The Indian National AT Policy must ensure that access to assistive technology is recognized as a fundamental right within a robust legal framework, covering all individuals with functional impairments (30). Rather than relying solely on models from high-income countries, the policy should align with global rights-based frameworks such as the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which India has ratified (10, 16). Nationally, the Rights of Persons with Disabilities Act, 2016, already establishes foundational principles of non-discrimination, accessibility, and equal opportunity (23). The National AT Policy should build upon this legislation to create seamless integration of assistive technology provision within healthcare services. By formally embedding AT as a legal right, India can strengthen universal health coverage, promote social inclusion, and ensure equitable access to rehabilitation and assistive products for all individuals in need (11, 36).

Global experiences in public health financing were consulted to inform possible adaptations suitable for India, recognizing differences in scale, resources, and population needs (37). Ayushman Bharat, formally known as the Pradhan Mantri Jan Arogya Yojana (PM-JAY), is the largest health insurance scheme in the world and offers a strong foundation for integrating assistive technologies into public health coverage (38). While international public insurance models, such as Medicare and Medicaid in the USA, provide useful insights into financing mechanisms, it is important to recognize that India's healthcare context is characterized by a larger and more diverse population, different economic realities, and varied healthcare infrastructure. Therefore, customized adaptation is required rather than direct transplantation of such models. Challenges and limitations observed in countries like Australia, Canada and USA such as gaps in coverage and sustainability concerns, must inform the development of a tailored approach suitable for India. Financial support mechanisms could include targeted subsidies, GST exemptions, or direct support to users, inspired by elements from Australia's National Disability Insurance Scheme (NDIS) and Norway's public insurance models. Co-payment structures may also be considered to balance affordability and system sustainability. These strategies, adapted to India's socio-economic context, will help ensure that assistive technologies are accessible to all individuals who need them, regardless of socio-economic status.

Current assistive technology schemes in India, including the Scheme of Assistance to Disabled Persons for Purchase/Fitting of Aids/Appliances (ADIP) and Rashtriya Vayoshri Yojana (RVY), have significant eligibility limitations (30, 39). ADIP requires a minimum 40% disability certification, monthly income below Rs. 30,000, and restricts repeat benefits within three years (20). RVY targets only senior citizens above 60 years from Below Poverty Line families with certified age-related disabilities (39). These strict criteria exclude many individuals with mild to moderate functional impairments who would benefit from assistive technologies, creating substantial unmet needs. The proposed National AT Policy must expand eligibility beyond these thresholds to ensure comprehensive coverage for all individuals requiring assistive products, regardless of disability percentage or socio-economic status (10).

National AT Policy must ensure that assistive technologies are readily available across both urban and rural settings in India. The policy should prioritize the development of efficient and decentralized distribution channels through existing health infrastructure, including National Institutes, Composite Regional Centres (CRCs), District Disability Rehabilitation Centres (DDRCs), and District Hospitals under the Ministry of Social Justice and Empowerment, along with Primary Health Centres (PHCs), Community Health Centres (CHCs), Sub-District Hospitals (SDHs), District Hospitals (DHs), and Medical Colleges (40, 41). Additionally, efforts should be made to establish Assistive Technology Experience Zones (AEZs) and to develop loan or rental services, enabling users to trial and borrow assistive devices before committing to purchase. These initiatives should be integrated within health and rehabilitation centers to enhance outreach, especially in underserved areas. Community-based rehabilitation (CBR) programs should be strengthened to provide local-level AT services, training, and support. Non-governmental organizations (NGOs), Disabled People's Organizations (DPOs), and community-based organizations play crucial complementary roles in last-mile delivery, awareness generation, and user feedback collection (42, 43). These organizations bridge critical gaps in government service delivery, particularly in remote and marginalized communities. Structured partnerships between public health systems and civil society organizations should be established to leverage grassroots networks, enhance community trust, and ensure culturally appropriate service delivery. CBR workers and community volunteers should be trained in basic AT assessment, fitting, and maintenance to create a sustainable local support ecosystem (18). While global experiences have demonstrated the benefits of decentralized and user-centered assistive technology programs, India's strategy must be tailored to address the diversity of its population, geographical spread, and healthcare delivery system to ensure equitable access (12).

