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Waterworth CJ, Marella M, O'Donovan J, Bright T, Dowell R, Bhutta MF. Barriers to access to ear and hearing care services in low- and middle- income countries: A scoping review. Glob Public Health 2022; 17:3869-3893. [PMID: 35319345 DOI: 10.1080/17441692.2022.2053734] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
People living in low- and middle- income countries (LMICs) meet significant challenges in accessing ear and hearing care (EHC) services. We conducted a scoping review to identify and summarise such barriers, to recognise gaps in the literature, and to identify potential solutions. Reviewers independently screened titles, abstracts and full-text articles and charted data. We undertook thematic analysis of supply and demand side dimensions of access, and summarised findings mapped against the Levesque framework. Of 3048 articles screened, 62 met inclusion criteria for review. Across the five access dimensions, supply-side constraints were more frequently described, the most common being a shortage of EHC workforce or appropriate facilities, despite high demand. We identified a thin geographical spread of literature on barriers to accessing EHC services in LMICs, reflecting low availability of such services. LMICs face a diverse range of demand and supply side challenges including workforce, equipment and resource shortages, and challenges for the majority of the population to pay for such services. There is a need for many LMICs to develop health policy and programmes in EHC, including integration into primary care, scaling up the EHC workforce through increased training and education, and improving EHC literacy through public health measures.
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Affiliation(s)
- Christopher J Waterworth
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia.,Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Manjula Marella
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - James O'Donovan
- Postgraduate School of Primary Care, Health Education North East England, Newcastle-upon-Tyne, UK
| | - Tess Bright
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Richard Dowell
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia
| | - Mahmood F Bhutta
- Clinical and Experimental Medicine, Brighton & Sussex Medical School, Brighton, UK.,Department of ENT, University Hospitals Sussex NHS Trust, Brighton, UK
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Kawakatsu Y, Adolph C, Mosser JF, Baffoe P, Cheshi F, Aiga H, Watkins D, Sherr KH. Factors consistently associated with utilisation of essential maternal and child health services in Nigeria: analysis of the five Nigerian national household surveys (2003-2018). BMJ Open 2022; 12:e061747. [PMID: 36115678 PMCID: PMC9486329 DOI: 10.1136/bmjopen-2022-061747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This study aims to identify the individual and contextual factors consistently associated with utilisation of essential maternal and child health services in Nigeria across time and household geolocation. DESIGN, SETTING AND PARTICIPANTS Secondary data from five nationally representative household surveys conducted in Nigeria from 2003 to 2018 were used in this study. The study participants are women and children depending on essential maternal and child health (MCH) services. OUTCOME MEASURES The outcome measures were indicators of whether participants used each of the following essential MCH services: antenatal care, facility-based delivery, modern contraceptive use, childhood immunisations (BCG, diphtheria, tetanus, pertussis/Pentavalent and measles) and treatments of childhood illnesses (fever, cough and diarrhoea). METHODS We estimated generalised additive models with logit links and smoothing terms for households' geolocation and survey years. RESULTS Higher maternal education and households' wealth were significantly associated with utilisation of all types of essential MCH services (p<0.05). On the other hand, households with more children under 5 years of age and in poor communities were significantly less likely to use essential MCH services (p<0.05). Except for childhood immunisations, greater access to transport was positively associated with utilisation (p<0.05). Households with longer travel times to the most accessible health facility were less likely to use all types of essential MCH services (p<0.05), except modern contraceptive use and treatment of childhood fever and/or cough. CONCLUSION This study adds to the evidence that maternal education and household wealth status are consistently associated with utilisation of essential MCH services across time and space. To increase utilisation of essential MCH services across different geolocations, interventions targeting poor communities and households with more children under 5 years of age should be appropriately designed. Moreover, additional interventions should prioritise to reduce inequities of essential MCH service utilisation between the wealth quantiles and between education status.
