Abstract

BackgroundThere is slow progress in early hearing detection and intervention (EHDI) services within South Africa. Audiologists are EHDI gatekeepers and can provide valuable insights into the barriers and facilitators that can progressively move EHDI towards best practice in South Africa.ObjectivesThe study aimed to determine the barriers and facilitators to EHDI in KwaZulu-Natal as reported by audiologists/speech therapists and audiologists (A/STAs).MethodA descriptive qualitative approach was used. Telephonic interviews were conducted with 12 A/STAs working in public and private healthcare facilities, using the strengths, weaknesses, opportunities, threats (SWOT) conceptual framework. Data was analysed using thematic analysis in conjunction with NVivo software.ResultsOne of the main barriers perceived by A/STAs, affecting EHDI was the lack of resources in healthcare facilities. The participants indicated that although there was a guideline in place to guide practice, it may be more suited to an urban area versus a rural area. Poor knowledge and awareness of EHDI was also identified as a barrier. Information provided from A/STAs at grassroots level, in the various provinces, may benefit in developing a more contextually relevant and practical guideline. Facilitators included; development of task teams specifically for EHDI programmes, creation of improved communication networks for collaboration and communication, training of healthcare professionals and improving data management systems.ConclusionStrategies such as an increase in resources, further education and training, development of contextually relevant, culturally, and linguistically diverse practices and protocols need to be in place to improve EHDI implementation. Further research, clinical implications and limitations are provided emanating from the study.

Highlights

  • Hearing loss is seen as a silent epidemic because of its invisible nature, as many clinical examinations fail to identify it (Petersen & Ramma, 2015) and is more predominant in neonates compared to other disorders routinely screened for (Imam, El-Farrash, Taha, & Bishoy, 2013)

  • This study aimed to explore the barriers and facilitators to early hearing detection and intervention (EHDI) in KZN, as reported by audiologists/speech therapists, and audiologists (A/STAs)

  • The first theme related to EHDI guideline improvements and included the aspects linked to guideline development, implementation, and review

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Summary

Introduction

Hearing loss is seen as a silent epidemic because of its invisible nature, as many clinical examinations fail to identify it (Petersen & Ramma, 2015) and is more predominant in neonates compared to other disorders routinely screened for (Imam, El-Farrash, Taha, & Bishoy, 2013). In South Africa, approximately 6357 children annually are born with a permanent hearing loss or develop it at an early age, with the majority being born in the public healthcare sector (Teixeira & Joubert, 2014). The prevalence of infants born with a permanent hearing loss in the public sector in South Africa is 3–6 per 1000 births (Khoza-Shangase, Kanji, Petrocchi-Bartal, & Farr, 2017; Michal & Khoza-Shangase, 2014). The early hearing detection and intervention (EHDI) guidelines were released by the Health Professions Council of South Africa (HPCSA) (HPCSA, 2007, 2018). EHDI programmes are the proposed standard of care for newborns and infants presenting with a hearing loss, enabling http://www.sajcd.org.za. There is slow progress in early hearing detection and intervention (EHDI) services within South Africa.

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