ITU Workshop on
“E-health services in low-resource settings:
Requirements and ITU role”
(Tokyo, Japan, 4-5 February 2013)
The Accessibility Imperative for eHealth: Demographic Realities and
Barriers to Usage
Axel Leblois
President and Executive Director,
G3ict
axel_leblois@g3ict.org
Tokyo, Japan, 4-5 February 2013
Topics
1.
2.
3.
4.
Disability and ICT Accessibility
Demographic data points for eHealth applications and services
Global legislative and regulatory
agenda
Recommendations
Tokyo, Japan, 4-5 February 2013
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Persons with Disabilities
Persons with disabilities include those
who have long-term physical, mental,
intellectual or sensory impairments
which in interaction with various
barriers may hinder their full and
effective participation in society on an
equal basis with others.
Source: Convention on the Rights of Persons with Disabilities,
Art. 1
Tokyo, Japan, 4-5 February 2013
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What Does Accessible ICTs Mean for
Persons with Disabilities?
Accessibility means what the user requires to
gain functional access to ICT:
Perceives the information
Understands it
Can act upon it
Sensorial, cognitive and physical disabilities: well
documented barriers (ISO, ITU definitions of
Human Factors)
Accessible solutions are available for TV,
mobile phones, Computers, web sites, fixed
phones, kiosks, electronic documents
4
Example of Alternative Modes of
Communication for Mobile
Visual
Text-to-Speech for Menus, SMS and email
Hearing
Video Relay Service with
sign language
Speech
Peer-to-peer video for
sign language
Dexterity
Wireless switches or voice
recognition for controls
and input
Cognition
Icon interfaces
Who Risks to Be Excluded from
e-Health Services?
*WHO World
Bank Report
on Disability
2011
**US Census
Bureau
***US
Department
of Education
One billion persons live with a disability,
2/3 with a severe disability*
80% in the developing world
Strong correlation with poverty
Over half of persons aged 65+ live with a
disability, fast growing population
segment**
Disability affects all age groups: 13.2%
of all public school students K to 12 in
the United States live with a disability***
57% of Microsoft Windows Users Likely to
Benefit from its Accessibility Features

57% of adult
computer users (age
18-64 in the US) are
likely or very likely to
benefit from
accessibility features

1 in 4 users
experiences a visual
difficulty.
1 in 4 experience
pain in wrists or
hands.
1 in 5 has a hearing
difficulty.
Very likely
to benefit
17%
Likely
to benefit
40%
Not likely
to benefit
43%
Study commissioned by Microsoft,
Conducted by Forrester Research
in 2003


“People with disabilities are often
invisible in official statistics”
Source: UNESCO, Education for All Global Monitoring Report 2006
Many Countries Lack Proper Statistics as
Evidenced by Inconsistent National Data
Caused by Types of Questions Yielding
Widely Different Disability Rates
Evidence of Exclusion: Gaps in Broadband
Adoption by Persons with Disabilities
• One third of the U.S. population has
not adopted broadband at home
although it is available in most cases
• 39% of those non adopters have
some type of disability, more than
twice the proportion of Americans
living with a disability: 15%
• Only 35 percent of Senior citizens
(those over the age of 65) have
broadband-at-home
Source: FCC Report • Similar gaps in other countries: UK,
close to 50% of non adopters live
by John Horrigan,
with disabilities, Korea, 25% gap.
February 2010
The Convention on the Rights of
Persons with Disabilities
Adopted by the United Nations General
Assembly on December 13, 2006 after 5
years of international multi-stakeholders
negotiations
156 Countries signatures, 126
ratifications
Article 9 defines accessibility obligations
including ICTs
Article 25 defines the Rights to Health for
Persons with Disabilities
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ICT Accessibility: a Prerequisite for
Persons with Disabilities to Exercise
their Rights
Preamble (v):
“Recognizing the importance of accessibility
to the physical, social, economic and cultural
environment, to health and education and to
information and communication, in enabling
persons with disabilities to fully enjoy all
human rights and fundamental freedoms”.
Right to Health without Discrimination
Requires e-Health to be Accessible
States Parties recognize that persons with
disabilities have the right to the enjoyment
of the highest attainable standard of health
without discrimination on the basis of
disability (Article 25 on Health)
Denial of “Reasonable Accommodation”
which includes ICTs, equals discrimination
(Article 2 on Definitions)
Tokyo, Japan, 4-5 February 2013
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Global Impact of CRPD ICT
Accessibility Obligations for e-Health
e-Health Accessibility Policies Lagging
Behind other Areas
Percentage of Countries with Existing
ICT Accessibility Policies in Specific Areas
Source: G3ict CRPD ICT Accessibility Progress Report 2012 – 52 countries
Primary and Secondary Education
55.3%
Rehabilitation Services
53.3%
Reasonable Accommodation at Workplace
53.2%
Higher Education
52.2%
Community Services
44.4%
Independent Living
43.5%
Emergency Response Services
38.3%
Voting systems
37.0%
Health Services
29.5%
Judicial Information and Legal Procedure
25.6%
Recommendations
Develop WHO-ITU
joint guidelines for eHealth accessibility
G3ict/UNITE
available to assist
with ITU-D
Ensure that ICT
accessibility is
required when
procuring e-Health
projects
Tokyo, Japan, 4-5 February 2013
Leverage
standards for:
Web accessibility
Electronic
documents
accessibility
Mobile accessibility
Fixed line
telephony
accessibility
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Thank You
For Your Attention
www.g3ict.org
www.e-accessibilitytoolkit.org
axel_leblois@g3ict.org
Appendixes
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G3ict Mission
“To Facilitate the Implementation of the
ICT Accessibility dispositions of the
Convention on the Rights of Persons with
Disabilities”
G3ict – ITU Toolkit for Policy Makers
Georgia: A Hub for Digital Accessibility Innovation
Atlanta, Georgia, USA, 1 October 2008
G3ict Web Resources
1.
www.g3ict.org
Publications
CRPD Progress Report
Meeting proceedings
2.
www.e-acessibilitytoolkit.org
G3ict – ITU Toolkit for Policy Makers
3.
www.m-enabling.com
G3ict summit to promote accessible
mobile
Making TV Accessible Report
•Prepared by Peter Looms, Chairman of
ITU-T Focus Group on Audiovisual
Media Accessibility
•Looks at how TV can be made more
accessible
•Timely given the transition from
analogue to digital TV
http://www.itu.int/ITU-D/sis/PwDs/index.phtml
24
Making Mobile Phones and
Services Accessible Report
•Prepared by a team of experts
•Explains in concrete terms, what is
meant by accessible mobile phones
•Developments in accessible mobile
apps
•Business opportunities and case
studies
•Policy guidelines
http://www.itu.int/ITU-D/sis/PwDs/index.phtml
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Useful References
UN Washington Group on Disability Statistics
Measuring Disability Prevalence, D. Mont et al, World
Bank, March 2007
Making Inclusion Operational: Legal and Institutional
Resources for World Bank Staff on the Inclusion of
Disability Issues in Investment Projects, K. Guernsey et
al, World Bank, October 2006
Beyond compliance: Business advantage of accessibility,
IBM Executive brief, Human Ability and Accessibility
Center, 2007
G3ict CRPD ICT Accessibility Progress Report
www.g3ict.org
ITU – G3ict Policy Toolkit for Policy Makers: www.eaccessibilitytoolkit.org
ITU – G3ict accessibility guides: www.g3ict.org