Kiribati, Maldives, Malta and Paraguay have been granted full membership of the International Paralympic Committee (IPC).
The National Paralympic Committees (NPC) in each country were approved as members by the IPC during its General Assembly in Bonn.
The ratification of the four nations brings the IPC's membership to 205, 182 of which are NPCs.
Four NPCs are currently suspended - Djibouti, Sudan, Comoros and Seychelles.
Kiribati becomes the ninth member nation from the Oceania region, while Maldives is the 44th NPC in Asia.
Malta is the 48th European NPC to become part of the IPC, and Paraguay marks the 33rd from the Americas.
The Paraguay Paralympic Committee and the Maldives Paralympic Committee were made provisional members in July 2018 and May of this year, respectively.
Athletes from the four countries can compete at IPC-sanctioned events, including the Paralympic Games, following the approval of their NPCs.
"It is an exciting and very enjoyable moment to our NPC and also to our country, Kiribati, as a whole as this recognition by IPC will not only allow us to be recognised internationally, but also will open the bright future for our Para athletes," said NPC Kiribati President Tekoaua Tamaroa.
Malta Paralympic Committee President Julian Baiada said membership of the IPC will "unlock a world of opportunities for Para sport and Para athletes in Malta, from participation in international competitions, to access to expertise and resources for the benefit of our athletes".
Ibrahim Ismail Ali, President of NPC Maldives, said it was a "dream come true" to be welcomed into the IPC family.
Higinia Giosa, NPC Paraguay President, said: "We want to continue growing.
"It is not an easy task, but we do it wholeheartedly."