Toward a Multi-layer Framework to Assess the Quality of Life Impact of Smartphones as Assistive Technology for People with Sensory Disabilities in Kenya
Maryam Bandukda, Lan Xiao, Giulia Barbareschi, Philip Oyier, Henry Athiany, Raul Szekely, Wallace M Karuguti, Mwangi J Matheri MJM, Victoria Austin, Catherine Holloway · 2025 · ASSETS 2025: 27th International ACM SIGACCESS Conference on Computers and Accessibility · doi:10.1145/3663547.3746352
Summary
This paper presents the first longitudinal mixed-methods study investigating the impact of smartphones as assistive technology on the quality of life (QoL) of blind or partially sighted (BPS) and deaf or hard of hearing (DHH) individuals in Kenya. The study involved 193 participants recruited through Kilimanjaro Blind Trust Africa (KBTA), a local disabled people's organization, over six months. Participants completed a baseline survey, received Samsung A14 Android smartphones with 2GB monthly data and two days of digital skills training, then completed a follow-up survey and semi-structured interviews (12 participants) six months later. The 121 participants who completed both surveys (72 DHH, 49 BPS) were analyzed quantitatively using Wilcoxon signed-rank tests. The study is contextualized within Kenya's growing but unequal smartphone ecosystem, where 83% of disabled individuals own smartphones compared to 41% of the non-disabled population — a 72% gap largely driven by affordability, awareness, accessibility, and digital literacy barriers. The research addresses a critical gap: while smartphones increasingly serve as digital assistive technology in low- and middle-income countries (LMICs) — substituting for expensive traditional AT like braille readers and hearing aids — comprehensive evidence of their QoL impact for BPS and DHH users has been lacking.
Key findings
Quantitative analysis showed significant improvements in 39 of 55 smartphone competence measures (71%) following training, with the strongest gains in calendar functions, file management, and enabling accessibility settings. Substantial increases were observed in use of accessibility features: Live Transcribe (Z=-6.425, p<0.001, r=0.823), Sound Amplifier (Z=-5.573, p<0.001, r=0.719), and Live Captions (Z=-5.936, p<0.001, r=0.748). Significant QoL improvement was detected in access to information (Z=-7.424, p<0.001, r=0.675). Qualitative findings revealed three overarching themes: (1) Impact on Self — increased independence, agency, self-esteem, and motivation to learn, with DHH participants using Live Transcribe to attend meetings without interpreters and BPS participants using Lookout to read documents and identify cash notes independently; (2) Social Interaction and Inclusion — technology-mediated communication through WhatsApp video calls for sign language, TalkBack-enabled participation in family group chats, and reduced reliance on intermediaries; (3) Material Well-being — access to employment through online job platforms, use of M-Pesa mobile payments made accessible via TalkBack, and participation in freelance remote work. The study also identified critical barriers: multilingual support gaps (LiveTranscribe struggling with Kenyan English accents and Kiswahili), inaccessible digital services (forms, date pickers), and typing challenges for BPS users. Building on these findings, the authors contribute the Assistive Technology Impact Framework (ATIF), a multi-level conceptual model structured across three ecological levels: Self (microsystem), Community (mesosystem), and Society (macrosystem), capturing how individual AT-enabled behaviours create ripple effects across these layers.
Relevance
This study provides essential empirical evidence for the case that affordable smartphones can serve as transformative assistive technology in low-resource settings — a finding with major implications for global AT policy and investment. The ATIF framework offers practitioners and policymakers a structured tool for evaluating AT interventions beyond individual functional outcomes, capturing the cascading social and economic effects that justify investment. Key practical takeaways include: digital skills training is as important as device provision (competence improvements drove QoL gains); accessibility features like Live Transcribe and TalkBack are genuinely life-changing in contexts where sign language interpreters and braille materials are unavailable; voice-based assistants must support non-native English accents and local languages to be useful in LMICs; and mobile financial services like M-Pesa need accessibility features to support financial independence. The study's limitations — urban bias (Nairobi area), potential positive bias from interview participants, and DHH participants' difficulty with written surveys — point to important methodological considerations for future Global South accessibility research.
Tags: smartphones · assistive technology · Global South · Kenya · blindness and visual impairment · deaf and hard of hearing · quality of life · digital inclusion · mobile accessibility · longitudinal study
Standards referenced: CRPD · WCAG · UN Sustainable Development Goals