Petrocchi-Bartal Luisa, Khoza-Shangase Katijah, Kanji Amisha
Department of Speech Pathology and Audiology, Faculty of Humanities, School of Human and Community Development, University of the Witwatersrand, Johannesburg 2050, South Africa.
Audiol Res. 2025 Jan 24;15(1):10. doi: 10.3390/audiolres15010010.
BACKGROUND/OBJECTIVES: Globally, many countries have endorsed the World Health Organisation's (WHO) early intervention (EI) guidelines through their legislation with contextual variations. Sensitive evaluation of gaps within EI-recommended systems is essential, especially in the translation of policy into practice across high-income and low- to middle-income country (LMIC) contexts, including South Africa. The main objective was to explore and identify the current evidence reflecting the application of hearing-specific government policy regarding EI and early education (EE) for hearing-impaired/d/Deaf/hard-of-hearing (HI/D/HH) children aged six and below.
An integrative review was conducted on peer-reviewed articles that examined policy in practice regarding EI for HI/D/HH children aged six and below. Studies were accessed via four databases (Ebscohost, Sabinet, Scopus, and ScienceDirect) and one search engine (Google Scholar) between 2014 and 2024. Qualitative evaluation ensued of themes identified deductively.
Twenty-six peer-reviewed studies were included. Deductive thematic analysis revealed six derived themes: EI timing, early hearing detection and intervention (EHDI)/EI mechanisms; EI services, EE, family considerations, and policy. Five of the 26 directly scrutinised government policy in its EI/EE practical application. Articles reflected the need for consideration of the complex processes that allow for policy actualisation, such as adequate infrastructure and family considerations.
A bottom-up approach to policy actualisation, with grass-roots contextual considerations such as EI access and caregiver concerns, may improve policy application. Current findings have implications, particularly for LMIC contexts including South Africa, where EI and EE policy scrutiny regarding hearing impairment/deafness specificity is imperative for understanding its application alignment.
背景/目标：在全球范围内，许多国家已通过立法认可了世界卫生组织（WHO）的早期干预（EI）指南，但存在因地制宜的差异。对EI推荐系统中的差距进行敏感评估至关重要，尤其是在将政策转化为高收入国家以及包括南非在内的低收入和中等收入国家（LMIC）的实际行动中。主要目标是探索并确定当前证据，以反映针对6岁及以下听力受损/失聪/重听（HI/D/HH）儿童的听力特异性政府EI和早期教育（EE）政策的应用情况。
对同行评审文章进行综合综述，这些文章研究了6岁及以下HI/D/HH儿童EI政策的实际应用情况。2014年至2024年间，通过四个数据库（Ebscohost、Sabinet、Scopus和ScienceDirect）和一个搜索引擎（谷歌学术）获取相关研究。随后对演绎确定的主题进行定性评估。
纳入了26项同行评审研究。演绎主题分析揭示了六个衍生主题：EI时机、早期听力检测与干预（EHDI）/EI机制；EI服务、EE、家庭因素和政策。26项研究中有5项直接审视了政府政策在EI/EE实际应用中的情况。文章反映出需要考虑政策实施所需的复杂过程，如充足的基础设施和家庭因素。
采用自下而上的政策实施方法，结合基层背景因素，如EI可及性和照顾者关注的问题，可能会改善政策应用。当前的研究结果具有重要意义，特别是对于包括南非在内的LMIC背景，在这些地区，针对听力障碍/失聪特异性的EI和EE政策审查对于理解其应用一致性至关重要。
