Infant hearing screening in a developing-country context: Status in two South African provinces

Abstract

Background. Newborn hearing screening (NHS) programmes are an important step toward early detection of hearing loss and require careful examination and planning within each context. The Health Professions Council of South Africa (HPCSA) has recommended specific contexts in which to actualise early hearing detection and intervention (EHDI) application. It is therefore imperative to explore if, and how, the current experience measures up to these recommendations.

Objective. To explore the feasibility and the current status of the implementation of NHS at various levels of healthcare within the South African context.

Methods. A non-experimental, descriptive, cross-sectional survey research design was employed, using a combination of questionnaires and face-toface semi-structured interviews. Participants comprised 30 primary healthcare (PHC) nursing managers across two provinces (Gauteng and North West) and 24 speech-language therapists and/or audiologists directly involved with NHS in secondary and tertiary levels of care within Gauteng.

Results. Our findings indicated that there was a lack of formal, standardised, and systematic EHDI implementation at all three levels of health care (primary, secondary and tertiary) with valuable reasons such as insufficient knowledge, lack of equipment, budgetary constraints, and human resource challenges being provided for this. Regardless of the level of care and varied resource allocations and levels of specialisation,EHDI implementation as advocated by the HPCSA in its 2007 position statement currently does not seem feasible, unless the number of barriers identified are addressed, and NHS becomes mandated.

Conclusion. Our findings have highlighted the need to ensure that context-specific studies in EHDI are conducted to ensure that national position statements are sensitive to contextual challenges and therefore allow for evidence-based practice, particularly in developing countries where resource constraints dictate success and/or failure of any well-intended programme.