Bringing AT services to everyone, everywhere
ATscale aims for comprehensive guidance to be available and supporting countries to introduce effective and innovative AT service delivery models across the life cycle.
As countries invest to strengthen their AT policies, systems, services and regulatory frameworks, it is critical that they have access to the latest evidence, knowledge and guidance on optimal approaches. ATscale is investing with partners to identify the right approach to creating an effective knowledge platform, as well as defining a programme of work to fill existing gaps in guidance.
ATscale is working with partners to define a programme of work to ensure that available policy guidance comprehensively covers the life cycle.
Ongoing interventions:
Domain: Enabling Ecosystem
Timeframe: Starting in 2025
Knowledge hub on assistive technology
To address the fragmented landscape of assistive technology (AT) resources and provide a clearer global overview of the AT sector, ATscale is developing a centralized online resource hub. This platform will consolidate high-quality resources, including guidelines, training modules, and toolkits, while also mapping key actors, country initiatives, and funding sources related to AT.
Domain: Enabling Ecosystem
Timeframe: 2024
Implementing partners: UNICEF, ILO, UNDRR and UN WOMEN
Positioning assistive technology in the global development agenda - climate action, employment, women and girls, and education
To elevate assistive technology in global development discussions, ATscale is working in collaboration with key UN agencies to develop four comprehensive policy briefs. These briefs will provide evidence-based insights, policy recommendations, and best practices, supporting national strategies, advocacy efforts, and cross-sectoral integration of AT solutions. Each brief will focus on a critical thematic area:
AT and education (in partnership with UNICEF)
AT and employment (in partnership with ILO)
AT in disaster risk reduction and climate action (in partnership with UNDRR)
AT for women and girls (in partnership with UN Women)
These policy briefs will serve as valuable resources for governments, policymakers, and stakeholders, helping to shape inclusive policies that enhance access to assistive technology and integrate AT solutions into broader development frameworks.
Domain: Hearing
Timeframe: 2024- ongoing
Implementing partner: World Health Organization (WHO)
Hearing Aids - Package of hearing care interventions
WHO is working on a global guideline for countries on ear and hearing care, including hearing aid fitting and related services and interventions at community, primary, secondary, and tertiary levels of care.
Domain: Hearing
Timeframe: 2024- ongoing
Implementing partner: World Health Organization (WHO)
Increasing the availability of quality-assured hearing aids by establishing a pre-qualification mechanism
ATscale is working to enhance the quality, safety, and efficacy of hearing aids by exploring the feasibility of a pre-qualification process. WHO is continuing to build a business case for prequalification of hearing aids and is working on a report, outlining the necessary steps for establishing a pre-qualification framework for hearing aids.
Domain: Mobility
Timeframe: 2024-ongoing
Implementing partner: International Society for Prosthetics and Orthotics (ISPO)
Outcome measures for people with prostheses
The International Society for Prosthetics and Orthotics (ISPO) is piloting the COMPASS outcome measures in multiple countries to assess their feasibility and resource requirements for use in rehabilitation care. COMPASS is a standardized set of outcome measures designed to evaluate individuals with lower limb absence both before and after rehabilitation.
Data collection is currently underway in four countries—Papua New Guinea, Kenya, Cambodia, and Georgia. The pilot includes countries with varied experience in using outcome measures, allowing for a comprehensive assessment of implementation needs.
As part of this initiative, ISPO is incorporating COMPASS into a mobile app and leading its translation into Spanish, with additional languages to be included over time. ISPO was selected as the implementing partner because it is the custodian of COMPASS, ensuring a structured feedback mechanism from country-level experiences at this early stage of adoption. The organization is working in collaboration with Orthocare Innovations LLC to support implementation.
Domain: Vision
Timeframe: September 2023 to February 2025
Implementing partner: IQVIA, L V Prasad Eye Institute
Large-Scale Scientific Study on Existing (hand-held) Autorefractor Technologies and Delivery of Associated Services
ATscale is supporting a large-scale research study to determine the effectiveness and feasibility of using hand-held autorefractors in LMICs. This study is conducted by IQVIA – a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry dedicated to delivering actionable insights - in collaboration with L V Prasad Eye Institute – a World Health Organization Collaborating Centre for Prevention of Blindness.
The study compares the effectiveness of different hand-held autorefractor models with other refraction devices, determines the feasibility of prescribing eyeglasses based on results of autorefraction alone, and assesses the potential for scaling up handheld autorefractors in public health settings within LMICs. The study will also evaluate how to best train community health care workers to use the selected autorefractors within different settings and for different populations.
Domain: Vision
Timeframe: 2024-2025
Implementing partner: World Health Organization (WHO)
Expansion of WHO’s Training in Assistive Products (TAP) on hearing and vision.
