Smartphone accessible audiology modules: improving access to basic ear and hearing health education for primary care providers in Tanzania.

Abstract

Objective: To develop and pilot test a combined-learning intervention for Tanzanian primary healthcare workers on ear and hearing care (EHC), comprising five self-led smartphone-based modules and in-person workshops.

Design: The intervention was piloted with primary healthcare workers in Tanzania. Pre- and post-training surveys assessed knowledge, confidence, and attitudes towards EHC via Likert scales. Statistical analysis (paired t-tests, McNemar tests) evaluated outcomes; p < 0.05 was considered statistically significant.

Study sample: 24 local Tanzanian primary healthcare workers.

Results: Post-training, participants showed significant improvements in EHC education and skills, including auditory pathology and anatomy (p < 0.01), cerumen extraction (p < 0.01), infection prevention protocols (p < 0.01), otoscopy (p = 0.02), paediatric referral protocols (p = 0.02), diagnostic identification of common otologic conditions (p < 0.01), and management of ear discharge (p < 0.01). However, confidence in interpreting audiograms (p = 0.08) and tympanograms (p = 0.19) remained unchanged, with participants requesting further hands-on training.

Conclusions: Smartphone-based learning paired with in-person training effectively enhanced practical EHC skills among primary healthcare workers, supporting task-shifting in low-resource settings. Perceived gaps in interpreting audiological tests highlight the need for further hands-on training. This model demonstrates scalability potential, particularly with rising smartphone access in Africa. Future iterations should prioritise longitudinal competency assessments and adaptive content to address clinical interpretation challenges, advancing equitable EHC delivery.