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Affiliation(s)
- Yoshito Kawakatsu
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Community-based Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Christopher Adolph
- Department of Political Science, University of Washington, Seattle, Washington, USA
- Center for Statistics and the Social Sciences, University of Washington, Seattle, Washington, USA
| | - Jonathan F Mosser
- Department of Health Metrics Sciences, University of Washington, Seattle, Washington, USA
| | | | | | - Hirotsugu Aiga
- Department of Health System Development, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - David Watkins
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Kenneth H Sherr
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Industrial & Systems Engineering, University of Washington, Seattle, Washington, USA
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Desalew A, Feto Gelano T, Semahegn A, Geda B, Ali T. Childhood hearing impairment and its associated factors in sub-Saharan Africa in the 21st century: A systematic review and meta-analysis. SAGE Open Med 2020. [PMID: 32435486 DOI: 10.1177/2050312120919240.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Childhood hearing impairment is still a significant cause of disability in the 21st century in developing countries. Particularly, the burden is more severe in sub-Saharan Africa, where the majority of children with hearing problems is living. Thre are great variations and inconsistencies of available findings conducted in sub-Saharan Africa. Hence, the aim of this review was to determine the pooled prevalence of childhood hearing impairment and its associated factors in sub-Saharan Africa. Methods Studies were searched from main databases (PubMed, CINAHL, and African Journals Online), Google Scholar, and other relevant sources using electronic and manual techniques. All observational studies, written in English and conducted among participants (aged less than 18 years) from 2000 to 2018, were eligible. Heterogeneity between included studies was assessed using I2, and publication bias was explored using visual inspection of the funnel plot. Statistical analysis was carried out to determine pooled prevalence using Stata version 14. In addition, subgroup analysis was carried out for the normality criteria of hearing thresholds and characteristics of the study populations. Results The pooled prevalence of hearing impairment was 10% (95% confidence interval (CI): 9%-11%). The magnitude of hearing impairment varies with the normality criterion used. The most commonly used threshold was 25 and 30 dB hearing level. The prevalence of hearing impairment based on normality criterion (>20 dB, >25 dB, >30 dB, and >35 dB) were 17%, 19%, 2%, and 1%, respectively. While in the questionnaire-based evaluation, the prevalence was 6% (95% CI: 3%-9%). In addition, based on population characteristics, the prevalence of hearing impairment for school or community-based children was 6% (95% CI: 5%-7%) while the prevalence for children with comorbidities was 23% (95% CI: 15%-31%). Chronic suppurative otitis media, impacted cerumen, advanced stage of human immunodeficiency virus, tuberculosis infection, and age of the children were associated with hearing impairment in sub-Saharan Africa. Conclusion Hearing impairment in children and adolescents in sub-Saharan Africa was high, and associated with preventable and treatable risk factors.
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Affiliation(s)
- Assefa Desalew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilayie Feto Gelano
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Agumasie Semahegn
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Ali
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Desalew A, Feto Gelano T, Semahegn A, Geda B, Ali T. Childhood hearing impairment and its associated factors in sub-Saharan Africa in the 21st century: A systematic review and meta-analysis. SAGE Open Med 2020; 8:2050312120919240. [PMID: 32435486 PMCID: PMC7222652 DOI: 10.1177/2050312120919240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Childhood hearing impairment is still a significant cause of disability in the 21st century in developing countries. Particularly, the burden is more severe in sub-Saharan Africa, where the majority of children with hearing problems is living. Thre are great variations and inconsistencies of available findings conducted in sub-Saharan Africa. Hence, the aim of this review was to determine the pooled prevalence of childhood hearing impairment and its associated factors in sub-Saharan Africa. METHODS Studies were searched from main databases (PubMed, CINAHL, and African Journals Online), Google Scholar, and other relevant sources using electronic and manual techniques. All observational studies, written in English and conducted among participants (aged less than 18 years) from 2000 to 2018, were eligible. Heterogeneity between included studies was assessed using I2, and publication bias was explored using visual inspection of the funnel plot. Statistical analysis was carried out to determine pooled prevalence using Stata version 14. In addition, subgroup analysis was carried out for the normality criteria of hearing thresholds and characteristics of the study populations. RESULTS The pooled prevalence of hearing impairment was 10% (95% confidence interval (CI): 9%-11%). The magnitude of hearing impairment varies with the normality criterion used. The most commonly used threshold was 25 and 30 dB hearing level. The prevalence of hearing impairment based on normality criterion (>20 dB, >25 dB, >30 dB, and >35 dB) were 17%, 19%, 2%, and 1%, respectively. While in the questionnaire-based evaluation, the prevalence was 6% (95% CI: 3%-9%). In addition, based on population characteristics, the prevalence of hearing impairment for school or community-based children was 6% (95% CI: 5%-7%) while the prevalence for children with comorbidities was 23% (95% CI: 15%-31%). Chronic suppurative otitis media, impacted cerumen, advanced stage of human immunodeficiency virus, tuberculosis infection, and age of the children were associated with hearing impairment in sub-Saharan Africa. CONCLUSION Hearing impairment in children and adolescents in sub-Saharan Africa was high, and associated with preventable and treatable risk factors.
