Market Shaping via Digital Public Infrastructure for Assistive Technology in Low-and Middle-Income Countries

Abstract

Digital assistive technology is increasingly delivered through smartphones, cloud services, dedicated devices, and embedded systems rather than a single dominant form factor. In low-and middle-income countries (LMICs), however, affordability, connectivity, electrical reliability, service capacity, and uneven language infrastructure still shape which digital pathways can be deployed and maintained at scale. This Perspective argues that market-shaping strategies should focus on the shared digital infrastructure below the application layer: representative datasets and language resources, reusable models and reference toolchains, and deployment pathways suited to constrained environments. It proposes a three-part Market Stack comprising governed data and language resources, reusable core models and reference pipelines, and localised commercialisation and service delivery by small and medium enterprises. The central claim is not that smartphones should be displaced, but that digital AT markets in constrained settings work best when innovators and procurers can choose among smartphone, dedicated, embedded, and hybrid pathways. Funders and policymakers should therefore treat data, language resources, and foundational tooling as public-interest investments that widen the range of assistive products able to reach LMIC markets.