Accelerating Early Hearing Detection and Intervention in South Africa

A newly published systematic review by Phanguphangu et al. (2025) in the Journal of Public Health in Africa has underscored a critical gap in South Africa’s maternal and child healthcare system: the late detection of congenital hearing loss (HL) in infants. The review found that, on average, congenital HL is identified at 30 months, far beyond the international 1-3-6 Early Hearing Detection and Intervention (EHDI) benchmarks, which recommend screening by 1 month, diagnosis by 3 months, and intervention by 6 months.

Hearing loss is the most common sensory impairment in children, with over 6,100 babies in South Africa born with or acquiring early-onset HL annually. If left undetected, it has severe lifelong consequences, including speech and language delays, poor academic performance, and reduced employment opportunities. The review highlights that without a strong universal newborn hearing screening (UNHS) programme, most children are diagnosed only after parents raise concerns, often when they are already struggling with communication and development.

A Public Health and Policy Crisis

The late identification of hearing loss is not just a health issue—it is a developmental emergency. Studies show that children who receive intervention before six months can achieve language milestones comparable to their hearing peers. Yet, in South Africa, systemic challenges such as lack of political prioritisation, limited resources, and competing health burdens mean that EHDI remains neglected in public health policies.

The World Health Organization’s 2021 World Report on Hearing has emphasised that early detection is cost-effective and leads to better educational and social outcomes. Other key thought leaders, such as Khoza-Shangase (2022), have also pointed out that South Africa has policy frameworks in place but lacks effective implementation and integration into the maternal and child health package.

What Needs to Change?

This new research makes a clear and urgent case for South Africa to align with global best practices on early hearing detection and intervention. Based on the findings, the following policy actions and stakeholder interventions could make a change:

1. Prioritise EHDI in National Maternal and Child Health Policies

• The Department of Health must integrate universal newborn hearing screening (UNHS) into standard postnatal care.
• Ensure early diagnostic and intervention services are available at primary healthcare (PHC) and district hospitals.
• Provide sustainable funding for EHDI as part of child development programmes.

2. Strengthen Health Systems to Support EHDI

• Train and equip midwives, nurses, and primary healthcare workers to conduct hearing screenings.
• Improve data collection and tracking to ensure timely follow-ups for diagnosed infants.
• Ensure the availability of affordable hearing aids and cochlear implants for children in need.

3. Increase Public Awareness and Community Advocacy

• Launch a national public awareness campaign on the importance of newborn hearing screening.
• Educate parents and caregivers to recognise the early signs of hearing loss and seek medical intervention.
• Leverage community health workers and traditional birth attendants to support early detection in rural areas.

4. Strengthen Collaboration Across Sectors

• Establish multi-sector partnerships with government, civil society, and private healthcare providers to drive EHDI implementation.
• Work with academic institutions and research bodies to build local evidence and solutions for hearing loss interventions.
• Partner with corporates and funders to provide assistive devices and technology for early intervention.

Take Action Now!

This is an opportunity for policymakers, healthcare professionals, civil society, and the private sector to come together and drive real change. The research is clear: early intervention changes lives. We cannot allow more children to fall through the cracks due to delayed hearing detection.

🔹 Spread the word—Share this article and raise awareness on social media.
🔹 Engage with policymakers—Advocate for EHDI to be prioritised in South Africa’s health system.
🔹 Support screening programmes—Partner with organisations working on early childhood health and development.

For more information on global hearing care priorities, check out the World Health Organization’s World Report on Hearing.