Table 5

Inhibitors of value co-creation in the humanitarian aid context for assistive technology users

Registration unitsContext units
Organisational inefficiencyA7: High staff turnover in humanitarian organisations
A10: Differing goals, motivations and interests among NGO and business stakeholders; ineffective partner communication
A13: Impacts of unclear regulatory guidelines
A30: Lack of coordination among humanitarian operation actors
A39: Lack of transparency in humanitarian logistics
A50: Unclear regulations regarding assistive devices
A51: Resistance to adopting new technologies or methods
A60: African underrepresentation limits adaptation of health strategies to local realities
A62: Challenges posed by bureaucratic barriers
Resource limitationA12: High cost and production delays for assistive products
A35: Challenging to obtain high-quality data for AI model training
A38: Limited economic incentives
A45: Need for training teachers and caregivers in personalised application
A50: Limited availability of material and human resources
A51: Project inability because of financial restrictions
A54: Rigidity in organisational structures
A56: Inadequate equipment limits innovation in assistive devices
A59: Financial limitations in AT
Insufficiency of research and technical knowledgeA6: Limited exchange of ideas between themes and approaches
A17: Challenges because of a lack of detailed technical information
A21: Complexity in operating AT
A22: Restricted access to scientific literature
A25: Challenges arising from insufficient technological advancements in research
A27: User resistance to new tools/methods because of lack of instruction and training
A37: Research expenditures biased toward basic and clinical research
A49: Scarcity of research on practical Primary Health Care (PHC) disaster preparedness
A50: Lack of formal training in 3D printing
A57: Lack of recognition of family dynamics and collective needs
Infrastructure challengesA4: Dependence on network infrastructure and connectivity
A5: Technology limitations because of cost
A6: Challenges in quality, capacity and delivery times
A15: Small and medium-sized enterprises (SMEs) lack structure and knowledge despite their willingness to help
A32: Problems with audio quality and connection difficulties
A38: Difficulty in considering multiple perspectives
A40: High costs of satellite data
A47: Information Technology (IT) infrastructure failure during disasters
A79: Competition for limited resources
A83: Lack of on-the-ground training and localised resources hinders local capacity development/sustenance
A84: Absence of strong institutional structures
Sociocultural factorsA1: Collaboration challenges because of communication issues
A53: Misinformation and rumours
A54: Power inequalities and social exclusion
A61: Sociocultural norms hinder the participation of certain groups
A87: Beliefs that care should be performed manually
Technological or research limitationsA4: Challenges in storing and transmitting sensitive health data
A9: Few projects are validated by people with disabilities
A13: Concerns regarding data privacy and security
A18: Conflicting expert opinions can lead to inconsistent results
A34: Weak, ambiguous relationship between aid flows and indicator performance
A40: Unstable scientific education policies and uncoordinated national/regional scientific activities
A42: Complex technologies
A44: Lack of incentives for developing/testing new technologies in low-income environments
A45: Wireless data transfer and health data security challenges
A46: Concerns about privacy, security and data bias
A56: End-user acceptance of new technologies
A71: Privacy intrusion
A78: Ethical and legal concerns in collecting and using personal information
A88: Ethical issues, including algorithmic bias and privacy concerns
Limited end-user participationA11: Resistance to stakeholder integration
A19: Complex solution development and testing processes
A23: Technical problems hindering system setup and use by non-specialised caregivers
A33: Late integration of users into the design process
A41: Assistive devices solely focused on technology and treatment
A61: Difficulties including diverse affected subgroups in accountability practices
A64: Complexity of design software and 3D printer operation
A81: Importance of including more end-users in evaluation tools

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