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
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
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
Project Aim
•
Develop appropriate materials
for the training of
Health Care Workers in
Primary Ear & Hearing Care
Generic Training Resource
• Modular – select relevant modules for
training specific groups
• Flexible – can be added to….
• Adapt for specific countries – Health
Authorities criteria
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
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
Advantages - Delphi tech
 Input from experts
 Reliability – get what you want every
time
 Relevance - inclusion of necessary
knowledge & skills
 Consensus reached
 Cost effective
Advisory Committee
32 Countries
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
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
GLOBAL INITIATIVE
LAUNCH
STRATEGIC PLANNING
TRAIN THE TRAINERS
Completed to Date:
Nigeria
Colombia
Kenya
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
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
So….what do these Training
Resources consist of?
RESOURCES:
• Basic level village health workers
-
• Intermediate trainer’s manual
& Intermediate student’s workbook
• Advanced level
(experienced PHC workers)
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)
Basic Resource
PEHC Home Page:
http://www.who.int/pbd/deafness/activities/hearing_care/en/index.html
Page from Basic level Manual
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
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
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
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
Performance testing
Prof Valerie Newton
Tester’s 2nd Position
Tester’s 3rd Position
1m
Child
Tester in 1st
Position
Parent
or carer
Table
Aural Rehabilitation
Communication Methods - Deaf Education
• Oral / Aural (HOH Deaf
wearing H/Aids with good
speech)
• develop listening,
speech & speech
reading skills
• Total
Communication
• Speech & signing
• Bilingual-Bicultural
• 1st language (local sign
language)
Other languages thru’ reading &
writing
EAR OPERATIONS
Minor operations
• myringotomy
• insertion of
grommets
Patient information
• Grommets
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……
Levels of training
INTERMEDIATE RESOURCE
ADVANCED RESOURCE
1. Structure & function of the ear
1. Prevalence, Causes & Prevention
2. Hearing Impairment & Deafness:
causes & prevention
2. Examination of the ear
3. The Outer ear: examine, treat,
refer
3. Detection & Testing of H/Impaired
4. Ear conditions diagnosis treatment
4. The ear canal: examine, diagnose,
clean
5. Ear operations
5. The Middle ear: examine,
diagnose, treat
6. Noise-induced hearing impairment
& hearing conservation
6. Assessing hearing & counselling
7. Aural rehabilitation and Deaf
Education
7. Hearing aids
8. Hearing Aids
INTERACTIVE PARTICIPATION
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
Talk...talk…talk...talk…
talk about H/Loss 
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