By Michael Gwarisa
The World Health Organization (WHO) has projected an increasing burden in disabling hearing loss in Africa at the back limited capacity to handle hearing loss ailments, an ill-equipped workforce amongst a host of other factors.
Data from 43 African countries show that while 36 countries provide EHC services at the tertiary level, similar services are not offered at primary care level. This is despite the fact that the common causes of hearing loss are mostly preventable through simple public health interventions, or measures to mitigate the risk factors.
According to country specific data, Zimbabwe currently has a 6 percent prevalence of disabling hearing loss which is one of the highest in the Southern African Region. Neighbouring South Africa has a 3 percent prevalence and Zambia 7’8 percent. According to WHO, over 430 million people globally live with disabling hearing loss and that by 2050 over 700 million people will have this condition. Africa alone has about 40 million people with hearing loss, a prevalence of 3.6%.
Dr Matsidiso Moeti, the WHO African Region Director said hearing loss was silent but growing condition on the region that needs urgent attention.
In the African Region alone, approximately 40 million people live with hearing loss, reflecting a prevalence of 3.6%. The implications of this extend beyond individual experience to affect communities, economies and society at large,” said Dr Moeti.
It is projected that 54 million people in Africa will have disabling hearing loss by 2030, and this will increase to 97 million people by 2050. According to WHO, failure to address hearing loss costs African economies US$ 27.1 billion dollars annually.
Among children living in low- and middle-income countries, the report said, up to 75% of hearing loss is due to preventable causes such as infections and common ear diseases as well as birth complications. Yet, the analysis found that most countries do not routinely conduct hearing screening of newborns.
The report identifies multiple factors driving the surge in prevalence of hearing loss in the African region. Primary among these is an acute shortage of ear and hearing care (EHC) specialists, as well as maldistribution of available workforce to the advantage of urban areas. More than 56% of African countries, for example, have only a single ear, nose and throat (ENT) specialist for every million people. In comparison, the European region has about 50 for every million people.
More than three-quarters of African countries, meanwhile, have fewer than one audiologist and one speech and language therapist for every one million people. In addition, although 33 million Africans could benefit from a hearing aid, only about 10% have access due to lack of EHC financing, and consequent high costs.
“Recognizing the urgency of addressing the situation, the 70th World Health Assembly, through resolution WHA70.13, underscored the need for coordinated global action to prevent hearing loss and facilitate rehabilitation of those affected. This pivotal resolution spurred initiatives such as the World report on hearing, which introduced the H.E.A.R.I.N.G. package of interventions for EHC, offering a comprehensive approach for tackling this challenge.”
She added that the WHO Regional Office for Africa has since embarked on a journey to conduct a comprehensive situational analysis using the WHO Ear and Hearing Care Situation Analysis Tool (EHCSAT).
“The result is this status report that not only outlines the current state of EHC in the African Region but also provides valuable insights into health system capacity and country-specific profiles.”
Even in countries with EHC programmes, EHC interventions are not integrated into such priority health programmes as school health programme, and occupational health or healthy ageing programme. This challenge, the authors said, was compounded by the lack of national policies and plans for strengthening delivery of EHC, and low implementation levels even where these plans exist. In addition, 35% of countries do not have a budget allocated to EHC activities, with patients having to bear the entire cost of any related treatment and care.
