Mohuya Akter, Kaoru Inoue, Natsuka Suyama, Yeasir Arafat Alve, Yuko Ito, Yoko Yamanishi, Peter Bontje
In Bangladesh, occupational engagement for individuals with spinal cord injury (SCI) is enriched by culturally grounded adaptations but shaped by enduring structural inequities and how assistive technology (AT) is integrated in daily life. In resource-limited settings marked by limited AT service provision, inaccessible infrastructure, and systematic exclusion, it is crucial to understand how AT facilitates occupational engagement, and thus occupational justice. This study explored how SCI individuals and their primary caregivers use AT to facilitate occupational engagement and identify which occupational rights they exercise in achieving occupational justice. Grounded in constructionist epistemology, 12 pairs of individuals with SCI and their primary caregivers from Bangladesh were purposively recruited. Data were collected through photo-elicitation focus group discussions. A constant-comparative analysis identified eight themes, which were mapped onto occupational rights under an occupational justice framework. ‘Constructing occupational identity’ and ‘Finding personal significance in one’s daily occupations’ aligned with Meaning, ‘Agency in occupational engagement’ with Choice, and ‘Harmonious distribution of time and effort’ with Balance. Three themes, ‘Creating occupational opportunities available in society’, ‘Ensuring tailored support to meet diverse needs’, and ‘Accessing opportunities of growth and development’ corresponded to Participation. Lastly, ‘Gaining attention and showcasing talent and competencies’ introduced Visibility as a newly identified occupational right, underscoring the importance of societal recognition. AT plays a critical role in promoting occupational engagement for occupational justice. Findings uncover visibility as a key discovery, calling for policy reforms to enhance AT accessibility and recognize visibility as essential for societal inclusion.