biggest obstacles to building self-sustaining assistive technology systems. It found that government-led programmes account for less than 15% of assistive technology distributed across the continent. At the same time, most countries lack dedicated budget lines or ring-fenced funding for assistive technology.
The review also found that more than 90% of assistive technology products used in sub-Saharan Africa are imported, exposing countries to supply chain disruptions and shifts in donor priorities.
That dependence extends to local manufacturers. Of the 42 manufacturers and innovators identified across Africa, only four receive stable government subsidies, including the Ethiopian Prosthetic and Orthotic Service (EPOS), which produces artificial limbs and supportive braces for people with physical disabilities and two orthopaedic service providers in Namibia. Most instead rely on grants, donations, and other unstable revenue streams to survive and expand, the report found.
Private-sector financing remains limited. The report cites Safaricom in Kenya and I&M Bank in Rwanda as rare examples of companies helping to finance assistive technology, rather than evidence of a broader market. Overall, it characterises Africa’s assistive technology financing landscape as one marked by donor dependence, high production costs, low insurance coverage and fragmented governance, conditions that it says make it difficult for even well-established manufacturers to operate sustainably at scale.
The report said the consequences of that instability fall directly on the people who need assistive technology most. “In countries where manufacturers rely on donations or unstable grant funding, users face inconsistent supply, long waiting times and limited device choice, often leaving them dependent on imported or poor-fit products,” it said.
Against that backdrop, the report identifies East Africa as home to the continent’s strongest locally coordinated assistive technology ecosystem. It says Kenya, Rwanda, Uganda and Tanzania have developed systems linking governments, academia, the private sector, civil society and international partners. Academic institutions play a central role in generating evidence to inform policy, while the region hosts 19 of the 42 assistive technology manufacturers and innovators identified.
Southern Africa follows closely. It says South Africa, Zambia and Zimbabwe have developed mature ecosystems anchored by social enterprises and long-established academic institutions, together hosting another 11 manufacturers and innovators.
West Africa presents a different picture. Despite being home to some of the continent’s largest economies, the region has only five of the 42 manufacturers and innovators identified in the review. Although Nigeria, Ghana, Sierra Leone and Senegal have adopted national assistive technology frameworks, the report says donor organisations continue to play a larger role than locally coordinated systems.
According to the review, Central Africa relies even more heavily on regional bodies and faith-based organisations to fill service delivery gaps, with limited evidence of sustained government leadership.
Nigeria illustrates the wider challenge. The report notes that Nigeria’s National Assistive Technology Scale-Up Plan, one of the few in West Africa to include formal costing, estimates that ₦12.6 billion ($9.16 million) is needed to implement the strategy, but government funding remains limited. Across West Africa, the share of assistive technology needs being met ranges from as little as 5% in Nigeria to more than 70% in localised pilot projects in Sierra Leone.
The review also found that governments across the continent are increasingly using Technical Working Groups to coordinate multi-stakeholder policy development, describing the approach as promising. Kenya, Ethiopia, Tanzania, and Zimbabwe are among the countries where these groups have been actively engaged in co-producing and validating AT policy.
But the report cautions that the groups have not yet delivered their full potential. “While promising, coordination across education, labour, industrial development, and youth systems remains weak,” it said.
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