摘要
EXECUTIVE SUMMARY These guidelines have been developed by an expert working group set up following a recommendation by the WHO-CBM Workshop on Needs and Technology Assessment for Hearing Aids Services in Developing Countries held in 1998. Current production of hearing aids is one-tenth of the global need and only one quarter of these are distributed to developing countries. There is an urgent nee d to provide hearing aids and services that are appropriate and affordable for developing cou ntries, taking into account the scarcity in resources of skills, training, services and finances in most developing countries. These guidelines set out minimum requirements and recommendations for such hearing aids and services, and are particularly targete d at manufacturers, distributors, policy makers and service providers at all levels. It is intended that the hearing aid requirements given here would enable manufacturers to produ ce them at low cost and in bulk with currently available technology. The guidelines recommend that priority for hearing aids and services should be given to children with an average hearing impairment in the range 31 to 80 dBHL in the better ear in the frequency range 500 Hz to 4 kHz, followed by adults with an av erage hearing impairment in the range 41 to 80 dBHL in the better ear in the same frequency ra nge. Behind the ear hearing aids should be the preferred option but body-worn aids ma y still be required in some situations, provided they are of similar reliability and no gre ater cost than behind the ear hearing aids. To ensure that a basis for specifying the electroac oustic performance of hearing aids is available a minimum performance specification is given; this does not preclude the use of higher performance aids as appropriate. Persons with profound hearing impairment may benefit from a Cochlear implant( CI ) but implantation is not recommended unless the necessary medical, technical, edu cational, psychological and hearing therapist resources and services are available. Also, where resources are limited, the available resources may be more effectively used to p revent a greater burden of hearing loss in more people through using less costly interven tions. Manufacture or assembly and servicing of hearing aids should be feasible in developing countries. Hearing aids and batteries that are imported from another country should be classified as medical devices in order to avoid import duty. Batteries should be zinc air or rechargeable type. The availability of a reliable supply of batterie s is essential. Earmoulds should be individually made by a two-stage syringe technique in locall y established static laboratories; other methods that maintain the same quality ma y be used. Portable, mobile facilities may be necessary in less accessible areas. Universal or stock size earmoulds should only be used as a temporary measure. Earmoulds should be replac ed at recommended intervals. Services for providing hearing aids to users are an essential component of a hea ring health system. The guidelines make recommendations for services which comprise r aising awareness, identification and assessment, provision, support for users, and trai ning. Awareness should be raised through the promotion of prime messages about the problems caused by hearing impairment, its detection, and prevention of its effe cts. These messages should be targeted at particular groups in society including people wit h hearing impairment, parents, teachers, community and national leaders, health care and e ducational and other service providers, and policy makers and administrators. Identification of hearing impairment should be done at the primary level by prim ary health care (PHC) workers with training and skills in primary ear and hearing ca re (PEHC). Persons with hearing impairment and discernible ear disease (such as otitis medi a) should receive medical &/or
EXECUTIVE SUMMARY These guidelines have been developed by an expert working group set up following a recommendation by the WHO-CBM Workshop on Needs and Technology Assessment for Hearing Aids Services in Developing Countries held in 1998. Current production of hearing aids is one-tenth of the global need and only one quarter of these are distributed to developing countries. There is an urgent nee d to provide hearing aids and services that are appropriate and affordable for developing cou ntries, taking into account the scarcity in resources of skills, training, services and finances in most developing countries. These guidelines set out minimum requirements and recommendations for such hearing aids and services, and are particularly targete d at manufacturers, distributors, policy makers and service providers at all levels. It is intended that the hearing aid requirements given here would enable manufacturers to produ ce them at low cost and in bulk with currently available technology. The guidelines recommend that priority for hearing aids and services should be given to children with an average hearing impairment in the range 31 to 80 dBHL in the better ear in the frequency range 500 Hz to 4 kHz, followed by adults with an av erage hearing impairment in the range 41 to 80 dBHL in the better ear in the same frequency ra nge. Behind the ear hearing aids should be the preferred option but body-worn aids ma y still be required in some situations, provided they are of similar reliability and no gre ater cost than behind the ear hearing aids. To ensure that a basis for specifying the electroac oustic performance of hearing aids is available a minimum performance specification is given; this does not preclude the use of higher performance aids as appropriate. Persons with profound hearing impairment may benefit from a Cochlear implant( CI ) but implantation is not recommended unless the necessary medical, technical, edu cational, psychological and hearing therapist resources and services are available. Also, where resources are limited, the available resources may be more effectively used to p revent a greater burden of hearing loss in more people through using less costly interven tions. Manufacture or assembly and servicing of hearing aids should be feasible in developing countries. Hearing aids and batteries that are imported from another country should be classified as medical devices in order to avoid import duty. Batteries should be zinc air or rechargeable type. The availability of a reliable supply of batterie s is essential. Earmoulds should be individually made by a two-stage syringe technique in locall y established static laboratories; other methods that maintain the same quality ma y be used. Portable, mobile facilities may be necessary in less accessible areas. Universal or stock size earmoulds should only be used as a temporary measure. Earmoulds should be replac ed at recommended intervals. Services for providing hearing aids to users are an essential component of a hea ring health system. The guidelines make recommendations for services which comprise r aising awareness, identification and assessment, provision, support for users, and trai ning. Awareness should be raised through the promotion of prime messages about the problems caused by hearing impairment, its detection, and prevention of its effe cts. These messages should be targeted at particular groups in society including people wit h hearing impairment, parents, teachers, community and national leaders, health care and e ducational and other service providers, and policy makers and administrators. Identification of hearing impairment should be done at the primary level by prim ary health care (PHC) workers with training and skills in primary ear and hearing ca re (PEHC). Persons with hearing impairment and discernible ear disease (such as otitis medi a) should receive medical &/or su
出处
《听力学及言语疾病杂志》
CAS
CSCD
2005年第1期16-34,共19页
Journal of Audiology and Speech Pathology
