Implementing infant hearing screening at maternal and child health clinics: Context and interactional processes
Infant hearing screening has become increasingly widespread as research evidence a dramatic benefit when early identification of hearing loss occurs before six-months of age. The Health Professions Council of South Africa (HPCSA) has recently published a hearing screening position statement recommending infant hearing screening in three contexts: the well-baby nursery, at discharge from the neonatal intensive care unit (NICU), and at Maternal and Child Health (MCH) clinics. The well-baby nursery and NICUs are established and internationally recognised screening contexts abundantly reported on whilst MCH clinics have not been investigated as screening contexts previously. The objective of this study was therefore to describe the context and interactional processes during an infant hearing screening programme at MCH clinics in a South African community to ascertain whether clinics provide a suitable milieu for hearing screening programmes. An exploratory descriptive design implementing a qualitative methodology was selected to describe the context and interactional processes experienced during an infant hearing screening programme at two MCH clinics in the Hammanskraal community. Five fieldworkers conducting the screening programme at the clinics documented experiences using systematic field notes and critical reflections for a fivemonth period. The two MCH clinics investigated proved to be suitable contexts to screen infants for hearing loss despite prevailing contextual barriers that are characteristic of primary healthcare clinics in developing contexts of South Africa. Interactional processes between fieldworkers, nursing staff and caregivers revealed that collaborative partnerships fostered by consistent service delivery, maintenance of an open channel of communication and basic courteousness, facilitated an effective initial infant hearing screening at the two clinics. MCH clinics demonstrate promise as a practical contextual solution to achieve widespread screening coverage in South Africa.
Keywords: infant hearing screening; Universal Newborn Hearing Screening; hearing loss; Maternal and Child Health Clinics; screening
Health SA Gesondheid Vol. 10 (4) 2005: pp. 3-15
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