ArticleBMC health services research2025
Hearing healthcare for all? Investigating accessibility of public audiology services in Johannesburg, South Africa.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Management pathways and outcomes of children with hearing loss identified through newborn and infant hearing screening at a tertiary paediatric hospital in the Western Cape, South Africa.The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings · 2026Article
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2 authors.
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Abstract
backgroundEquitable access to audiology services is crucial for early detection, diagnosis, and management of hearing loss, particularly in resource-constrained settings like South Africa's public healthcare sector. Despite the availability of services, systemic inefficiencies, workforce shortages, indirect costs, and limited public awareness hinder effective utilisation. This study examines patients' experiences with public audiology services in Johannesburg across five key dimensions: availability, affordability, accommodation, linguistic and cultural considerations, and awareness.
objectivesThe study aimed to (1) assess the availability of audiology services; (2) identify financial barriers affecting access; (3) examine accommodation structures; (4) investigate linguistic and cultural influences on service accessibility; (5) evaluate patient awareness of audiology services; and (6) explore the psychosocial impact of hearing loss.
methodsThis descriptive, qualitative study was conducted at two public healthcare facilities in Johannesburg: a tertiary hospital and a primary care clinic. Using purposive sampling, 20 adult patients who had accessed audiology services were recruited. In-person semi-structured interviews were conducted using a self-developed interview guide, designed by the research team based on literature and study objectives. The guide was reviewed for clarity and piloted for relevance. Interview data were transcribed and analysed using Braun and Clarke's six-phase thematic analysis. Basic descriptive statistics were used to summarise demographics, and Fisher's Exact Test was employed to explore associations between employment status and perceived affordability.
resultsMost participants (17/20; 85%) lived within 30 min of their facility, but 35% reported waiting more than two months for appointments. While services were free, 60% of participants cited transport and hearing aid maintenance costs as significant barriers. Half of participants were unemployed, but no significant association was found between employment status and perceived financial burden (Fisher's Exact Test, p = 0.077). Most participants (80%) received care in a language they understood, though 30% preferred their first language. Limited awareness of audiology services (85%) before referral was a recurring theme. Psychosocial impacts included frustration, isolation, and reduced quality of life, which improved after receiving care.
conclusionWhile audiology services are geographically and financially accessible, systemic, structural, and informational barriers undermine equitable access. A policy-driven approach-focusing on public education, decentralised care, improved scheduling, and financial support-is essential to strengthen hearing healthcare in South Africa.
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