Programme to Address Shortfall in Child Speech-Language and Audiology Services

Western Cape Premier, Helen Zille, and Western Cape Minister of Health, Theuns Botha, launched a new initiative aimed at introducing speech-language therapy and audiology services for children at all levels of the District Health System on 9 September 2014.

The programme will first be piloted in the Mitchells Plain health sub-district over the next two and a half years and will then be rolled-out across the rest of the province.

The significance of the pilot project is that there is now an intervention to identify the problem at primary healthcare level. Once identified, the child will be referred for follow-up treatments, be it preventative, rehabilitative and or curative.

It is envisaged that this ground-breaking pilot programme will benefit over 20 000 children who will have access to preventative, rehabilitative and curative services for speech, language and hearing disorders. Provision will also be made for the training of staff in the Mitchells Plain sub-district and at all levels of the health system in the future. There will also be a focus on improving referral systems and providing increased support to children who have been diagnosed with speech and hearing difficulties and their families.

The programme will ensure that early intervention is provided to children, particularly those living in poor communities who are identified as having speech and hearing difficulties.

Speech-language and hearing problems are among the most common childhood disorders in the province and the rest of the country. Approximately 17 infants are born with hearing difficulties, or will develop hearing loss, in South Africa each day – 85% of these infants are also dependent on the public health sector for treatment and support.

The implementation model for the Western Cape Government’s new programme has been developed by the Carel du Toit Centre. The centre will also be responsible for refining the programme further during the pilot phase and for rolling it out across the province in the future. The Western Cape Department of Health will provide R7.3 million for the pilot while, the Children’s Hospital Trust will fundraise a further R3 million.

Currently, only very limited speech-language and audiology services are provided by the public health system with most children needing to be referred to tertiary hospitals for diagnosis and treatment. This has resulted in the speech-language therapy department at the Red Cross War Memorial Children’s Hospital having a constant waiting list of almost 800 children, who wait 12 to 18 months for an appointment.

Furthermore, children referred to the hospital’s audiology department must currently wait between four and six months to be seen for the first time, and then face extended intervals between follow-up visits. As a result, large numbers of children do not receive the treatment they need immediately, and as regularly as they need it, which severely affects their quality of life and chances of succeeding.

The Department of Health, under the new programme, will therefore also create one additional Ear Nose and Throat (ENT) Specialist post at Red Cross War Memorial Children’s Hospital to assist with the clinical diagnosis of patients referred through the screening programme and to perform corrective surgery. This will ultimately reduce the backlog and current waiting times.

The current case load at the Red Cross War Memorial Children’s Hospital indicates that approximately 40 to 50% of young patients are referred from health facilities in Mitchells Plain/Klipfontein, making it the primary feeder area. This is why the Mitchells Plain sub-district has been chosen for the roll-out of the pilot.

Western Cape Minister of Health, Theuns Botha, said he was very proud of the partnership approach for this project. “The pilot is an example of what we can achieve in partnership. I will keep a keen eye on the progress with the screenings, and especially the outcomes. The more screenings we are able to do now, the better the speech and hearing outcomes in the years to come. It is crucial that children with hearing loss are identified as early as possible. Personally I am very excited that we are now shifting our focus to non-preventable diseases.”       

Premier Zille stated that every child deserves an equal opportunity to fulfil their dreams and become successful, independent adults later in life.   

That is why the Western Cape Government has introduced this programme to ensure that this specialised healthcare is accessible and affordable to underprivileged children and their families.

We believe that this initiative will contribute towards ensuring that children who are born with speech or hearing difficulties are not disadvantaged even further because of lack of treatment and support.  We aim to introduce these critical medical services across all levels of the healthcare system in the future including home- and community-based care, primary care clinics and community health centres, intermediate care facilities, and at district hospitals.

We call on parents to support this programme and if their babies or children show any signs of hearing or speech difficulties to immediately take them to their nearest clinic or health facility so they can be screened, referred and receive the treatment they need. It is only through all of us accepting our responsibilities that we will ensure children being born with disabilities are taken care of and receive the support and the opportunities they need to reach their full potential.

“By alleviating the burden on the Red Cross War Memorial Children’s Hospital, the Children’s Hospital Trust’s commitment to funding a portion of the costs will ensure that the Hospital is able to treat those children with specialist speech-language and audiology needs more effectively and timeously in future. The intended outcome of the refinement of these services is that more appropriate referrals are made for tertiary level care and thus lessen the load for tertiary hospitals, where patients can be correctly diagnosed and treated at preceding levels of health services,” says Louise Driver, CEO of the Children’s Hospital Trust.

“Early intervention and access to equal opportunities have always been at the heart of the Carel du Toit Centre. After years of research and community involvement, we are grateful and proud of this equal partnership between the Carel du Toit Centre, the Western Cape Government Health and the Children’s Hospital Trust, which will make a life changing difference to children with any kind of communication difficulty as well as their families. By integrating Speech-Language and Audiology services into the District Health System, rehabilitation services will be entering a bright new future” says Ruth Bourne, Principle of the Carel du Toit Centre.