Community-based adult hearing care provided by community healthcare workers using mHealth technologies

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Community-based adult hearing care provided by community healthcare workers using mHealth technologies


JournalGlobal Health Action
Article typeJournal research article – Clinical research
Publication date – Aug – 2022
Authors – Caitlin Frisby, Robert H. Eikelboom, Faheema Mahomed-Asmail, Hannah Kuper, Tersia de Kock, Vinaya Manchaiah, De Wet Swanepoel
Keywordscommunity health, Community-based rehabilitation, Hearing loss, Low-and middle-income countries, mhealth, teleaudiology
Open access – Yes
SpecialityDigital health, ENT surgery
World region Southern Africa
Country: South Africa
Language – English
Submitted to the One Surgery Index on August 25, 2022 at 9:18 pm
Abstract:

Background
The rising prevalence of hearing loss is a global health concern. Professional hearing services are largely absent within low- and middle-income countries where appropriate skills are lacking. Task-shifting to community healthcare workers (CHWs) supported by mHealth technologies is an important strategy to address the problem.

Objective
To evaluate the feasibility of a community-based rehabilitation model providing hearing aids to adults in low-income communities using CHWs supported by mHealth technologies.

Method
Between September 2020 and October 2021, hearing aid assessments and fittings were implemented for adults aged 18 and above in two low-income communities in the Western Cape, South Africa, using trained CHWs. A quantitative approach with illustrative open-ended questions was utilised to measure and analyse hearing aid outcomes. Data were collected through initial face-to-face interviews, telephone interviews, and face-to-face visits post-fitting. Responses to open-ended questions were analysed using inductive thematic analysis. The International Outcome Inventory – Hearing Aids questionnaire determined standardised hearing aid outcomes.

Results
Of the 152 adults in the community who self-reported hearing difficulties, 148 were successfully tested by CHWs during home visits. Most had normal hearing (39.9%), 24.3% had bilateral sensorineural hearing loss, 20.9% had suspected conductive hearing loss, and 14.9% had unilateral hearing loss, of which 5.4% had suspected conductive loss. Forty adults met the inclusion criteria to be fitted with hearing aids. Nineteen of these were fitted bilaterally. Positive hearing aid outcomes and minimal device handling challenges were reported 45 days post-fitting and were maintained at six months. The majority (73.7%) of participants fitted were still making use of their hearing aids at the six-month follow-up.

Conclusions
Implementing a hearing healthcare service-delivery model facilitated by CHWs in low-income communities is feasible. mHealth technologies used by CHWs can support scalable service-delivery models with the potential for improved access and affordability in low-income settings.

OSI Number – 21741

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