By Vinaya Manchaiah and Ross Roeser
This article is a part of the July/August 2018, Volume 30, Number 4, Audiology Today issue.
Background and the Need
It is well established that hearing loss is one of most frequent chronic conditions in older adults and a major health issue, particularly for the low- and middle-income nations. As an example, the World Health Organization (WHO) estimates that there are more than 360 million people with disabling hearing loss (WHO, 2012). Data indicate that more than 80 percent of this population are from low- and middle-income countries with little to no access to any audiological services. Estimates from WHO suggest that in developing nations only about 3 percent of those in need of hearing care have access to and avail themselves of appropriate services (WHO, 2004). Hearing care services are impeded mainly by the two following major barriers:
- Service clustering—Most of the services are confined to urban/suburban areas. For example, a survey of audiologists in private practice reported that only 13 percent are working in rural settings (ASHA, 2015). Even in advanced developing countries like India, greater numbers of hearing–care services are in urban areas with limited access to residents in rural areas (Manchaiah, 2016).
- Cost—High purchase and maintenance expenses are related to hearing aid use. Therefore, there is a clear need for services that are capable of reaching individuals underserved due to limited resources, and those who are deprived financially.
Audiology education and practice vary considerably across countries. In North America and some parts of Europe audiology is well defined, and audiology services and delivery models are quite developed and sophisticated; in some countries audiology is considered an “autonomous” profession. In most parts of the world, however, the profession of audiology is still in its infancy and is viewed as a support profession under the umbrella of another profession (e.g., otolaryngology, acoustics, etc.). Hence, there is much work to be done in audiology to bridge this inequality in education and access to services. Moreover, much can be learned, even within the developed world, by comparing audiology practices across countries and taking inspirations from established and functional working practices to enhance the standard of audiological care.
We believe the first step in bridging the gap in the access to audiology care is to better understand audiology education and practice; and to form a network to connect audiologists and other stakeholders around the world. Based on this premise, our work began on the Global Audiology Initiative.
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