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Cochlear implantation is a timeous and cost-effective solution for severe-profound sensorineural hearing loss, and has transformed the lives of many individuals with significant hearing loss. The advent of cochlear implantation has meant that, for the first time, one of the senses (hearing), having been entirely lost, can be restored. This, the first of a two-part series on cochlear implantation in South Africa (SA) puts global (and especially SA) hearing loss in perspective, sets out the principles of cochlear implantation and briefly sketches the history of this world-changing technology.

Background: Hearing loss prevalence is exceptionally high across developing world regions, including Africa, which has the greatest burden of hearing loss compared to other continents. Despite the availability of cost-efficient preventative and intervention measures for hearing loss, these hearing healthcare resources and services remain inaccessible in many developing countries. The purpose of this study was to describe audiologists’ perceptions regarding hearing healthcare resources and services within South Africa’s (SA) public healthcare system.Methods: A national telephonic survey study was conducted with audiologists in public healthcare system hospitals across SA, and the final sample comprised 100 audiologists.Results: Most audiologists perceived that their hospitals did not have adequate hearing healthcare resources to render efficient audiology services to patients. Furthermore, binaural amplification devices (invasive and non-invasive) for adults with bilateral hearing loss who adhered to the criteria for these devices were perceived to be unavailable in most hospitals. Audiologists also perceived that universal newborn hearing screening services, adult aural rehabilitation services, and follow-up care of all hearing devices post-warranty expiration were limited.Conclusion: A greater understanding of the status of hearing healthcare in SA’s public healthcare system hospitals is critical in gaining support for hearing loss from SA’s legislative sector and advocating for the integration of disability and quality of life concerns related to hearing loss on the national healthcare agenda.

Telehealth promises increased access to hearing healthcare services, primarily in areas where hearing healthcare resources are limited, such as within the South African public healthcare system. Telehealth for hearing healthcare is especially important during the COVID-19 pandemic, where physical distancing has been essential. This study aimed to describe audiologists’ perceptions regarding telehealth services for hearing loss within South Africa’s public healthcare system. This study was divided into two phases. During Phase 1, 97 audiologists completed an electronic survey regarding their perceptions of telehealth for hearing loss within South African public sector hospitals. Synchronous virtual focus-group discussions were conducted during Phase 2. Results indicated that audiologists recognized telehealth services’ potential to improve hearing healthcare efficiency within the public sector, and most (84.1%) were willing to use it. However, telehealth’s actual uptake was low despite almost doubling during the COVID-19 pandemic. Prominent perceived barriers to telehealth were primarily related to hospital resources, including the unavailability of equipment for the remote hearing/specialized assessments, internet-related barriers, and limited IT infrastructure. An increased understanding of telehealth in South Africa’s public healthcare system will assist in identifying and in improving potential barriers to telehealth, including hospital resources and infrastructure.

Cochlear implantation is a timeous and cost-effective solution for severe-to-profound sensorineural hearing loss (SNHL) and has transformed the lives of many individuals with significant hearing loss. The advent of cochlear implantation has meant that, for the first time, one of the senses (hearing), having been entirely lost, can be restored. The previous article in this series sketched the problem of severe-toprofound SNHL, and how cochlear implantation can overcome this, how a cochlear implant (CI) works, the history of cochlear implantation and the principles of the multidisciplinary CI team. The current status of cochlear implantation in South Africa (SA) is the subject of discussion in this article, the second of this two-part series on cochlear implantation. It comprises a study of the best available current data on the status of CI in SA.