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Affiliation(s)
- Assefa Desalew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilayie Feto Gelano
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Agumasie Semahegn
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Ali
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102165. [PMID: 30279358 PMCID: PMC6210163 DOI: 10.3390/ijerph15102165] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 02/05/2023]
Abstract
Rehabilitation seeks to optimize functioning of people with impairments and includes a range of specific health services—diagnosis, treatment, surgery, assistive devices, and therapy. Evidence on access to rehabilitation services for people with disabilities in low- and middle-income countries (LMICs) is limited. A systematic review was conducted to examine this in depth. In February 2017, six databases were searched for studies measuring access to rehabilitation among people with disabilities in LMICs. Eligible measures of access to rehabilitation included: use of assistive devices, use of specialist health services, and adherence to treatment. Two reviewers independently screened titles, abstracts, and full texts. Data was extracted by one reviewer and checked by a second. Of 13,048 screened studies, 77 were eligible for inclusion. These covered a broad geographic area. 17% of studies measured access to hearing-specific services; 22% vision-specific; 31% physical impairment-specific; and 44% measured access to mental impairment-specific services. A further 35% measured access to services for any disability. A diverse range of measures of disability and access were used across studies making comparability difficult. However, there was some evidence that access to rehabilitation is low among people with disabilities. No clear patterns were seen in access by equity measures such as age, locality, socioeconomic status, or country income group due to the limited number of studies measuring these indicators, and the range of measures used. Access to rehabilitation services was highly variable and poorly measured within the studies in the review, but generally shown to be low. Far better metrics are needed, including through clinical assessment, before we have a true appreciation of the population level need for and coverage of these services.
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Chakrabarti S. State of deaf children in West Bengal, India: What can be done to improve outcome. Int J Pediatr Otorhinolaryngol 2018; 110:37-42. [PMID: 29859584 DOI: 10.1016/j.ijporl.2018.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/13/2018] [Accepted: 04/26/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Prelingual deafness in children demands urgent action as best outcome is dependent on earliest possible diagnosis and intervention. Objective of this study was to determine age of suspicion, diagnosis, intervention, and outcome in a representative group of deaf children in West Bengal, India, and suggest ways of improving these parameters. METHODS In this cross-sectional study, ages of suspicion, diagnosis, intervention and outcome of 303 randomly selected deaf children were elicited from a cohort of 1316 children with deafness identified in an earlier study. RESULTS Median ages of suspicion, diagnosis and amplification were 18, 72 and 84 months respectively. Age of suspicion was significantly related to parental education (p < 0.05); age of diagnosis to parental education and socio-economic status (p < 0.001) and children's geographic location (p < 0.01). Following diagnosis, 86% of children received hearing aids but only 6% used their aids consistently; 86% were non-verbal, 12% could communicate with a mixture of speech and gesture and only 2% with speech alone. CONCLUSION Current situation of deaf children in West Bengal, and evidence indicates, in much of India, is insupportable. However, widely diverse socio-economic conditions and scarcity of public health infrastructure preclude one solution of the problem for the whole country. In absence of the ideal universal newborn hearing screening, rigorously monitored and costed pilot programs of different models of early detection and intervention using newborn hearing screening, targeted screening and trial of calibrated noisemakers by primary care workers should be tried to see which works best where, so that successful programs can be scaled up over time.
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Affiliation(s)
- Suniti Chakrabarti
- Pratibandhi Kalyan Kendra, Abinash Mukherjee Road, Hooghly, West Bengal, PIN 712103, India.
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Mactaggart I, Cappa C, Kuper H, Loeb M, Polack S. Field testing a draft version of the UNICEF/Washington Group Module on child functioning and disability. Background, methodology and preliminary findings from Cameroon and India. ALTER-EUROPEAN JOURNAL OF DISABILITY RESEARCH 2016; 10:345-360. [PMID: 31049115 DOI: 10.1016/j.alter.2016.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Global child disability data are generally non-comparable, comprising different tools, methodologies and disability definitions. UNICEF and The Washington Group on Disability Statistics (WG) have developed a new tool on child functioning and disability to address this need. Aims The aim of this paper is to describe the development of the new module, and to present an independent field test of the draft module in two contrasting settings. Methods UNICEF and the WG developed a parent-reported survey module to identify children aged 2-17 years with functional difficulties in population-based surveys through: review of existing documentation, consultation with experts and cognitive testing. A field test of the draft module was undertaken in Cameroon and India within a population-based survey. Functional limitation in each of 14 domains was scored on a scale comprising "no difficulty", "some difficulty", "a lot of difficulty" and "cannot do". Results In all, 1713 children in Cameroon and 1101 children in India were assessed. Sixty-four percent of children in Cameroon and 35% of children in India were reported to have at least some difficulty in one or more domain. The proportion reported to have either "a lot of difficulty" or "cannot do" was 9% in Cameroon and 4% in India. There were no significant differences in reported functional difficulties by sex but children aged 2-4 were reported to have fewer functional difficulties of any kind compared with older children in both countries. Conclusion Comparable estimates were generated between the two countries, providing an initial overview of the tool's outputs. The continued development of this standardised questionnaire for the collection of robust and reliable data on child disability is essential.
