My first Magazine EDUCARE MAGAZINE SPECIAL NOVEMBER EDITION 2019 | Page 22

educarelearning
community members using mobile
health (mHealth) technologies. The
project has been run in the Western Cape
in South Africa. This is the first report in
the world of combined hearing and
vision screening for young children.
Our findings show that a mobile
health supported service-delivery system
can dramatically increase access to
hearing and vision services for preschool
children in poor communities.
The research
Between September 2017 and December
2018 we introduced and implemented a
screening programme in preschools in
Khayelitsha and Mitchells Plain in Cape
Town. Both are poor communities.
We appointed unemployed community
members and trained them as lay health
workers to provide both hearing and
vision screening at preschool centres.
We gave the community health workers
smar tphones with pre-installed
applications. The mobile health
technology used was provided by the
hearX Group, a digital health company
that was started from our work at the
University of Pretoria. The hearScreen
app provided a quick and reliable hearing
check using automated protocols and
user-friendly designs. Vision was
checked using the Peek Acuity app
provided by the UK-based partner Peek
Vision. Peek vision has been used
previously for population-based testing
in countries like Kenya.
Children who failed the initial hearing
screening were screened for a second
time a week later. The screening was
done at their preschool. It included
otoscopy, an examination that involves
looking into the inner ear with an
instrument called an otoscope. The
project audiologist conducted this
second screening. Children who failed
this screening were referred to public
health diagnostic audiology services.
Children who failed the initial vision
screening and re-screening were referred
to primary health care facilities for a
diagnostic optometry evaluation.
All follow-up ser vices and
interventions were provided by public
health services, for example, hearing
aids, spectacles, or other medical
intervention.
Our programme, the Ears and Eyes for
Education project, is supported by a
local NGO for children with hearing
loss, the Carel du Toit centre, as an
implementation partner. The project is
also supported by the Swiss-based Hear
the World foundation.
The results from the first 8023 children
screened across 271 preschools show
hearing and vision ability was accurately
assessed at low cost.
Referral rates for follow-up services
were comparable to school screening by
health professionals. Average test time
for hearing and vision in our programme
was just over 2 minutes, cutting typical
test times in half.
The community-based model meant that
tests were done for $5.63. This included
all costs related to testing and personnel.
More than a hundred children in this
3
sample were diagnosed with a hearing or
visual impairment for the very first time.
They are now receiving treatment.
Scaling impact for hearing and vision
care
The enormous disparity between the
global need for hearing and vision
services, and the inability of traditional
models delivered by trained
professionals to address this need, is a
clear call for new ways of making care
widely accessible.
This research showcases the potential
of mobile health innovations to enable
the transformation in the lives of
children with hearing and vision
problems. It is especially encouraging
because children from disadvantaged
communities, who already face many
challenges, are being helped.
Author
De Wet Swanepoel
Professor in Audiology in the Department of Speech-Language
Pathology and Audiology, University of Pretoria, also co-
founder and scientific advisor to the hearX group
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