Lessons learnt from assistive technology ecosystem strengthening programmes in 12 low- and middle-income countries

PURPOSE: Delivering on a global mission to increase access to assistive technology (AT) requires strategic vision, targeted programmes and a commitment to iterative learning. In 2023, ATscale, the Global Partnership for Assistive Technology, oversaw short-term programme investments to twelve low- and middle-income countries to strengthen developing assistive technology ecosystems through data collection, policy creation and capacity building. This paper aims to gather and critically appraise lessons learnt from these whole-of-country investments. METHODS: Case study method entailed (i) a desktop review of documentation and (ii) semi-structured interviews across stakeholder groups in twelve countries. The results were thematically explored and critically analysed according to the ATscale Theory of Change. RESULTS: Despite diverse country contexts, results showed common themes in the areas of achievements, implementation challenges and sustainability of programme efforts. When tailored to country context, programmes were demonstrated to develop and strengthen assistive technology ecosystems according to metrics such as AT-specific legislation, increased data collection, improved coordination amongst stakeholders and national efforts creating key documents such as Priority Assistive Product Lists (APLs), strategies and roadmaps. Extrinsic factors such as bureaucracy and political instability, and intrinsic factors such as short programme windows, influenced success. The sustainability of these efforts is dependent on further funding and continued engagement in-country. CONCLUSION: This research showed the benefit of such investments in countries with nascent AT ecosystems and demonstrates the applicability of the Theory of Change being implemented. The lessons captured provide valuable learnings and have already been incorporated into guidance to improve future programmes.