(A136) Overcoming Barriers to Pediatric Hearing Care: Insights from Rural Kenya

Introduction: Hearing loss (HL) is a global health concern, particularly in resource-limited settings where access to specialists and interventions is scarce. This initiative aimed to develop and assess the feasibility of a hearing screening protocol for children in Kilifi County, Kenya, and to identify challenges associated with its implementation.

Methods: A protocol was designed to introduce hearing screenings into Kilifi County schools. Teachers identified children with potential HL based on classroom observations. Screening utilized hearX tablets and the mHealthStudio mobile app to assess hearing at 1000 Hz, 2000 Hz, and 4000 Hz. Children who failed initial screening subsequently underwent more thorough diagnostic testing. Digital otoscopes captured tympanic membrane images for identification and documentation of pathology.

Results: Preliminary implementation highlighted several challenges. Variable teacher participation affected the efficiency of identifying children at risk. Resource constraints, including availability of equipment and on-site medical personnel, complicated the ability to address acute ear conditions during screenings. Limited access to transportation made referrals to the small network of specialists difficult. Despite these challenges, this approach identified children with HL and acute otologic pathology, facilitated basic on-site treatment and referrals, and ultimately demonstrated the potential for scalability with targeted improvements in dissemination, staffing, funding, and local healthcare partnerships.

Conclusions: Hearing screening in resource-limited settings like Kilifi County, Kenya is feasible but requires addressing logistical challenges, resource gaps, and referral barriers. Insights from this initiative will guide future efforts to refine protocols, strengthen partnerships, and improve access to hearing care.