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Affiliation(s)
- Islay Mactaggart
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Claudia Cappa
- Data and Analytics Section, United Nations Children's Fund, New York, USA
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Mitchell Loeb
- Centres for Disease Control and Prevention/National Centre for Health Statistics, Hyattsville, MD, USA
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
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Mulwafu W, Kuper H, Ensink RJH. Prevalence and causes of hearing impairment in Africa. Trop Med Int Health 2015; 21:158-65. [DOI: 10.1111/tmi.12640] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - H. Kuper
- International Centre for Evidence in Disability; London School of Hygiene and Tropical Medicine; London UK
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Kawakatsu Y, Kaneko S, Karama M, Honda S. Prevalence and risk factors of neurological impairment among children aged 6-9 years: from population based cross sectional study in western Kenya. BMC Pediatr 2012. [PMID: 23206271 PMCID: PMC3519515 DOI: 10.1186/1471-2431-12-186] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The burden of disability is more severe among children in low income countries. Moreover, the number of children with disabilities (CWDs) in sub-Saharan Africa is predicted to increase with reduction in child mortality. Although the issue on CWDs is important in sub-Saharan Africa, there are few researches on risk factors of disabilities. The purpose of this study was to evaluate the risk factors of neurological impairment (NI) among children in western Kenya. Methods The present study was conducted in Mbita district (which has high HIV infectious prevalence), Kenya from April 2009 to December 2010. The study consisted of two phases. In phase 1, the Ten Question Questionnaire (TQQ) was administered to all 6362 caregivers of children aged 6–9 years. In phase two, all 413 children with TQQ positive and a similar number of controls (n=420) which were randomly selected from children with TQQ negative were examined for physical and cognitive status. In addition, a structured questionnaire was also conducted to their caregivers. Results The prevalence was estimated to be 29/1000. Among the types of impairments, cognitive impairment was the most common (24/1000), followed by physical impairment (5/1000). In multivariate analysis, having more than five children [adjusted odds ratio (AOR): 2.85; 95%IC: 1.25 – 6.49; p=0.013], maternal age older than 35 years old [AOR: 2.31; 95%IC: 1.05 – 5.07; p=0.036] were significant factors associated with NI. In addition, monthly income under 3000 ksh [AOR: 2.79; 95%IC: 1.28 – 6.08; p=0.010] and no maternal tetanus shot during antenatal care [AOR: 5.17; 95%IC: 1.56 – 17.14; p=0.007] were also significantly related with having moderate/severe neurological impairment. Conclusion It was indicated that increasing coverage of antenatal care including maternal tetanus shot and education of how to take care of neonatal children to prevent neurological impairment are important.
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An overview of motor skill performance and balance in hearing impaired children. Ital J Pediatr 2011; 37:33. [PMID: 21756300 PMCID: PMC3143087 DOI: 10.1186/1824-7288-37-33] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 07/14/2011] [Indexed: 11/15/2022] Open
Abstract
Childhood hearing impairment is a common chronic condition that may have a major impact on acquisition of speech, social and physical development. Numerous literature states that injury to the vestibular organs may result in accompanying balance and motor development disorders. But still postural control and motor assessments are not a routine procedure in hearing impaired children. Hence, we aim to provide an overview on motor skill performance and balance in hearing impaired children.
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Taha AA, Pratt SR, Farahat TM, Abdel-Rasoul GM, Albtanony MA, Elrashiedy ALE, Alwakeel HR, Zein A. Prevalence and Risk Factors of Hearing Impairment Among Primary-School Children in Shebin El-Kom District, Egypt. Am J Audiol 2010; 19:46-60. [DOI: 10.1044/1059-0889(2010/09-0030)] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
This study examined the feasibility of screening hearing loss in rural and urban schools in Egypt, and investigated the prevalence and causes of hearing impairment (HI) in Egyptian primary-school students.
