Making ear and hearing care accessible for all in Zambia

In the past 18 months, health workers from 92 facilities around the country have been trained in primary ear and hearing care.

Alice Makofi with her daughter Memory Chisenga at their home in Chambeshi Village, Zambia. Memory recieved treatment for a severe ear infection at a health facility in their district. © WHO / Gareth Bentley

In Zambia, it is estimated that 4–6% of the population have hearing loss, and many more suffer from ear diseases. Yet there are only five ear, nose and throat (ENT) specialists and one audiologist for the country’s 17 million people.

To help address this gap, following the World Health Assembly in 2017, the Government of Zambia adopted a plan to develop quality ear and hearing care services as close to people as possible.

Nurse Carol Sinkende attends to a patient at the Lukomba Rural Health Centre. © WHO / Gareth Bentley

Using the national ENT Strategic Plan 2017–2021 as a guide, and with support from the German and Scottish governments, Zambia rolled out a pilot project to train nurses and clinical officers working in the country’s national health service on primary ear and hearing care.

Through a systematic rollout of a cascade training plan based on the WHO primary ear and hearing care training manuals, 28 nurses, 43 clinical officers and 133 community health workers from 92 facilities have been trained over the past 18 months.

Nurse Carol Sinkende was one of the health workers to attend the training. Since then, she has become acutely aware of the sounds around her — the chirping of the birds, the humming of passing vehicles and the barking of dogs.

At the Lukomba Rural Health Centre in the Kapiri Mposhi District, Carol is the only health worker trained in ear and hearing care services. Before her training, she referred patients with ear and hearing care needs to the hospital in another district for screening and treatment. Now she is able to take on both tasks herself.

Nurse Carol Sinkende attends prepares to treat a patient at the Lukomba Rural Health Centre. © WHO / Gareth Bentley

Carol says one of the best parts of her job is when she provides hearing aids to patients who previously could not hear. She says the smile they make when they hear for the first time melts her heart.

“I have found a new passion,” Carol says. “I would love to further my studies, to make a difference, to reach a level where I can begin to influence policies that are going to help people with hearing loss.”

The Lukomba Rural Health Centre. © WHO / Gareth Bentley

Now 50 primary ear and hearing care services have been established at peri-urban and rural health centres across the country. Since Carol was trained in 2019, she has screened more than 600 patients.

Dr Racheal Hapunda, Ear and Hearing Care Programme Coordinator for Zambia’s Ministry of Health, says that as the programme continues to grow and expand, the country is on track to realize the vision of making ear and hearing care accessible for all.

Learn more about hearing loss.

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The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable.

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