Language and culture in speech-language and hearing professions in South Africa: Re-imagining practice.

Abstract

South African speech-language and hearing (SLH) professions are facing significant challenges in the provision of clinical services to patients from a context that is culturally and linguistically diverse (CLD) due to historic exclusions in higher education training programmes. Over 20 years postapartheid, little has changed in training, research, as well as clinical service provision in these professions. In line with the Health Professions Council of South Africa's (HPCSA) SLH Professional Board's quest to transform SLH curriculum and in adherence to its recently published Guidelines for Practice in a CLD South Africa, in this review article, the authors deliberate on re-imagining practice within the African context. They do this within a known demand versus capacity challenge, as well as an existing clinician versus patients CLD incongruence, where even the clinical educators, a majority of whom are not African, are facing the challenge of an ever more diverse student cohort. The authors systematically deliberate on this in undergraduate clinical curriculum, challenging the professions to interrogate their clinical orientation with respect to African contextual relevance and contextual responsiveness (and responsibility); identifying gaps within clinical training and training platforms; highlighting the influencing factors with regard to the provision of linguistically and culturally appropriate SLH clinical training services and, lastly, making recommendations about what needs to happen. The Afrocentric Batho Pele principles, framed around the concept of ubuntu, which guide clinical intervention within the South African Healthcare sector, frame the deliberations in this article.