SWITZERLAND—As the world commemorates World Hearing Day on March 3, the World Health Organization (WHO) has issued new technical recommendations on hearing aid service delivery options for low- and middle-income settings.

The new guide’s release coincides with World Hearing Day, which in 2024 has a theme of ‘Changing mindsets: Let’s make ear and hearing care a reality for all’, emphasizing the significance of correcting widespread misconceptions about hearing loss among the general public and primary health practitioners.

This publication is intended to provide practical recommendations to countries implementing hearing aid services in places with limited human resources for hearing assessment, fitting, and maintenance.

The guidance, created with assistance from the ATScale Global Partnership for Assistive Technology, is based on the task-sharing paradigm for professionals and trained non-specialists.

It includes two approaches, one for adults and one for children aged 5 and above, as well as resources with suggestions for healthy ear care, hearing aid use, and how to support persons with hearing loss.

More than 430 million individuals suffer from debilitating hearing loss, which, if left untreated, harms their quality of life. This figure is expected to increase to approximately 2.5 billion people with some degree of hearing loss by 2050, with at least 700 million requiring hearing rehabilitation.

The vast majority of persons with hearing loss live in low- and middle-income countries, and most of them can benefit considerably from prompt and effective interventions, such as the use of hearing devices (hearing aids and implants) and rehabilitative services.

Dr. Bente Mikkelsen, WHO Director for the Department of Noncommunicable Diseases, believes that over 400 million people with hearing loss could benefit from adopting hearing equipment.  However, fewer than 20% of these demands are met.

Unaddressed hearing loss is a global public health concern that costs more than $1 trillion per year. He argues that, given the global dearth of ear and hearing care specialists, we must reconsider how we normally provide services.

According to the new guidance, the first of two major issues in ear and hearing care is a lack of healthcare system capacity for providing integrated ear and hearing care throughout people’s lives, which is demonstrated by a lack of policies, human resources, and committed funds.

WHO’s service delivery methodologies aim to address this issue by better-utilizing non-specialists in hearing care to boost capacity.

Misperceptions and stigmatizing beliefs regarding hearing loss and ear illnesses are also significant challenges, as they are strongly embedded in society and frequently restrict the success of attempts to enhance hearing care.

One of the most common misconceptions is that hearing loss is an unavoidable aspect of aging older, and that hearing aids are ineffective or too expensive.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, for his part as a commemoration message, says that hearing loss is commonly referred to as an “invisible disability,” not only because there are no apparent symptoms, but also because it has long been stigmatized in communities and overlooked by policymakers.

Dr. Shelly Chadha, WHO’s technical lead for ear and hearing care, also emphasizes that common beliefs about hearing loss often hinder individuals from getting the services they need, even when they are accessible.

She also emphasizes that any effort to increase hearing care provision through health system improvement must be matched by efforts to promote awareness and reduce stigma associated with ear and hearing care.

Misconceptions also exist among primary health care practitioners, who may regard this as a’specialized’ or ‘difficult to perform’ service, resulting in a failure to recognize and treat even problems that do not require specialist care.

To succeed, beliefs regarding ear and hearing care must change. This is critical for improving access and lowering the expense of untreated hearing loss.

WHO has released a number of information products and tools to improve public awareness and dispel prevalent myths and misconceptions.

A brief for health professionals explains the rationale and directions for engaging primary level service providers in hearing care provision.

Governments should take steps to include ear and hearing care into primary health care, promote community-based approaches that bring services closer to individuals, and spearhead campaigns to raise awareness and reduce stigma associated with hearing loss.

Health care providers must also play an important role in providing enough attention and treatment to persons suffering from common ear and hearing ailments.

Civil society organizations, parents, teachers, and clinicians can use WHO’s awareness materials and community resources to educate people about the value of ear and hearing care.

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