Status and gaps in newborn hearing screening in South Africa: A cross-sectoral review.
Karin Joubert, Duoné Swart
Newborn hearing screening in South Africa is concentrated in Gauteng and the Western Cape, which hold 56% of all reported services.
Rural provinces have little or no access. The two most common barriers across every sector are that parents do not know screening exists and that families do not return for follow-up.
Key findings
1Gauteng and the Western Cape account for 56% of all reported NHS services, while North West, Limpopo and Mpumalanga are critically underserved, with no private-sector services in those three provinces.
2The two most frequently cited challenges across all sectors were lack of parental awareness about hearing screening (28% private, 16% public, 19% NGO) and poor follow-up attendance after a refer result (22% private, 21% public, 25% NGO).
3Eighteen sites across all sectors used non-audiologist screeners, most of whom were trained dedicated hearing screeners. Every one of these programmes was overseen and managed by an audiologist who also provided the initial training.
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What it does not show
Recruitment went through two professional organisations, so audiologists in rural or under-resourced areas with limited access to professional networks or online platforms may have been under-represented, meaning the provinces that need screening most may be the least visible in the data. All data are self-reported by the audiologists themselves, so equipment availability and service coverage may be stated more favourably than the actual state of the service. Data were collected between March and July 2022. Any NHS initiatives, new partnerships, or mHealth rollouts that happened after that window are not reflected. The survey captures the status of services at the time of collection but does not measure how many babies were actually screened, how many passed or referred, or how many completed the diagnostic and intervention pathway.
Declared interests
The authors state the research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
The easy way to misread this
Do not read the high equipment availability (AABR, OAE, tympanometry at 49-57% of sites) as evidence that screening is happening at scale. The survey shows services are concentrated in two provinces, the public sector offers screening mostly at tertiary hospitals rather than community clinics, and the two most common challenges are that parents do not know screening exists and that families do not return for follow-up. Having the machine in the room is not the same as a baby being screened.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →