Results from the current study have assisted in identifying procedural and logistical assets and barriers to implementation of HPCSA clinic guidelines for early hearing detection and intervention (EHDI) at immunisation clinics in South Africa.

Background. In the developing world, it is critical that the acceptable principle that early hearing detection and intervention (EHDI) programmes be contextually useful, given the extensive level of difficulties faced by these regions. The Health Professions Council of South Africa (HPCSA) has recommended specific contexts in which to actualise EHDI application. One of these contexts relates to hearing screening at immunisation clinics within the first 6 weeks of life. Objective. To explore the current status of the implementation of the HPCSA's 2007 guidelines for clinic-based hearing screening within the South African primary healthcare clinic (PHC) setting. Methods. Within a qualitative research design, 30 PHC nurses representing 30 PHC clinics in the North West and Gauteng Provinces were interviewed using a structured questionnaire. Qualitative as well as thematic content analysis strategies were adopted in analysing data. Results. There is a lack of formal EHDI implementation at PHC clinics in both provinces. Lack of equipment, budgetary constraints and human resource challenges are the reasons for this. Regardless of the province's socioeconomic development based on the deprivation index, EHDI implementation at clinic level is not feasible unless the barriers are addressed. Conclusion. There is a need to ensure that context-specific studies in EHDI are conducted. This will ensure that national position statements are sensitive to contextual challenges and that they allow for evidence-based practice. This is particularly relevant in developing countries where resource constraints dictate the success or failure of any well-intentioned programme. The HPCSA's 2007 position statement needs to be reviewed taking careful cognisance of feasibility study findings such as the current one. Findings have implications for nurses training, future studies, and policy formulation, as well as clinical plans for EHDI in developing contexts.

Purpose: To explore the feasibility of infant hearing screening from a developing country context. Methods: A descriptive research design was employed, using a combination of surveys, questionnaires and face-to-face semi-structured interviews; as well as conduction of audiological measures such as otoacoustic emissions (OAEs) and automated auditory brainstem responses (AABR) during hearing screening. Participants comprised low–risk neonates, high-risk neonates and primary health care nursing managers. Results: Findings indicated that (1) screening at the Midwife Obstetric Unit 3-day assessment clinic may be more practical; (2) screening at primary health care clinics is not feasible until the identified barriers are addressed and; (3) factors such as ambient noise levels, availability of space for screening and time of discharge influence the practicability and efficiency of screening within a hospital context. Conclusion: There are a number of factors which influence the practicability and efficiency of newborn hearing screening. Each of these factors may vary depending on the level of healthcare setting and may either facilitate or act as barriers toward the implementation of newborn hearing screening in the South African context.

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