Stakeholders' perspectives on the implementation of school hearing screening in Botswana.

Background: School-based hearing screening programmes play an important role in identifying and providing appropriate intervention services to children with progressive, late-onset, or acquired hearing loss.

Aim: To describe the knowledge and perspectives of government stakeholders within the Ministry of Health and the Ministry of Education and Skills Development on the implementation of school entry hearing screening programmes in Botswana.

Setting: The study was conducted in two administrative districts: Gaborone and the South-East District, Botswana.

Methods: A qualitative descriptive design was used. Fifteen key government stakeholders, including policymakers and service providers (audiologists, nurses, Grade 1 teachers), were purposefully sampled. Semi-structured interviews were conducted with each stakeholder. All audio recordings were transcribed verbatim. Reflexive thematic analysis was performed with the assistance of NVivo 12 software.

Results: There was variable knowledge of policy with most of the service providers not being aware of the existing current national school health policy. All stakeholders interviewed demonstrated universal support for implementation of the policy in relation to school-based hearing screening. Some service providers suggested that hearing screening services could be integrated into existing school health programmes. Barriers and facilitators for policy implementation were also identified.

Conclusion: Stakeholders' knowledge and support of the school health policy suggest that there is potential for the implementation of school-based hearing screening programmes.

Contribution: This study created awareness of a provision for school hearing screening in an existing policy that had not been implemented. The findings present an opportunity for advocating for the implementation of school hearing screening programmes.