1
|
Parmar B, Phiri M, Jailos L, Kachapila R, Saleb B, Mulwafu W, Manchaiah V, Bhamla MS. Comparing outcomes of ultra-low-cost hearing aids to programmable, refurbished hearing aids for adults with high frequency hearing loss in Malawi: a feasibility study. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1153056. [PMID: 37378050 PMCID: PMC10291059 DOI: 10.3389/fresc.2023.1153056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 05/08/2023] [Indexed: 06/29/2023]
Abstract
Introduction Access to ear and hearing health services are limited or non-existent in low-income countries, with less than 10% of the global production of hearing aids distributed to this population. The aim of this feasibility study was to compare the outcomes of an ultra-low-cost hearing aid (LoCHAid) to programmable, refurbished hearing aids for adults with high-frequency hearing loss, in Blantyre, Malawi. Methods Sixteen adults with high frequency hearing loss, and no prior experience of hearing aids, took part in this study, nine were fitted with the LoCHAid and seven were fitted with refurbished, programmable hearing aids, for a one-month trial. Five standardized hearing qualities questionnaires were used to compare outcomes pre and post device fitting and between devices. Questionnaire scales were analysed using general linear models and inductive thematic analysis was used to evaluate qualitative data. Results Overall, there was no significant difference found between LoCHAid and refurbished hearing aids, and the two device types each showed a similar degree of improvement after fitting. Qualitative data analysis identified two key themes: Sound Quality and User experience. Conclusion The results from this feasibility study are encouraging, but a comprehensive, larger clinical study is needed to draw firm conclusions about the LoCHAid's performance. This study has identified key improvement indicators required to enhance sound quality and user experience of the LoCHAid.
Collapse
Affiliation(s)
- Bhavisha Parmar
- DeafKidz International, London, United Kingdom
- Ear Institute, University College London, London, United Kingdom
- SOUND lab, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Mwanaisha Phiri
- Audiology and ENT, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Louis Jailos
- Audiology and ENT, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Regina Kachapila
- Audiology and ENT, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Benjamin Saleb
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, United States
- Interdisciplinary Graduate Program in Quantitative Biosciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Wakisa Mulwafu
- Audiology and ENT, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Vinay Manchaiah
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, United States
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, CO, United States
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - M. Saad Bhamla
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| |
Collapse
|
2
|
Abstract
Having predictable, stable and adequate financial resources is essential for achieving universal coverage of essential health products and services, including assistive products. Access to such resources would enable governments and participating organizations to initiate and maintain a system for providing assistive products and associated services, as well as to grow the scope and scale of their operations over time. While limited funding is not the only reason to explain the shortfall in the provision of assistive products globally, unpredictable and inadequate public funding has been cited as the primary cause of poor access to these products in many countries. Several financing options have been presented in this paper that could be considered by decision-makers to initiate or supplement the financing of assistive products.
Collapse
Affiliation(s)
- Kiu Tay-Teo
- Department of Health Products Policy and Standards, World Health Organization, Geneva, Switzerland
| | - Diane Bell
- Faculty of Business and Management Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.,Department of Health Systems Governance and Financing, Stellenbosch University, Stellenbosch, South Africa
| | - Matthew Jowett
- Department of Health Products Policy and Standards, World Health Organization, Geneva, Switzerland
| |
Collapse
|
4
|
Stevens H, Huys I. Innovative Approaches to Increase Access to Medicines in Developing Countries. Front Med (Lausanne) 2017. [PMID: 29270407 DOI: 10.3389/fmed.2017.00218/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Access to essential medicines is problematic for one third of all persons worldwide. The price of many medicines (i.e., drugs, vaccines, and diagnostics) is unaffordable to the majority of the population in need, especially in least-developed countries, but also increasingly in middle-income countries. Several innovative approaches, based on partnerships, intellectual property, and pricing, are used to stimulate innovation, promote healthcare delivery, and reduce global health disparities. No single approach suffices, and therefore stakeholders need to further engage in partnerships promoting knowledge and technology transfer in assuring essential medicines to be manufactured, authorized, and distributed in low- and middle-income countries (LMICs) in an effort of making them available at affordable and acceptable conditions.
Collapse
Affiliation(s)
- Hilde Stevens
- Institute for Interdisciplinary Innovation in healthcare (I3h), Unversité libre de Bruxelles (ULB), Brussels, Belgium
| | - Isabelle Huys
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
5
|
Stevens H, Huys I. Innovative Approaches to Increase Access to Medicines in Developing Countries. Front Med (Lausanne) 2017; 4:218. [PMID: 29270407 PMCID: PMC5725781 DOI: 10.3389/fmed.2017.00218] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/20/2017] [Indexed: 11/13/2022] Open
Abstract
Access to essential medicines is problematic for one third of all persons worldwide. The price of many medicines (i.e., drugs, vaccines, and diagnostics) is unaffordable to the majority of the population in need, especially in least-developed countries, but also increasingly in middle-income countries. Several innovative approaches, based on partnerships, intellectual property, and pricing, are used to stimulate innovation, promote healthcare delivery, and reduce global health disparities. No single approach suffices, and therefore stakeholders need to further engage in partnerships promoting knowledge and technology transfer in assuring essential medicines to be manufactured, authorized, and distributed in low- and middle-income countries (LMICs) in an effort of making them available at affordable and acceptable conditions.
Collapse
Affiliation(s)
- Hilde Stevens
- Institute for Interdisciplinary Innovation in healthcare (I3h), Unversité libre de Bruxelles (ULB), Brussels, Belgium
| | - Isabelle Huys
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
6
|
Keidser G, Convery E. Self-Fitting Hearing Aids: Status Quo and Future Predictions. Trends Hear 2016; 20:2331216516643284. [PMID: 27072929 PMCID: PMC4871211 DOI: 10.1177/2331216516643284] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 11/27/2022] Open
Abstract
A self-contained, self-fitting hearing aid (SFHA) is a device that enables the user to perform both threshold measurements leading to a prescribed hearing aid setting and fine-tuning, without the need for audiological support or access to other equipment. The SFHA has been proposed as a potential solution to address unmet hearing health care in developing countries and remote locations in the developed world and is considered a means to lower cost and increase uptake of hearing aids in developed countries. This article reviews the status of the SFHA and the evidence for its feasibility and challenges and predicts where it is heading. Devices that can be considered partly or fully self-fitting without audiological support were identified in the direct-to-consumer market. None of these devices are considered self-contained as they require access to other hardware such as a proprietary interface, computer, smartphone, or tablet for manipulation. While there is evidence that self-administered fitting processes can provide valid and reliable results, their success relies on user-friendly device designs and interfaces and easy-to-interpret instructions. Until these issues have been sufficiently addressed, optional assistance with the self-fitting process and on-going use of SFHAs is recommended. Affordability and a sustainable delivery system remain additional challenges for the SFHA in developing countries. Future predictions include a growth in self-fitting products, with most future SFHAs consisting of earpieces that connect wirelessly with a smartphone and providers offering assistance through a telehealth infrastructure, and the integration of SFHAs into the traditional hearing health-care model.
Collapse
Affiliation(s)
- Gitte Keidser
- National Acoustic Laboratories and the Hearing CRC, New South Wales, Australia
| | - Elizabeth Convery
- National Acoustic Laboratories and the Hearing CRC, New South Wales, Australia
| |
Collapse
|