1. WHO Programme for Prevention of Deafness And Hearing Impairment WHO PRIMARY EAR AND HEARING CARE TRAINING RESOURCE Vancouver, Canada 2 – 6 July 2008 Ms Sally Harvest Education Consultant

2. WHO PRIMARY EAR & HEARING CARE TRAINING RESOURCE Student’s Workbook - Intermediate Level WHO PRIMARY EAR & HEARING CARE TRAINING RESOURCE Student’s Workbook - Intermediate Level PEHC Home Page: http://www.who.int/pbd/deafness/activities/hearing_care/en/index.html

3. Developing an appropriate training resource WHO – 278 million have disabling hearing impairment Estimated 50% is preventable 1 ENT per 2 million population in developing countries (IFOS) PHC workers lack training, equipment & facilities

4. Project Aim Develop appropriate materials for the training of Health Care Workers in Primary Ear & Hearing Care

5. Generic Training Resource Modular – select relevant modules for training specific groups Flexible – can be added to…. Adapt for specific countries – Health Authorities criteria

6. Project Objectives  Produce a knowledge & skills-based training resource  Produce outcomes based training resource  Develop (culturally) appropriate materials  Ensure that training materials can be utilized as a key resource in the workplace  Establish content of training manual using the Delphi Technique

7. Delphi Technique  An information gathering technique  Elicits information and judgements from participants  Facilitates problem-solving, planning & decision-making  PHC experts recruited globally  Reduces costs without jeopardising participation

8. Advantages - Delphi tech  Input from experts  Reliability – get what you want every time  Relevance - inclusion of necessary knowledge & skills  Consensus reached  Cost effective

9. Participating organisations: IFOS – Int. Federation of oto-rhinolaryngological societies HI - Hearing International IFHOH International Society of Audiology Univ of Manchester - Centre Human communication WHO – Collaborating Centres CBM Advisory Committee 32 Countries

10. Field testing: PEHC training resource India & Nigeria Why? Not office based Identify training needs of dev countries Include locals – participation Encourage ownership of training resource Ensure culturally appropriate training

11. GLOBAL INITIATIVE LAUNCH STRATEGIC PLANNING TRAIN THE TRAINERS Completed to Date: Nigeria Colombia Kenya

12. Making an impact Through the development of the outcomes-based, interactive teaching resource it is hoped that PHC workers will become competent …… Primary Ear & Hearing Care Workers

13. PEHC Training Resource Aimed at primary level health workers in developing countries Simple, effective methods - reduce burden of ear disease & hearing disorders Prevention, treatment & management Outcomes based training Launched 7 March ‘06 on WHO web

14. So….what do these Training Resources consist of?

15. RESOURCES: Basic level - village health workers Intermediate trainer’s manual & Intermediate student’s workbook Advanced level (experienced PHC workers)

16. BASIC RESOURCE Raises Awareness: Need for ear hygiene How to prevent common ear & hearing disorders Reasons for hearing impairment How to encourage communication with deaf/hard of hearing Management & possible solutions (ear/hearing)

17. Basic Resource PEHC Home Page: http://www.who.int/pbd/deafness/activities/hearing_care/en/index.html

18. Page from Basic level Manual

19. Intermediate Resource Contents - Modules 1.Structure & function of the ear 2.Hearing Impairment & Deafness: causes & prevention 3.The Outer ear: examine, treat, refer 4.The ear canal: examine, diagnose, clean 5.The Middle ear: examine, diagnose, treat 6.Assessing hearing & counselling 7.Hearing aids

20. By the end of this module the Health Care Worker should be able to: Explain why hearing is important Recognise and name the parts of the ear Explain the function of the ear Explain the path sound travels through the ear Explain how people hear

21. STRUCTURE OF MODULES Trainer’s manual Title Graphic(s) Outcomes Terminology Pre-test (with answers) Preparation Activity symbols Content Post-test (with answers) Student’s workbook Title Graphic(s) Outcomes Terminology Pre-test Activity symbols Content Post-Test

22. ADVANCED RESOURCE Contents - Modules 1. Prevalence, Causes & Prevention of deafness 2. Examination of the ear 3. Detection & Testing of Hearing Impaired 4. Ear conditions – diagnosis & treatment 5. Ear operations 6. Noise-induced h/impairment & hearing conservation 7. Aural rehabilitation & Deaf Education 8. Hearing Aids

23. Performance testing Prof Valerie Newton Tester’s 2 nd Position Tester’s 3 rd Position TableTester in 1st Position Child Parent or carer 1m

24. Aural Rehabilitation Communication Methods - Deaf Education Oral / Aural (HOH Deaf wearing H/Aids with good speech) Total Communication Bilingual-Bicultural develop listening, speech & speech reading skills Speech & signing 1 st language (local sign language) Other languages thru’ reading & writing

25. EAR OPERATIONS Minor operations myringotomy insertion of grommets Patient information Grommets

26. Patient info TYMPANOPLASTY (MYRINGOPLASTY and OSSICULOPLASTY) Explanation: Hearing loss for some time could be caused by a hole in the eardrum that doesn’t heal. Description of procedure……

27. Levels of training INTERMEDIATE RESOURCE 1. Structure & function of the ear 2. Hearing Impairment & Deafness: causes & prevention 3. The Outer ear: examine, treat, refer 4. The ear canal: examine, diagnose, clean 5. The Middle ear: examine, diagnose, treat 6. Assessing hearing & counselling 7. Hearing aids ADVANCED RESOURCE 1. Prevalence, Causes & Prevention 2. Examination of the ear 3. Detection & Testing of H/Impaired 4. Ear conditions diagnosis treatment 5. Ear operations 6. Noise-induced hearing impairment & hearing conservation 7. Aural rehabilitation and Deaf Education 8. Hearing Aids

28. INTERACTIVE PARTICIPATION

29. Primary Health Care Workers  Become competent Primary Ear & Hearing Care Workers  Demonstrate an understanding of Primary Ear & Hearing Care  Confidently identify & manage common ear disease & hearing impairment  Fulfil a vital role in decreasing the number of hearing impaired people

30. Talk...talk…talk...talk… talk about H/Loss