Functional Needs Assessment Tool for estimating population-level functional difficulties and the need for services and assistive products: pilot testing in Western Uganda

Background Reliable data on population-level need for rehabilitation services and assistive products (AP) across different settings are lacking. The Functional Needs Assessment Tool (FNAT) is a new survey method for estimating the prevalence of functional difficulties/impairment and the need for services and AP. It combines self-report, clinical impairment and functional assessments across seven domains: vision, hearing, mobility, communication, cognition, self-care, and mental health. Data are collected using a bespoke mobile application and web-based platform. The FNAT methodology is presented in the first paper in this series. Objective The FNAT was pilot-tested in Kalungu District, Uganda, between March and July 2023 to assess the feasibility of the methodology and the functionality of the mobile data collection application. Methods Two pilot studies were conducted across 18 communities/villages, including 305 (pilot 1) and 550 (pilot 2) participants aged 2 years and older. Participants were identified using a two-stage cluster sampling method and underwent assessments using standardised tools to evaluate functional difficulties/impairments and the need for services and AP. Results The pilot studies identified several key learnings, such as the need for questionnaire revisions and improvements to the application programming. It confirmed the feasibility of completing the two-stage assessments over 2 days with a cluster size of 45 participants (participants aged 2 years and older) while including visual acuity screening for all participants. Discussion The FNAT is a feasible approach for estimating the prevalence of functional difficulties and the need for and coverage of related services and AP, with lessons learned for future development, and should be tested at scale. The field-test study is presented in the final paper in this series.