Infant hearing screening from a developing country context: status from two South African provinces

Background: New-born 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 imperative therefore to explore if and how the current experience measures up to these recommendations.Objective: to explore the feasibility of and the current status of the implementation of NHS at various levels of health care within the South African context.Methods: A non-experimental, descriptive, cross-sectional survey research design was employed, using a combination of questionnaires and face-to-face semi-structured interviews. Participants comprised 30 primary health care (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: Current findings indicated 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 their varied resource allocations and levels of specialisation; EHDI implementation as advocated by the HPCSA (2007) position statement currently does not seem feasible, unless the number of barriers identified are addressed, and NHS becomes mandated.Conclusion: Current findings have highlighted the need for ensuring 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-intentioned programme

Infant Hearing Screening at Primary Healthcare Immunisation Clinics in South Africa: The Current Status

Background. In the developing world; it is critical that the acceptable principle that early hearing detection and intervention (EHDI) programmes be contextually useful; given the extensive level of difficulties faced by these regions. The Health Professions Council of South Africa (HPCSA) has recommended specific contexts in which to actualise EHDI application. One of these contexts relates to hearing screening at immunisation clinics within the first 6 weeks of life.Objective. To explore the current status of the implementation of the HPCSA's 2007 guidelines for clinic-based hearing screening within the South African primary healthcare clinic (PHC) setting. Methods. Within a qualitative research design; 30 PHC nurses representing 30 PHC clinics in the North West and Gauteng Provinces were interviewed using a structured questionnaire. Qualitative as well as thematic content analysis strategies were adopted in analysing data.Results. There is a lack of formal EHDI implementation at PHC clinics in both provinces. Lack of equipment; budgetary constraints and human resource challenges are the reasons for this. Regardless of the province's socioeconomic development based on the deprivation index; EHDI implementation at clinic level is not feasible unless the barriers are addressed. Conclusion. There is a need to ensure that context-specific studies in EHDI are conducted. This will ensure that national position statements are sensitive to contextual challenges and that they allow for evidence-based practice. This is particularly relevant in developing countries where resource constraints dictate the success or failure of any well-intentioned programme. The HPCSA's 2007 position statement needs to be reviewed taking careful cognisance of feasibility study findings such as the current one. Findings have implications for nurses training; future studies; and policy formulation; as well as clinical plans for EHDI in developing contexts