Method
A total of 555 children (6–12 years of age) from a rural and an urban school in the Shebin El-Kom District of Egypt were screened for HI at their schools. A 2-stage screening procedure was used, and positive cases were referred for a diagnostic hearing assessment at a regional medical facility. Risk factors were investigated through a parent questionnaire and an environmental study consisting of noise, ventilation, and crowding measurements at the schools.
Results
The screening failure rate was 25.6%, and the prevalence of confirmed HI was 20.9%. The rate of HI did not differ across the schools. Conductive hearing loss of minimal to mild severity was the most common type of HI. The most important predictors for HI were parent suspicion, otitis media, household smoking, low socioeconomic status, and postnatal jaundice.
Conclusions
The prevalence of HI did not differ across settings and was more common than reported in children from developed countries. The screening results also suggest that professionals with limited audiology background can be trained to implement hearing screening programs in Egyptian schools.
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Affiliation(s)
| | - Sheila R. Pratt
- University of Pittsburgh and Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Medical System, PA
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van der Spuy T, Pottas L. Infant hearing loss in South Africa: age of intervention and parental needs for support. Int J Audiol 2008; 47 Suppl 1:S30-5. [PMID: 18781511 DOI: 10.1080/14992020802286210] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hearing loss is referred to as the silent, overlooked epidemic in developing countries, and data reporting the mean age of diagnosis and intervention is virtually non-existent due to limited systematic or routine screening programs. The objective of this paper is to present findings of recent practice in early diagnosis and intervention services in an urban South African context, with specific reference to parental needs for support. Data was collected by means of questionnaire surveys for 54 parents of children with congenital or early-onset hearing loss, followed by focus group discussions conducted with 10 parents. The results of this study indicate the mean age of diagnosis to be 23 months (+/-18 SD), the mean age of initial hearing-aid fitting to be 28 months (+/-19 SD), and the mean age of enrollment into an early intervention program to be 31 months (+/-19 SD). In addition, results signify that this diverse and challenging population of parents of young hearing-impaired children largely depends on the ongoing support, guidance, and commitment of the pediatric audiologist.
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Affiliation(s)
- Talita van der Spuy
- Department of Communication Pathology, University of Pretoria, Pretoria, South Africa.
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Yucel E, Derim D, Celik D. The needs of hearing impaired children's parents who attend to auditory verbal therapy-counseling program. Int J Pediatr Otorhinolaryngol 2008; 72:1097-111. [PMID: 18468697 DOI: 10.1016/j.ijporl.2008.03.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2007] [Revised: 03/26/2008] [Accepted: 03/27/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Exploring the information and support needs of parents with hearing impairment in habilitation process. The effects of variables such as duration of hearing aid use and habilitation (duration of intervention) and the number of hearing impaired individuals in family are also considered during the evaluation. METHODS Sixty-five parents of children between 24 and 348 months of age (median: 80) participated in this study by returning the completed in The Family Needs Survey. Age at diagnosis of deafness varied from 1 to 84 months of age (median: 16). The duration of hearing aid use was 8-252 months (median: 24) and the duration of intervention was 2-176 months (median: 36). In view of the fact that the family dynamics might have effects on the type and amount of the needs of parents, the number of siblings (none, two or more siblings) and the presence of hearing impaired individuals apart from their child was also explored. RESULTS The parental needs with regard to different topics such as general information, hearing loss, communication-services and educational resources, family and social support, childcare and community services, financial were evaluated separately. The needs of parents participating in a multi-dimensional Auditory-Verbal intervention program differed by their preferential demands. The duration of intervention was found significantly correlated with the amount of information needs related with other conditions their children may have, explaining their children's hearing problem to others, locating good baby-sitters and day-care programs for their children and transportation (p< or =0.05). It was also found that the long-termed continuing intervention generates additional psychotherapeutic, social and financial needs for the parents. No significant correlation was found between hearing impaired individuals existence with the type and amount of family needs (p>0.05). CONCLUSION These findings support the positive effect of persistent and long-term Auditory-Verbal therapy and Counseling approach which incorporates parents as inalienable members in all rehabilitation process. Creating an adequate and appropriate educational environment by considering individualized needs and family dynamics in a long term and persistent Auditory-Verbal therapy and Counseling approach are all equally important. In addition to a team approach to management, with parents taking a major role in the habilitation process, and all these will lead to a much better outcome.
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Affiliation(s)
- Esra Yucel
- Department of Otorhinolaryngology, Hacettepe University, Audiology and Speech Pathology Section, Ankara, Turkey.
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