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Hearing Care Access

Improving Equitable Access to Hearing Care

Swanepoel, De Wet PhD; Roux, Renate le

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doi: 10.1097/01.HJ.0000532398.21300.2f
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Hearing loss is an often-underestimated global health care concern. The most recent World Health Organization (WHO) estimates, however, emphasized the growing global prevalence of disabling hearing loss. The 2018 estimates indicated that 466 million people across the globe are living with disabling hearing loss (Fig. 1). This figure is estimated to increase to 630 million by 2030 and 900 million by 2050 (WHO, 2018). When considering all severities and etiologies of hearing loss, 1.3 billion people had hearing loss in 2016 (Lancet. 2017 Sep 16;390(10100):1211). The impact of disabling hearing loss on the individual is not only sensory, but also extends to their socio-emotional, socio-economic, and vocational spheres (Lancet, 2017; WHO, 2017). Childhood hearing loss may have an especially devastating effect on a child's academic and socio-emotional development as he or she grows older.

Figure 1
Figure 1:
WHO estimates across world regions for prevalence of permanent disabling hearing loss (WHO, 2018).

Disabling hearing loss primarily affects patients and their families, but it also has a secondary impact on a country's societal and economic infrastructures. The WHO estimated that disabling hearing loss had a global cost of over $750 billion international dollars in 2017 (WHO, 2017). While awareness of the burden of disabling hearing loss is increasing, the lack of preventive and treatment programs for hearing loss is a concern.

BARRIERS TO ACCESS

A primary factor in the lack of prevention and treatment programs for hearing loss is inaccessibility of hearing health care services across the globe. In particular, access to hearing health care services in low- to middle-income countries is very limited. For example, in many countries in sub-Saharan Africa, it is not uncommon to find more than a million people per hearing health care provider (WHO, 2013). The lack of hearing health care services in these low- to middle-income countries is alarming, as almost 80 percent of the world's population with disabling hearing loss resides in these countries (Glob Health Action. 2017;10[1]:1289736). The lack of hearing health care services in many places around the world includes limited availability of assistive devices like hearing aids and cochlear implants for people with hearing loss. Hearing aid production cannot meet the global demand for hearing aids, especially in developing countries, where less than three percent of people requiring hearing aids are able to receive them (WHO, 2017).

BRIDGING THE GAP

Alternative service delivery models have been investigated to help increase access to hearing health care using new technologies and decentralized approaches (Am J Audiol. 2017 Oct 12;26(3S):426). New methods that employ the latest technology, including web-based applications and connective devices, and audiological service delivery through telehealth are only some of the promising and sustainable ways to improve the accessibility and affordability of hearing health care (Clark and Swanepoel, 2014).

Increasing access to hearing health care services and resources should be a global priority to reduce the overall prevalence and burden of disabling hearing loss. Developing equitable access to these resources requires engagement and advocacy from patients, caregivers, and stakeholders. For example, the issue of global access to hearing health care will be highlighted in a special roundtable session at the 2018 World Congress of Audiology with WHO's Shelly Chadha, PhD, pioneering hearing care researcher Bolajoko Olusanya from Nigeria, and Jackie Oduor of Kenya, who will share valuable insights into her life as a parent supporting three children with hearing loss. Promoting similar collaborations is a critical step toward identifying issues and solutions to pressing needs issues in global hearing health care.

De Wet Swanepoel, PhD
Renate le Roux
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