The National AT Policy must emphasize the systematic integration of assistive technologies within public health and rehabilitation services, ensuring that AT forms part of a holistic health intervention strategy (44). Assistive products should also be incorporated into India's education and para-sports systems to support inclusive development from an early stage. A multidisciplinary approach, involving doctors, therapists, rehabilitation professionals, and assistive technology specialists, should be promoted across healthcare facilities (16). These teams would be responsible for assessing individual needs, prescribing appropriate assistive products, and monitoring their usage and outcomes. Global experiences have demonstrated the value of integrating assistive technology into mainstream service delivery; however, India's approach must be adapted to its demographic diversity, healthcare infrastructure, and socio-economic conditions to ensure equitable access and long-term sustainability (41, 45).

Building widespread awareness about assistive technologies is a foundational requirement for generating demand, identifying unmet needs, and ensuring the effective uptake of assistive products across India (4). The National AT Policy prioritizes structured national awareness campaigns led by the Central Health Education Bureau (CHEB) in collaboration with State Health Departments. These campaigns will have clearly defined annual targets to reach diverse populations, including rural, remote, and underserved communities. Without adequate awareness, even accessible assistive products risk underutilization (46, 47). Campaign content will address common misconceptions, such as the belief that assistive devices are only for those with severe disabilities or imply dependence. Awareness strategies will be culturally tailored to reduce stigma and promote assistive technologies as tools for empowerment, independence, and improved quality of life (47). Regular capacity-building initiatives will be institutionalized for healthcare professionals, allied health workers, and frontline service providers to ensure they are skilled in assessing, prescribing, and promoting assistive technology (48). In addition, community-based education and training modules will be developed and deployed to empower users, families, and caregivers. These coordinated efforts seek to foster a supportive environment that strengthens demand for assistive technologies and enhances uptake, thereby improving health outcomes and social inclusion for persons with functional impairments across India (49).

The National AT Policy must recognize digital assistive technologies (DAT), including text-to-speech software, speech-to-text applications, voice recognition systems, wearables, smart prosthetics, and digital communication aids, as central to enhancing accessibility and independence for individuals with functional impairments (50). India must encourage the development, local manufacturing, and adoption of these technologies to address the diverse needs of its population. Globally, the integration of digital health and telehealth solutions has expanded significantly across both high- and middle-income countries, particularly since the COVID-19 pandemic (51). India can leverage its growing digital health infrastructure to integrate telehealth services within the AT provision framework, enabling remote assessments, prescriptions, and monitoring of assistive technologies, particularly for individuals living in rural or underserved regions (52). However, significant equity challenges must be addressed, including digital literacy disparities, affordability barriers for digital AT devices, and inadequate internet connectivity in rural areas (4). The policy should include specific provisions for digital literacy training programs, subsidized internet access schemes, and low-cost digital AT solutions designed for Indian users. Leveraging the Ayushman Bharat Digital Mission infrastructure, the policy should establish tele-rehabilitation platforms, remote prescription services, and AI-enabled assistive applications optimized for diverse linguistic and cultural contexts (53). Special emphasis should be placed on developing offline-capable digital AT solutions and multi-language interfaces to ensure inclusivity across India's diverse population (4). Promoting digital inclusion will be critical for overcoming geographic barriers and ensuring that innovative assistive solutions reach all who need them, irrespective of location (54).

