Country Engagement
People in low- and middle-income countries are disproportionately affected by barriers to access quality, appropriate, affordable assistive technology. ATscale and partners collaborate across sectors to build stronger systems to improve the lives of people in need of AT. All initiatives funded by ATscale are for the benefit of countries eligible to receive Overseas Development Assistance, and multilateral development institutions, as defined on the updated Development Assistance Committee List.
ATscale provides governments and relevant AT stakeholders with support to co-create integrated national AT strategies and plans. It then provides catalytic investment to implement the plan over three years initially, inviting other partners to collaborate.
Country engagement to date
In 2022, ATscale approved funding for a three-year Joint Investment Plan to the Government of Kenya to help them strengthen AT systems to reach more than 275,000 additional AT users by 2025.
ATscale has also facilitated a three-year catalytic AT investment plan in Cambodia, with an ambitious focus to scale up access to eyeglasses and strengthen physical rehabilitation services.
ATscale is supporting the governments of Tajikistan, Georgia, and Azerbaijan with a three-year project to integrate AT into primary health care services.
In Senegal, ATscale worked closely with the government and other stakeholders to develop a plan, which is yet to be finalized and approved.
In Ukraine, ATscale supported the Ministry of Health, through the WHO European Regional Office, to provide WHO’s ‘AT10’, a kit of 10 assistive products most needed by people displaced due to emergency. To date 2,200 people have received the AT they need through these kits, and ATscale’s support encouraged other donors to provide 5 additional kits.
In 2023, ATscale will focus on ensuring its first country-level investments deliver results and reach as many people as possible. With partners, ATscale is scoping the potential to work in a further 12 countries ready to receive ATscale support, and plans to pilot work with countries to bring particular products and services to scale.
Kenya becomes the first country to receive catalytic investment from ATscale
2023 - 2025
Georgia, Tajikistan, and Azerbaijan use ATscale catalytic investment to strengthen assistive technology systems
2023 - 2025
Cambodia strengthens systems and accelerates access to assistive technology for vision, and mobility
2023 - 2025
Scale up Refractive Error Services and Refine Financing Models for Eyeglasses Provision in Cambodia
June 2021 – June 2023
Investments of USD 7.5 million spread over 3 years (2023-2025) are funding a government-owned joint investment plan developed to address the most pressing assistive technology needs in the country. All key assistive technology stakeholders in the country contributed to preparing the plan, with interventions spanning mobility, vision, hearing, and communication. The aim is to ensure that by 2025 an additional 275,000 people in Kenya get the assistive technology they need. The government is mobilizing domestic resources to complement ATscale’s financial support. The plan includes long-term investment in rehabilitation services, and the establishment of a regional assistive technology center of excellence together with WHO.
Dr Patrick Amoth, Director General, Dr. Susan Nakhumicha, Cabinet Secretary from the Ministry of Health Kenya and Pascal Bijleveld, ATscale CEO, at the program launch in Nairobi
The Ministry of Health formally launched the program on 2 March 2023 in Nairobi alongside its launch of the Rehabilitation and AT Strategy Plan, and Disability Guidelines. A coordination committee has been set up to guide and oversee the project. The Clinton Health Access Initiative (CHAI) was selected competitively as an implementing partner to provide management and coordination support to the Ministry of Health to implement the plan.
A regional joint investment plan covering Georgia, Tajikistan, and Azerbaijan aims to strengthen delivery systems and provide 23,000 people with the assistive technology they need. The plan also aims to engage other donors, partners and stakeholders so that even more people will benefit from increased access to AT, with an anticipated 1.7 million additional people getting AT over the next three years (2023-2025).
This comprehensive and integrated regional plan was developed in collaboration with the WHO Regional Office for Europe (WHO EURO) along with key stakeholders in the countries, including governments - across multiple sectors - and organizations of people living with disabilities. WHO EURO has been selected as an implementation partner to provide coordination and technical support and scale up access to assistive technology. The plan aims to design, test and implement measures that shape the assistive technology market; increase coordination and promote synergies across assistive technology and rehabilitation services; strengthen the participation of assistive technology users; and foster intra- and inter-country learning on assistive technology and rehabilitation.
Cambodia’s Ministry of Health (MoH) and the Ministry of Education, Youth, and Sports (MoSVY) came together to create a joint investment plan to address key issues the population faces in getting the assistive technology they need. The resulting consultative process was led by government officials from the Ministry of Health (MOH), Ministry of Social and Veteran Affairs (MOSVY), Ministry of Education (MoEd), Youth and Sports (MOEYS) and included People with Disabilities Foundation (PWDF) and representatives from the Cambodia Disabled People’s Organization (CDPO). Partners in the country, working with various different areas of functional difficulties and assistive technology, provided technical input to the plan.
