https://orcid.org/0000-0002-9922-2927
![Sample our Social Sciences journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/110822/TOC-Subject-Sample-2021-Social-Sciences.jpg"})
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.
Responsible Editor
Jennifer Stewart Williams
Responsible Editor
Jennifer Stewart Williams
Acknowledgments
The authors would like to thank and acknowledge the CHWs, Lundi Mdokwana, Zukiswa Mtimkulu, and Neziswa Fololo, for their dedication and assistance in implementing this service-delivery model. The CHWs were not involved in the research design, analysis, data interpretation, or research article compilation.
Disclosure statement
The authors declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: The fifth author is the director of the hearX Foundation. The last author is a co-founder and scientific advisor for the hearX Group, South Africa.
Ethics and consent
Ethical approval was granted by the Research Ethics Committee, Faculty of Humanities, University of Pretoria (HUM030/0621). Written consent was obtained from participants before the commencement of data collection.
Paper context
Task-shifting supported by mHealth technologies has enabled community healthcare workers to provide various hearing healthcare services. Currently, however, there is a lack of evidence for a comprehensive community-based model for adult hearing care. This study evaluated an innovative hearing service-delivery model in a low-income community, using community healthcare workers supported by mHealth technologies. This model has the potential to improve accessibility and affordability in low-income countries to manage hearing loss.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/16549716.2022.2095784
Additional information
Funding
Notes on contributors
Caitlin Frisby
According to the International Committee of Medical Journal Editors criteria, all authors have contributed equally to this work and met the authorship requirements.