Learning Note: Country Investment Fund
Clinton Health Access Initiative
July 20, 2022
Under AT2030 Country Investment Fund project, CHAI has demonstrated the potential to work with governments on a shift away from parallel and fragmented AT provision towards integration with public systems for scale and sustainability. Including:
- Launch the first National Assistive Products Lists (APL) in Africa: The WHO Priority Assistive Products List was introduced in 2018. It aspires to follow in the footsteps of the WHO Model List of Essential Medicines, which creates awareness among the public, mobilizes resources and stimulates competition.
- Launch new AT policy and ambitious National AT Scale-up Strategies: CHAI worked with government partners to develop first-ever national AT scale-up strategies, which provide direction to all stakeholders involved about the critical priorities to sustainably strengthen AT systems.
- Collect data on the AT need and pioneer a new data system: CHAI worked with the WHO to support governments Liberia and Rwanda to conduct rapid AT-Assessments (rATA), and is supporting the Government of Rwanda, via the National Council of Persons with Disabilities, to pioneer a comprehensive data system on disability. The Disability Management Information System (DMIS) aims to register persons with disabilities and their needs, create data dashboards for policy makers, and help organize case management by linking with various support groups (e.g., OPDs). The DMIS registry incorporates data collection methods such as Washing Group questions and rATA.
- Develop an Investment Case for AT: Limited or no financing is available for AT from national budgets. Countries with government managed health insurance schemes either do not provide coverage for AT or provide very limited coverage for AT both in range of products and in levels of reimbursement. CHAI worked with the Government of Nigeria, via the newly established National Commission for Persons with Disabilities, to develop an investment case for AT and identify potential sources of financing.
- Support Training in Assistive Products pilot: There are shortages and uneven distribution of AT-related workforce such as prosthetist/orthotists, audiologists, optometrists. CHAI and WHO implemented a pilot project utilizing the Training in Assistive Products platform to provide in-service training for healthcare providers on screening and provision of basic assistive products in 12 facilities across five counties (out of 15 counties in Liberia). This was the first-ever in-service training conducted by Ministry of Health on assistive products.
- Create tools to replicate ‘what works’: CHAI has worked with GDI Hub and Maynooth University to document learnings for replication by other partners
CHAI cmpleted activities which deliver foundational, strategic, agreed national AT priorities, and reach disabled people directly with access to AT across four focus countries – Liberia, Nigeria, Rwanda, and Sierra Leone. AT2030 has catalyzed momentum and the foundations have been laid for better financing, and more routine availability of higher quality AT.