Promotion of research into the development of new, affordable, and culturally appropriate AT through national research initiatives and collaborations with universities, private companies, and international organizations should be key focus of the National Policy (45). Like USA's partnership with tech companies in the field of AT innovation and Canada's emphasis on inclusive design, India can foster a vibrant research ecosystem that prioritizes local needs (26, 28). Similarly, like Norway's strong collaborations with industry players in healthcare innovation, Public-private partnerships will be crucial for scaling innovative solutions. International collaboration (WHO, UN, UNDP, UNICEF, AT Scale, GDI Hub etc.) also help in exchanging ideas, ensuring that the latest global advancements are accessible to the Indian population (27).

Dynamic monitoring, evaluation, and feedback systems must be embedded within the National AT Policy to ensure continuous improvement, responsiveness, and long-term sustainability. These systems should be capable of systematically tracking the impact of assistive technologies on users’ health outcomes, functionality, quality of life, and accessibility to services. Periodic reviews, program audits, and structured data collection should become integral components of policy implementation. Establishing a user-centered feedback mechanism within healthcare and rehabilitation services will enable individuals with functional impairments to share their experiences, highlight challenges, and suggest areas for improvement. A robust monitoring and evaluation system will not only ensure accountability but also provide critical evidence to refine strategies, address gaps, and ensure that assistive technology services remain relevant and effective for India's diverse population.

The National AT Policy should promote systems for recycling, reutilization, and sustainable procurement of assistive products (4). Individuals should be encouraged and supported to exchange, donate, or refurbish devices that are no longer in use, ensuring that functional products reach those who might otherwise be unable to afford them (55, 56). Establishing structured recycling and reutilization programs will help reduce waste, optimize resource use, and extend the life cycle of assistive devices (56). Furthermore, the policy should emphasize sustainable procurement practices to ensure that assistive products are affordable, durable, environmentally friendly, and accessible to all socio-economic groups (34). Prioritizing resource optimization will help prevent overproduction and promote equitable distribution, ensuring that the diverse needs of India's population are efficiently and responsibly met.

The National AT Policy must emphasize cross-sector collaboration to ensure that assistive technologies are integrated into multiple dimensions of public life (18). Effective partnerships between key ministries, including Health and Family Welfare, Education, Social Justice and Empowerment, and Science & Technology, will be essential to avoid fragmented approaches and promote a cohesive national strategy. Engagement with non-governmental organizations, civil society organizations, and advocacy groups is equally important to ensure that the voices of marginalized and underserved populations are incorporated into the policy process (57). Global experiences demonstrate that strong collaboration across sectors can enhance service delivery and improve access; however, India's approach must be tailored to its specific demographic, administrative, and socio-economic contexts. Building an inclusive and coordinated framework will be critical to ensuring that assistive technology services are accessible, equitable, and sustainable across the country (16).

Effective private sector engagement will be crucial for scaling assistive technology manufacturing, distribution, and innovation (18). The policy should establish incentive structures including tax breaks, Corporate Social Responsibility credits, and expedited regulatory approvals to stimulate local manufacturing and research (57). Structured public-private partnership models must be developed for comprehensive distribution networks, maintenance services, and technical support systems. Beyond healthcare, assistive technology integration should extend into education, employment, and transportation sectors to promote broader social inclusion and accessibility (10). Private sector collaboration will help create sustainable business models while ensuring affordability and quality of assistive products across diverse socio-economic segments (57).

A National AT Policy can catalyze the creation of a multi-cluster manufacturing ecosystem in India by fostering innovation, investment, and collaboration through targeted incentives. Tax benefits, subsidies, fast-track regulatory approvals, and Corporate Social Responsibility credits can encourage small and medium enterprises to establish specialized manufacturing units. Partnerships with academic institutions, research organizations, and international companies will drive technological advancements while ensuring affordability and quality standards. Regional clusters specializing in specific assistive technology categories can create economies of scale, generate employment, and strengthen supply chain networks. This ecosystem approach, supported by private sector engagement and cross-sectoral collaboration, will not only meet domestic demand but also position India as a global assistive technology manufacturing hub, contributing to export revenues and technological leadership.