To build country workforce capacity to provide assistive products at community and primary healthcare level, through expansion of WHO’s Training in Assistive Products (TAP) on hearing and vision.
Completed interventions
Domain: Vision
Timeframe: 2024-2025
Implementing partner: WHO
Global guidance on integrated vision & hearing screening delivery approaches
The guidance will support countries to deliver joint vision and hearing screening for school-aged children. This guidance encompasses several key areas, including targets, evidence-based screening tests, referral criteria, human resource requirements, and various service delivery approaches.
The guide was launched on World Hearing Day (March 2024).
Domain: Enabling Ecosystem
Timeframe: 2020
AT National Policy, Strategy, Planning (NPSP) Costing Tool
Policy choices by governments about how and when to introduce or scale up AT programmes and how to include them in public (health) systems and insurance schemes should be informed by reliable estimates of the resources required.
The aim of this intervention was to provide decision-makers in ministries responsible for the provision of assistive technology with tools to support the generation of the cost-related data they need to inform their plans.
Two different costing tools were developed - one that supports planning at a strategic level and one for the costing of concrete assistive product provision packages. They are excel-based AT costing models that allow for tailoring to take into account different scale-up strategies, models of provision and the inclusion of different assistive products (eyeglasses, hearing aids, wheelchairs, prostheses). The tools are versatile and adaptable to varied contexts.
AT National Policy, Strategy, Planning (NPSP) Costing Tool
The AT National Policy, Strategy, Planning (NPSP) Costing Tool calculates multi-year cost projections of the resources needed to implement strategic activities and inventions linked to a national AT policy, strategy, or plan and produces multi-year cost projections. It is designed for health planners and policymakers to help inform budget planning and financing dialogue.
The tool has already been used in Liberia, Malawi, and Sierra Leone to cost national AT plans.
The package includes:
NPSP tool populated with sample data
2. Assistive Product Provision (APP) Costing Tool
The Assistive Product Provision (APP) Costing Tool calculates costs for a five-year projection of start-up costs and incremental costs per person for assistive product provision packages. The tool can also model combined provision of these services (e.g., within school health or primary health care). The tool is designed for health system managers and policymakers to help plan future services and prepare investment cases.
The tool has been used in South Africa to cost comprehensive hearing services and will also be used to plan the cost of integrated vision/hearing service provision.
The package includes:
Domain: Hearing
Identifying needs and testing solutions for people with hearing loss in low- and middle-income countries
This intervention focused on the use of pre-programmed hearing aids for individuals with hearing loss in low- and middle-income countries. Research was conducted to understand the hearing profiles and characteristics of clinical samples across these countries, and to compare the effectiveness of pre-programmable hearing aids with conventionally customized hearing aids.
The findings showed that pre-programmable hearing aids can be effective for individuals with mild to moderately severe hearing loss, but those with more severe hearing loss may require conventional fitting or manual communication programs. While pre-programmable hearing aids may not be as effective as conventionally customized aids for all individuals, they are a highly scalable and accessible option for hearing rehabilitation in low- and middle-income countries.
Domain: Mobility
Timeframe: 2020
Development of Lower Extremity Amputation Dataset (LEAD) and a list of Outcome Measures for Prosthetic and Amputation Services (COMPASS)
The lack of standardized data to demonstrate impact has hindered support for rehabilitation services for people with lower limb absence. To address this, the International Society for Prosthetics and Orthotics (ISPO) established two international consensus processes: one to create a core data set for lower limb absence (LEAD), and another to standardize outcome measures for routine clinical practice (COMPASS).
LEAD ensures standardized data collection across different efforts, facilitating data comparison and aggregation. COMPASS, supported by additional tools, enables the measurement of rehabilitation intervention effects and is included within LEAD to provide outcome data. A COMPASS User Guide provides protocols for standardized administration of outcome measures.
These initiatives aim to inform policy decisions, support rehabilitation programs, and enhance the evaluation and development of prosthetic services and technologies.
Read the Project Report
Read the COMPASS User Guide
Domain: Vision
Timeframe: 2022
Implementing partner: WHO
Handbook on vision screening and end to end provision of eyeglasses
ATscale collaborated with WHO to develop a handbook offering technical guidance for the development and implementation of early vision screening and comprehensive eye care, with a focus on correcting refractive errors with eyeglasses. This handbook addresses screening targets, screening sites, evidence-based screening tests, innovative devices, referral criteria, human resource requirements, and various service delivery models for integrating screening with eyeglass provision for school-age children, non-school-going children, and older adults.
Furthermore, a technical guidance document was created to assist countries in providing high-quality eye screening, referral, and eyeglass provision.