Early hearing detection and intervention in KwaZulu-Natal: analysis of barriers and facilitators from guideline generation to clinical application.
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Background: There is slow progress in early hearing detection and intervention (EHDI) services within South Africa. Despite enabling guidelines, such as the Joint committee on Infant Hearing (JCIH) and Health Professionals Council of South Africa (HPCSA), EHDI guidelines supporting EHDI as a standard of care, various barriers hinder the translation of these guidelines into clinical practice, as envisaged. Audiologists are EHDI gatekeepers and can provide valuable insights into these challenges, as well as strengths or opportunities that can progressively move EHDI towards best practice in South Africa. Objective: The study aimed to determine the barriers and facilitators to EHDI in KwaZulu-Natal (KZN) as reported by audiologists/speech therapists and audiologists’ (A/STAs). Method: An exploratory-descriptive qualitative approach was used, by conducting telephonic interviews with 12 A/STAs working in public and private healthcare facilities, within KwaZulu-Natal. Data was analysed using thematic analysis, in conjunction with NVivo software. Results: Five main themes emerged from the data as follows: improving EHDI guidelines; investing in resources and infrastructure for EHDI service provision; facilitating professional development, training and education and strengthening intersectoral collaboration for EHDI services; managing follow-up and evaluating protocols and procedures for screening; and engaging, understanding and supporting caregivers/families. Conclusion: Despite the availability of EHDI guidelines and some progress in service delivery, participants indicated that implementation of EHDI remains a challenge. Strategies such as an increase in resources, further education and training, development of contextually relevant, culturally and linguistically diverse practices and protocols need to be in place to improve EHDI implementation.