Ear and Hearing Care Workforce: Current Status and its Implications

Abstract

Objective: This study aimed to provide comprehensive global evidence on the availability of ear and hearing care (EHC) professionals and real-life examples that showcase the impact of workforce shortages on the workload faced by existing professionals. Methods: Six sources of data were used to estimate availability of EHC workforce: a scoping literature review, World Health Organization (WHO) National Health Workforce Accounts platform, WHO Member States survey and regional consultations, hearing care organizations survey, and official government statistics. EHC professionals’ workload undertaking common interventions was estimated through the WHO workload indicators of staffing need human resource management tool. Results: With data on otolaryngologists from 138, audiologists from 102, speech and language therapists from 124, and teachers of the deaf from 86 countries, this study revealed large gaps in availability of EHC cadres. The majority of countries in the African region had less than one professional in each cadre per million in comparison with most European countries having up to 50 times higher densities. Workload indicators of staffing need calculations revealed the challenging workload faced by existing EHC professionals, with ratios between existing and required staff of 0.01–0.86. Conclusion: There is an enormous shortage of EHC professionals and urgent actions are needed to ensure sufficient and equitable access to services. Task sharing, a novel approach for improving access to hearing care alongside the development of new cadres, can be a vital strategy in overcoming the shortage of highly qualified providers in many settings, even in well-resourced health systems, to facilitate equitable access to required EHC services.

The world report on hearing, 2021

“…The most glaring gap in health system capacity is in human resources. 11 Among low-income countries surveyed, 78% (14/18) have fewer than one ear, nose and throat specialist per million population and 93% (14/15) have fewer than one audiologist per million. Even in countries with relatively high proportions of professionals in the field of ear and hearing care, inequitable distribution and other factors can limit access.…”

“…This lack of access poses challenges for people in need of care and places unreasonable demands on the cadres providing these services. 11 These challenges can be overcome through strategic government-led planning that integrates people-centred ear and hearing care within national health plans for universal health coverage (UHC). Care services can be implemented through adoption of established public health approaches such as tasksharing and telemedicine.…”

Density of Health Workforce Correlates to Disease Outcomes: Evidence From Global Data in Otolaryngology

“…We obtained country-specific raw data on workforce estimates of ENT surgical specialists from the authors of the recent World Health Organization publication on this topic. 8 Those authors derived their data from a review of published literature, supplemented with data from several regional, national, and international surveys that they designed and distributed. Workforce density was expressed as number of specialists per 100,000 population, and we adapted this same metric.…”

Training, supervision and performance of Community Health Workers in the delivery of ear and hearing care to 321 community members in rural Uganda

“…The global burden of hearing loss is estimated at $750 million annually, with up to 73% of these costs, and the majority of the affected population, living in low-or middle-income countries. 1 A shortage of trained ear and hearing specialists in low-or middle-income countries hampers delivery of programmes to counter this issue [2][3][4] and may necessitate alternative models of service delivery 5 including "task shifting" (redistribution of tasks from specialists to workers with fewer qualifications and less training 6 ) or "task sharing" (collaboration between healthcare workers and simultaneous upskilling of alternative cadres of healthcare workers 7 ). Task shifting or sharing with Community Health Workers has the potential to reduce cost of care, increase access to health services in remote regions and improve disease outcomes.…”