Neonatal hearing screening services at primary health care clinics in Gauteng.

Casoojee, Aisha
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Hearing impairment has been hailed a silent epidemic. Early Hearing Detection and Intervention (EHDI) models of service delivery have therefore been proposed for infants in South Africa so that they may be provided with timely, and appropriate audiological, educational and medical intervention. Neonatal hearing screening in South Africa is currently primarily conducted at Primary Health Care (PHC) clinics. The main objective of the study was to determine whether the neonatal hearing screening services provided at PHC clinics in the City of Johannesburg (CoJ) adhere to the guidelines, norms and standards as outlined by the Integrated National Disability Strategy [INDS] (1997), the Health Professions Council of South Africa [HPCSA] Position Statement (2007) on EHDI and the PHC Package (2002). This was achieved through a non-experimental, descriptive, survey research design. Nurses employed at PHC clinics and children who attended the PHC clinics formed the two participant groups. Data was collected via a self-administered questionnaire, a retrospective data compilation form and observations. Descriptive statistical measures were used to describe the information obtained during data collection. Results indicate that nurses employed within the CoJ PHC clinics do not comply with the proposed neonatal hearing screening practices as outlined in the INDS and the PHC Package. Context specific barriers, including limited knowledge, service delivery gaps, and workload inequities have been identified as contributory factors to the variations and inconsistencies of protocol adherence by PHC nurses. Effective referral systems are important to ensure that these children are provided with appropriate services within the critical period for language development. The optimisation of current governmental hearing screening protocols are thus a feasible, temporary measure until such time that EHDI programmes be mandated at a governmental level.
Audiologist, Early hearing detection and intervention, Primary health care, Hearing screening, Nurses