Access to Ear and Hearing Care Globally: A Survey of Stakeholder Perceptions from the Lancet Commission on Global Hearing Loss.

Abstract

Objective: Characterize global access to ear and hearing care (EHC) to inform future policy recommendations.

Study design: Survey using convenience sampling.

Setting: Subjects were surveyed via contact lists of the World Health Organization, Global Otolaryngology-Head and Neck Surgery Initiative, and Global HEAR Collaborative.

Participants: Otolaryngologists, audiologists, other health care professionals, adults with hearing loss, parents/caregivers of children with hearing loss, and policymakers.

Intervention: None.

Main outcome and measures: Responses to questions regarding EHC screening programs, workforce, supports, access to care, and government priority by World Bank income group.

Results: There were 125 included survey responses from EHC stakeholders representing 59 countries: 71% from low- and middle-income countries (LMICs) and 29% from high-income countries (HICs). Compared with respondents from LMICs, those from HICs more frequently indicated that their country had adequate numbers of ENTs, audiologists, SLPs, and EHC community health workers. This trend was consistent across questions regarding number of training programs for EHC workforce, presence of hearing screening programs, cost of hearing aids and cochlear implants, availability of EHC supports and services, affordability of EHC, government funding or investment, and inclusion of EHC in national health strategy.

Conclusion: Globally, EHC is limited by systems-level barriers that disproportionately affect LMICs. Urgent policy development and intervention is needed to eliminate these barriers and improve EHC around the world.