Opinion Paper

A call for linguistic and culturally congruent family-centred early hearing detection and intervention programmes in South Africa

Ntsako P. Maluleke
South African Journal of Communication Disorders | Vol 71, No 1 | a992 | DOI: https://doi.org/10.4102/sajcd.v71i1.992 | © 2024 Ntsako P. Maluleke | This work is licensed under CC Attribution 4.0
Submitted: 02 May 2023 | Published: 19 March 2024

About the author(s)

Ntsako P. Maluleke, Department of Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa


Early Hearing Detection and Intervention (EHDI) programmes are recognised as the standard of care for newborns and infants presenting with hearing impairment, globally. However, widespread implementation of these programmes is far from being realised and faces numerous challenges within the South African context. The United Nations’ sustainable development goal 3.8 and South Africa’s national development plan seek to achieve equitable access to healthcare service, including EHDI. However, healthcare access is a complex concept which encompasses the dimensions: availability, affordability, acceptability and accommodation in healthcare. South Africa has made great progress towards universal implementation of EHDI programmes. Despite this progress, availability and affordability of these programmes are limited and their acceptability has received limited research focus in this context. Furthermore, accommodation of caregivers, as co-drivers of EHDI programmes and ensuring that EHDI programmes are linguistically and culturally congruent have also been overlooked within the South African context.

Contribution: Increased robust efforts in improving access through availability and affordability of EHDI programmes are warranted in South Africa. However, improving access to these programmes through availability and affordability initiatives alone will not result in a pragmatic improvement in their accessibility. Acceptability of these programmes and accommodations such as involving caregivers and family members of children with hearing impairment as equal partners in EHDI programmes and being cognisant of their linguistic and cultural needs must be considered.


early intervention; EHDI; family-centred early intervention; FCEI; hearing impairment; hearing screening.


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