Improving access to hearing care in low- and middle-income settings

For World Hearing Day, marked on March 3, the World Health Organisation (WHO) has released new technical guidance on hearing aid service delivery approaches for low- and middle-income settings. The guidance, developed with support from the ATScale Global Partnership for Assistive Technology, is based on the principle of task sharing among specialists and trained non-specialists. It includes two approaches, one targeting adults and the other for children aged 5 and over, and is accompanied by resources with tips for healthy ear care practices, the use of hearing aids, and how to support people living with hearing loss.

The release of the new guide coincides with World Hearing Day. The theme for 2024 is "Changing mindsets: Let us make ear and hearing care a reality for all,"  highlighting the importance of correcting misconceptions about hearing loss that are common among the general public and primary health providers.

Existing mindsets limit access to hearing care: The first of two key challenges in ear and hearing care is the lack of health system capacity for the provision of integrated ear and hearing care throughout people's lives, as evidenced by a lack of policies, human resources, and dedicated finances. The service delivery approaches detailed by WHO aim to overcome this challenge by better utilising non-specialists in providing hearing care to increase capacity.

The second key challenge relates to misperceptions and stigmatising mindsets about hearing loss and ear diseases, which are deeply ingrained within societies and often limit the success of efforts to improve hearing care. Common misperceptions include the idea that hearing loss is an inevitable part of old age and that hearing aids do not work well or are too expensive.

"Common myths about hearing loss often prevent people from seeking the services they require, even where these services are available," said Dr. Shelly Chadha, technical lead for ear and hearing care at WHO. "Any effort to improve hearing care provision through health system strengthening must be accompanied by work to raise awareness within societies and address stigma related to ear and hearing care."

Misperceptions are also prevalent among primary health care providers, who may consider this to be a specialised or difficult-to-provide service, resulting in failure to identify and treat even those conditions that do not need specialist care.

Changing mindsets: Changing mindsets related to ear and hearing care is crucial for improving access and mitigating the cost of unaddressed hearing loss. To address common myths and misperceptions, WHO has released several information products and resources to raise public awareness. A factsheet for health professionals provides a clear rationale and directions for the engagement of primary-level service providers in hearing care provision.

Governments should take steps to integrate ear and hearing care within primary health care, implement community-based approaches that bring services close to people, and lead initiatives to raise awareness and mitigate stigma related to hearing loss. Health care providers must also play their role by ensuring they give due attention and care to people with common ear and hearing problems. Civil society groups, parents, teachers, and physicians can use WHO's awareness materials and community resources to inform people about the importance of ear and hearing care.

Source: World Health Organisation