Training for hearing care providers

Abstract

The lack of an appropriately trained global hearing-care workforce is recognized as a barrier to developing and implementing services to treat ear and hearing disorders. In this article we examine some of the published literature on the current global workforce for ear and hearing care. We outline the status of both the primary-care workforce, including community health workers, and specialist services, including audiologists, ear, nose and throat specialists, speech and language therapists, and teachers of the deaf. We discuss models of training health workers in ear and hearing care, including the role of task-sharing and the challenges of training in low and middle-income countries. We structure the article by the components of ear and hearing care that may be delivered in isolation or in integrated models of care: primary care assessment and intervention; screening; hearing tests; hearing rehabilitation; middle-ear surgery; deaf services; and cochlear implant programmes. We highlight important knowledge gaps and areas for future research and reporting.

The willingness to participate in biomedical research involving human beings in low‐ and middle‐income countries: a systematic review

“…Some of the reasons identified in this review could influence the voluntary decision to participate in research. For example, (expected) personal or community health benefits, access to health care, (dis)trust or community pressure could affect autonomy in the consent to participate in research, or de facto constitute controlling influences affecting autonomy [15,112].…”

“…Literature and international ethical guidelines for research conduct [14] mention a number of ways that could help to mitigate the potential threats of these reasons to participate to voluntary informed consent. Simultaneously, barriers to research identified in this review, such as need for/lack of social support, fear of stigmatisation, inconvenience and therapeutic misconception can also be addressed using these approaches [112,113].…”

“…First, community engagement, in which the role of the family and community (leaders) in decision making is acknowledged and incorporated [112]. Community engagement addresses the importance of (expected) personal and/or community benefit in the decision to participate in research, and can enhance the understanding of research [112].…”

“…First, community engagement, in which the role of the family and community (leaders) in decision making is acknowledged and incorporated [112]. Community engagement addresses the importance of (expected) personal and/or community benefit in the decision to participate in research, and can enhance the understanding of research [112]. The 2016 CIOMS International Ethical Guidelines for Health-related Research Involving Humans similarly recommend to engage communities when conducting (clinical) research in low-resource settings to ensure ethical and scientific quality [14].…”

“…Therefore, the third manner in which potential influences could be addressed is to incorporate procedures in informed consent processes that safeguard the understanding of the nature and implications of the research. Various existing strategies can be employed, including sufficient time for subjects to consider their participation and discuss it with family and friends; and provision of adequate information about what research entails (about research in general and the specific research in particular) from someone without a dependency relationship (such as between physician and patient) ( [4,15], [112]).…”