An assessment of the management of hearing impairment within the school health education programme (SHEP) in the Ashanti Akim North District

Hearing impairment is a major cause of low academic performance and can affect a child’s entire development milestone. Mild to severe childhood hearing impairment may have deleterious effect on speech, language and educational development which may mostly have social and psychological implications that affects the entire life of the victim and even their family. Hearing impairment that is hidden and unidentified among school pupils is prevalent in most developing countries. Yet our knowledge about the potential risk factors and means to identify them as well as manage them are very limited. In the Ashanti Akim North district, the incidence and prevalence are also not known precisely because school screening for hearing impairment takes low priority and reports are not available; moreover those that are available are incomplete. In addition, information about the magnitude of hearing impairment among school pupils within the district is also lacking. Using a multistage cluster sampling method and a cross sectional design, the prevalence of hearing impairment was determined with 1430 pupils between seven to sixteen years. An assessment of the management of hearing impairment within the School Health Education Programme (SHEP) was also investigated with 100 School Health Education Programme (SHEP) officials in the Ashanti Akim North district. In the introduction for the study, a brief background was given to indicate the role of the hearing mechanism in speech, language and educational development and how the research will be geared toward recommending measures to be instituted to help manage the hearing impaired within a comprehensive SHEP. Again, the main problem of the study is the fact that no audiometric hearing assessment has ever been conducted in the district to ascertain the hearing status and pathologies related to the hearing mechanism of the school going children which has gone a long way to hinder some of the children’s educational, social, psychological and emotional development. Generally, background investigations, which were informally carried out, indicated that ignorant about the signs of diseases of the hearing mechanism, accessibility to facility for possible diagnosis and treatment, habilitation or rehabilitation mechanisms and poverty are assumed to be the remote reasons related to the problem of the study. Under methods and materials, the chapter gives a description of the area and the population for the study. It also presents an account of the sample size, sampling procedure and the variables. The major data collection materials were: structured questionnaire, informal discussion, observation, an audiometer, and an otoscope. It then includes a description of the scope of the study, the pretest procedure, data collection and the analyses process. It also describes the measures, which were put in place to assure data quality and the ethical considerations for the study as well. The total numbers of pupils screened to establish the prevalence of hearing impairment among primary school children were 1430 and the number of SHEP officials who responded to the structured questionnaire was 100 in all. The results indicated a hearing impairment prevalence of 11.9% among upper primary pupils aged 7 —16 years. The major findings for the otoscopy, audiometry, and the investigation as whether or not identification and management of hearing impairment was included in the SHEP is summarised as follows: i. A high proportion of impacted wax of 24% ii. A high proportion of full wax of 62% iii. 3.7% canal infections unilaterally iv. 0.8% canal infection bilaterally v. 1.5% discharge from the middle ear, an indication of Otitis Media vi. The management of hearing impairment was excluded from the SHEP vii. Lack of expertise with the necessary basic skills to identify and manage hearing problems viii. Lack of basic equipment for identification and management of hearing impairment ix. Absolutely no funds for ear care activity in the schools Therefore from the findings of the study, it can be concluded that hearing impairment among primary school pupils are a serious problem in the Ashanti Akim North District and calls for immediate planning of effective and efficient identification and management strategies. In view of the outcome of the study some recommendations have been made at the end of the study to ensure that early identification, hearing conservation programmes, prevention practices and the required periodic hearing assessment programmes are included in the School Health Education Programme to ensure effective management of pupils suffering from hearing impairment.

Source: KNUST