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    Wheelchairs and hearing aids

    Wheelchairs and hearing aids: A chair that fits, and a voice you can hear.

    More than 2.5 billion people need at least one assistive product, like a wheelchair or a hearing aid. In some low-income countries as few as 3% have what they need, against 90% in some high-income ones.

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    Ryan K. Hertel · heyitskenton

    The problem

    What we're up against.

    • Where you live decides it.

      As few as 3% of people in some low-income countries have the assistive products they need, against 90% in some high-income countries.

    • Chairs that never come.

      About 80 million people need a wheelchair. In low- and middle-income countries, only 5% of those who need one have one.

    • Hearing loss, untreated.

      430 million people need care for disabling hearing loss, and 83% of the people who need a hearing aid don't use one.

    • Too few are made.

      Hearing aid production meets less than 10% of the world's need.

    What works

    Proven, and ready to grow.

    • Hearing aids help people hear and live better.

      A Cochrane review of 16 randomized trials found hearing aids likely improve listening and hearing-related quality of life for adults with mild to moderate loss, with a large effect.

    • Training makes a chair work.

      Across randomized trials, wheelchair skills training raised users' skill scores by 14%, and it helped new users most.

    • A chair can bring work.

      In Peru, Uganda and Vietnam, people given a wheelchair saw lasting gains in work and income.

    • Fitting close to home.

      In a randomized trial with teenagers in Bangladesh, community workers fitting hearing aids proved a workable, effective option where specialists are scarce.

    • A strong return, on paper.

      Every dollar put into hearing care could return nearly $15, and modeling for assistive technology as a whole finds a return of about nine to one.

    What a family could fund

    Where the money goes furthest.

    • A chair that fits, for life.

      The global partnership for assistive technology puts a properly fitted wheelchair for an adult, with the training, repairs and replacements a lifetime takes, at about $2,500.

    • Chairs at a fair price.

      UNICEF buys standard wheelchairs for governments at $250 to $500, and Free Wheelchair Mission, the largest single provider, reports about $96 a chair with freight.

    • Room in hearing care.

      Charities' bulk buying of hearing aids is small, and shrinking for lack of money.

    Honest limits

    What money can't promise.

    • Chairs get left behind.

      In one Ethiopian study, 36.4% of mobility products had been abandoned, most often when the device didn't suit the user's surroundings or the user had no say in choosing it.

    • Hearing aids in drawers.

      In Wales, about 20% of adults with hearing aids don't use them at all.

    • Upkeep costs, year after year.

      In one Nigerian study, a year of hearing aid batteries could cost more than an average farming family earns in a year.

    • Some gains fade, and the data is thin.

      Health gains from new wheelchairs had faded by the study's last check, and the big returns come from models, because research on disability and assistive technology is still scarce.

    Hard questions

    Asked and answered.

    1. You might ask

      Why not just ship free wheelchairs?

      Ryan

      Free chairs often arrive without a wheelchair service, so users are never properly assessed and fitted.

    2. You might ask

      Do hearing aids prevent dementia?

      Ryan

      Not proven. In a large trial, hearing care didn't slow older adults' memory and thinking decline overall, though hearing aids clearly help people hear and take part.

    3. You might ask

      Why pay for far more than the chair?

      Ryan

      Because a device without follow-up tends to fail: poor follow-up can shorten how long it's usable and lead people to give it up.

    In the slider

    See what your fortune could do here.

    Wheelchairs and hearing aids

    The slider prices this cause with these numbers:

    • About $2,500 pays for an adult's fitted wheelchair for life, with assessment, training, repairs and replacements.
    • The whole need is the 50 million adults in low- and middle-income countries who need a wheelchair. Children need theirs too, at a higher cost.
    • A modeled cost. A chair alone costs far less, but without fitting and follow-up, devices often go unused.
    Try it in the sliderTalk to Ryan

    More of the Blueprint

    Keep reading.

    5 more chapters on the way

    Back to Keep 100

    Sources

    Every number in this chapter, and where it came from.

    1. Source 1: Assistive technology (fact sheet) (opens in a new tab)

      World Health Organization, 2 January 2024. Checked 16 October 2026.

    2. Source 2: The Case for Investing in Assistive Technology (opens in a new tab)

      ATscale, the Global Partnership for Assistive Technology, November 2020. Checked 16 October 2026.

      A model of the lifetime cost of each product, with fitting, training, repairs and replacements. The adult wheelchair figures are each table row's last column.

    3. Source 3: Deafness and hearing loss (fact sheet) (opens in a new tab)

      World Health Organization, 3 March 2026. Checked 16 October 2026.

    4. Source 4: Global and regional needs, unmet needs and access to hearing aids (Orji and others) (opens in a new tab)

      International Journal of Audiology, 3 February 2020. Checked 16 October 2026.

      An estimate built on the Global Burden of Disease study.

    5. Source 5: Hearing aids for mild to moderate hearing loss in adults (Ferguson and others) (opens in a new tab)

      Cochrane Database of Systematic Reviews, 26 August 2026. Checked 16 October 2026.

    6. Source 6: Effectiveness of the Wheelchair Skills Training Program: a systematic review and meta-analysis (Keeler and others) (opens in a new tab)

      Disability and Rehabilitation: Assistive Technology, 4 April 2018. Checked 16 October 2026.

    7. Source 7: The long-term impact of wheelchair delivery on the lives of people with disabilities in three countries of the world (Shore and Shore) (opens in a new tab)

      African Journal of Disability, 8 September 2017. Checked 16 October 2026.

      People in Peru, Uganda and Vietnam, followed for two and a half years.

    8. Source 8: Is centre-based provision of hearing aids better than community-based provision? A cluster-randomized trial among adolescents in Bangladesh (Borg, Ekman and Östergren) (opens in a new tab)

      Disability and Rehabilitation: Assistive Technology, 2 June 2017. Checked 16 October 2026.

    9. Source 9: Global return on investment and cost-effectiveness of WHO's HEAR interventions for hearing loss: a modelling study (Tordrup and others) (opens in a new tab)

      The Lancet Global Health, January 2022. Checked 16 October 2026.

      A model covering most of the world's countries.

    10. Source 10: Assistive Products Market Report 2025 (opens in a new tab)

      ATscale and the Clinton Health Access Initiative, June 2025. Checked 16 October 2026.

      Providers' prices and volumes are their own figures.

    11. Source 11: Mobility assistive product abandonment and associated factors in Amhara regional state, Ethiopia: a multi centre study (Guadie, Demeke and Aldersey) (opens in a new tab)

      Disability and Rehabilitation: Assistive Technology, 13 February 2026. Checked 16 October 2026.

    12. Source 12: Adoption, use and non-use of hearing aids: a robust estimate based on Welsh national survey statistics (Dillon and others) (opens in a new tab)

      International Journal of Audiology, 12 June 2020. Checked 16 October 2026.

    13. Source 13: World report on hearing (opens in a new tab)

      World Health Organization, 3 March 2021. Checked 16 October 2026.

      The report itself is a PDF, linked from this page.

    14. Source 14: Product Narrative: Wheelchairs (opens in a new tab)

      ATscale and the Clinton Health Access Initiative, August 2019. Checked 16 October 2026.

    15. Source 15: Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial (Lin and others) (opens in a new tab)

      The Lancet, 18 July 2023. Checked 16 October 2026.

    16. Source 16: Global report on assistive technology (opens in a new tab)

      World Health Organization and UNICEF, 15 May 2022. Checked 16 October 2026.

      The report itself is a PDF, linked from this page.