Developing self-sustainable hearing centers in the developing world--case study of EARs Inc project in Dominican Republic.

PURPOSE: This paper presents the case study of the project EARS Ind developed in the Dominican Republic (DR) with the purpose of increasing access and affordability of hearing aid technology for the hearing impaired. This case study demonstrates how a program can fit hearing aids to patients with hearing impairments can be developed in low and middle income countries.

METHODS

The project planning documents and project statistics and reports were reviewed. A questionnaire and follow-up interviews were used to gain a clear understanding of the situation in the EARS Inc. DR hearing aid project.

RESULTS

The case study is presented of the development and services in the DR with a particular focus on the choices made in regard to hearing aid services including manufacturer choices, procurement, distribution, pricing and service delivery. The development of these services included the simultaneous development of a training program, ear mould laboratory, hearing aid repair services, also sales of batteries and accessories as well as the development of calibration services.

CONCLUSIONS

The development of comprehensive diagnostic and rehabilitation services requires equipping and training local staff.

IMPLICATIONS FOR REHABILITATION: A good hearing aid fitting is more than technology--patient education and the clinician fitting the hearing aid are important. Access to follow-up services including battery supplies, hearing aid adjustments and hearing aid repairs is essential to any hearing aid fitting program in low and middle income countries. Check the WHO guidelines for hearing aid provision in developing countries when planning a program. When working in a country co-ordinate with local professional involved in hearing health where available.