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IHHAPP Addresses Barrier to Hearing Aid Fittings in Developing Countries

Fried, Debra

doi: 10.1097/01.HJ.0000425798.49439.e1

Ms. Fried is the coordinator of the Audiology Center and the program manager of the Newborn Hearing Screening Program at Mount Sinai Medical Center in New York. She is also a director of audiology for Mayflower Medical Outreach.

Figure. Deb

Figure. Deb



About 278 million people—4.2 percent of the world population—have disabling hearing impairment, according to the World Health Organization (WHO). The vast majority of these individuals live in resource-poor countries, where access to audiology services is limited. Developing countries need an estimated seven million hearing aids, but fewer than one million people actually have this technology. The reasons for this paucity of hearing aid fittings are complex, but one of the major barriers to providing hearing aids has been their high cost.

Audiologists involved with humanitarian missions seek to bring hearing aids to the communities they serve. Obtaining donated hearing aids is an excellent start, but a sustainable program cannot reach its potential without a long-term commitment for donations. The high single-unit cost of hearing aids generally prevents the acquisition of large quantities for distribution. The International Humanitarian Hearing Aid Purchasing Program (IHHAPP) was developed to address this issue.

In keeping with the overall vision and mission of the WHO, the goal of IHHAPP is to ensure that the high-quality hearing aids required to serve the large population of individuals in developing countries who have hearing loss are accessible and affordable. This mission follows in the footsteps of various individuals and organizations that have spearheaded such movements since 1995. The IHHAPP goal of affordability can be met by entering into special agreements with respected hearing aid manufacturers to purchase hearing aids at reduced cost.

IHHAPP is able to offer new, low-cost, high-quality, digital behind-the-ear hearing aids to qualified members. Sophisticated equipment is not necessary; all adjustments can be made with a mini screwdriver. These devices have trim pots for adjusting low- and high-frequency gain and maximum power output. Feedback management and noise-reduction features are also included, as are listening programs for noise. Telecoils are available on some models. The current models offered can amplify mild to profound hearing losses. The price per unit is under $100, with discounts offered for high-volume orders.

IHHAPP works to facilitate hearing aid purchases to qualified humanitarian programs and nonprofit organizations worldwide. The hearing aids are not intended to be sold for profit or to compete with existing hearing aid distribution networks. Mayflower Medical Outreach, a U.S. non-governmental organization with a long track record in working with the hearing-impaired population in Nicaragua, is administering IHHAPP. Mayflower Medical Outreach audiologists and otolaryngologists have extensive experience working with humanitarian projects.

A streamlined web-based ordering process has been launched for prospective clients. The hearing aid company's specification sheets and pricing information are available through the website, as is contact information for inquiries. Potential members apply by completing an application. They are required to provide information about their organization and hearing aid program, letters of reference, and a signed letter of agreement. Once approved, members can place their orders online. The hearing aids are shipped directly to them.

IHHAPP seeks to increase the number of participating hearing aid manufacturers to provide clients with a wide choice. This also represents an excellent opportunity for hearing aid manufacturers to expand their reach internationally by serving new markets. Eliminating high cost as a barrier represents a step in the right direction for true global hearing health care, with the ultimate goal to expand the distribution of hearing aids worldwide to underserved populations.

Visit the IHHAPP website at or email the organization at for more information.

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Audiology Without Borders

This column highlights the works of humanitarian hearing healthcare programs and is edited by active humanitarians Jackie Clark, PhD, and King Chung, PhD. Dr. Clark is a clinical associate professor in audiology at the University of Texas at Dallas, and Dr. Chung is an associate professor of audiology at Northern Illinois University in DeKalb.

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