With ATscale’s investment of USD 4.5 million over three years (2023-2025), Cambodia aims to expand physical rehabilitation services, particularly prosthetics and wheelchairs. It also aims to scale up vision screenings and improve the provision of affordable eyeglasses in the public sector, while improving quality in the private sector. The investment will help an additional 274,000 people in Cambodia get the AT they need. ATscale has selected a consortium of partners (Clinton Health Access Initiative, Humanity Inclusion, and Cambodian Disabled People’s Organisation) to provide management and coordination support to the concerned ministries for the implementation of the plan.
Globally, at least 826 million people do not have the eyeglasses they need (as of June 2021). This can have a negative impact on their health, education, quality of life, and general wellbeing. This unmet need for eyeglasses is mainly concentrated in low and middle-income countries.
Increasing access to eyeglasses calls for a multisectoral approach that brings together the public and private sector, multilateral organizations, civil society actors and donors. It requires an approach that increases the demand for eyeglasses from governments and populations, improves access to screening and provision, and accelerates the availability of quality and affordable eyeglasses.
Community Eye Screening, Cambodia. Courtesy of the Fred Hollows Foundation
This project, led by the Fred Hollows Foundation, in Cambodia takes a partnership approach to increase demand for eyeglasses through improving the population’s knowledge and understanding about eye health and positively influencing consumer behaviour towards wearing eyeglasses. It increases both the number of places to obtain eyeglasses and delivery mechanisms for care by establishing screening and eye health provision through school eye health programmes and vision centers across 16 provinces. The project creates sustainable access to refractive services (to identify and treat conditions such as glaucoma, cataract, and diabetic retinopathy) and eyeglasses. Within this project an estimated 80,000 children and 30,000 adults will obtain affordable eyeglasses.
The project was introduced at a critical time when Cambodia was developing its five-year National Eye Health Plan and it contributes to firmly embedding best practice models and indicators related to refractive error in the national strategy. ATscale is working with the Government of Cambodia and the private sector to understand the potential for scaling up national health financing and service provision models including key policies and systems. The project proposes solutions that provide sustainable, efficient, equitable and effective coverage and financial protection.
The work is done in close partnership with the Cambodian Ministries of Health (MoH); Education, Youth and Sport (MOEYS); Women’s Affairs (MOWA); and of Social Affairs, Veterans and Youth Rehabilitation (MOSVY), Disabled People's Organisations (DPOs), and a large private sector partner.
The intervention is funded by the United States Agency for International Development (USAID) in support of ATscale and managed by the United Nations Office for Project Services (UNOPS).
Grantee: The Fred Hollows Foundation
The war in Ukraine is having a devastating effect on people with disabilities who are particularly vulnerable and affected by the violence, displacement, and prolonged exposure to stress.
The ongoing conflict resulted in an alarming rise in the need for assistive technology (AT) for people who have been forced to flee their homes and are separated from support networks and services. A WHO survey in 2021 found that 12% of the Ukrainian population needed one or more assistive products.. This figure will have grown substantially as a result of the conflict. Several NGOs, UN agencies and governments from neighbouring countries are providing emergency rehabilitation and AT services in hospital settings, but huge gaps remain.
The conflict disrupted health services and displaced the skilled health workforce. Moreover, the number of people needing AT due to new injuries and damage of existing AT is growing within the country. Many people have been forced to abandon their assistive devices while fleeing the conflict. The need is urgent, and ATscale is collaborating with the WHO European Regional Office (EURO) to support Ukraine’s President's Office, the Ministry of Health, and the Ministry of Social Policy to increase access to AT.
Video by WHO Ukraine
Supporting AT service delivery in humanitarian settings
Providing AT to people in humanitarian settings tends to be limited to procurement and distribution with little attention to service delivery. AT requires tailored fitting, follow-up and regular maintenance to ensure its safe and effective use. With support from ATscale, WHO EURO will integrate procurement and distribution with service delivery systems in ‘AT clusters’ within the health system. The clusters are set up to provide AT services that meet the needs of the user.
WHO EURO worked with the Ukrainian Ministry of Health to establish up to ten ‘AT clusters’ equipped with WHO’s ‘AT10’, a kit of 10 assistive products identified as needed most widely by people in conflict situations, comprising wheelchairs, crutches, walking frames, walking sticks, and self care (incontinence) products. The list was informed by findings from the rATA survey 2021. Volunteers were trained in prescription, referral, fitting and maintenance of assistive products through the WHO TAP Module (Training on Assistive Products). Monitoring and tracking of AT provision was ensured by incorporating AT service delivery modules in the existing e-health platform. In addition to providing assistive products at these centres, a service was developed for people unable to attend the clusters.
To date in early 2023, 2,200 people have received the AT they need through these kits. In addition, funds will cover service delivery costs (training, delivery, follow-up, monitoring, etc). WHO EURO is responsible for the implementation working closely with the Ministry of Health.
ATscale’s support to Ukraine is designed to be catalytic, to show proof of concept and get the approach off the ground. We hope that the investment will set a foundation for other interested donors to build on further, and invest in additional kits to reach more people in need. Further, we aim to generate useful learnings from this never-tried-before system-based approach that can then be applied to other similar contexts.
Banner photo: Deafkidz International