Skip to 0 minutes and 10 secondsSTEVE CRUMP: The pathway of care that we're testing at the moment in Pakistan, in partnership with DFID, is about equipping community health workers to conduct a very simple screening for deafness. If we see, or suspect, a child is deaf, they are then referred for an in-depth audiological assessment. During that process, we ascertain what level of deafness the child has got. And then, once we know where we're at, we then put in place a bespoke programme of care, which would invariably involve sign language skills training, speech and language therapy, and, if appropriate, and if effective for the child concerned given their level of deafness, the fitting of a hearing aid.

Skip to 0 minutes and 56 secondsWhat we would also do, is address any medical condition that's causing the deafness, and also any mental health concerns that have arisen as a result of the isolation, the frustration, that often occurs with deafness. We will also support the parents, to empower and resource their kids, and also support them in accessing education. So that is looking at the educational opportunities available, and to enable them to make informed decisions about where they want their child to be educated - their deaf child to be educated. In Pakistan, that's about brokering access to some of the schools for the deaf, and some of the education for the deaf facilities that are there.

Skip to 1 minute and 48 secondsAnd ensuring, then, that parents understand what's involved, the intricacies, the challenges of bilingual education, and ensuring that they make the decisions that they want. So there is there that interaction of health and education, because clearly by looking to respond to the ear and hearing care needs of the child, by responding to their deafness, by equipping them to communicate, we can then take decisions about what the best educational solution is for that child.

Case study: addressing a broad range of needs

As we come towards the end of the week and the end of the course, we want to present a programme that addresses healthcare and a child’s broader needs, including access to education and freedom from violence and abuse.

In the video above and programme outline below, Steve Crump and Gemma Twitchen present a programme from DeafKidz International, an organisation working in 11 countries to support D/deaf children across four themes: (1) Rights; (2) Livelihoods; (3) Access to Appropriate Technology; and (4) Wellbeing.

Their global vision is that every D/deaf child lives in a safe, caring and supportive environment, free from poverty, violence and exploitation. DeafKidz International work with various service providers and disabled persons organisations (DPOs) to create sustainable change.

The term D/deaf is used by DeafKidz International to represent those who identify as a member of the deaf community (capital D) and those who are deaf and have hearing loss, but do not identify as part of the community (lower-case d).

Safe Futures Pakistan

DeafKidz International in collaboration with Ayesha Bashir Trust Hospital, Gujrat, Pakistan. Funded by UKAid.

Project background

Across the world, the prevalence of hearing loss is highest in South Asia, where 2.4% of individuals have disabling hearing loss, compared with 0.5% in high-income countries.1 In Pakistan, research shows an association between hearing issues and consanguinity, infection and poor access to healthcare.2 There is currently no hearing screening programme in Pakistan and few infants are assessed and diagnosed. Additionally, the awareness of D/deafness is low and D/deaf children are vulnerable to discrimination and abuse. The project “Signing Safe Futures Pakistan!” presents an opportunity to address this gap through early and integrated intervention, so that no D/deaf child is left behind.

Project Summary

This programme aims to reduce the discrimination experienced by D/deaf children and young people in Gujrat, Pakistan, by developing and testing an integrated programme and pathway of care. This programme includes:

  1. Raising awareness of D/deafness in the community and primary healthcare through leaflets and community events.
  2. Screening for hearing impairment at primary care level using mobile phone screening devices.
  3. Trained health workers look for signs of D/deafness in the community and encourage community members to have their hearing screened.
  4. Onward referral to secondary & tertiary care for assessment, management and support for diagnosed D/deafness. This includes sign language support, speech and language therapy, and hearing aids.
  5. Safeguarding, communication and parenting support are provided, to help maximize a child’s potential and ensure parents are given the information and guidance to support their child.
  6. Parents are given information on access to education and are connected with various schools.

This programme adopts a holistic approach to help ensure children are able to access appropriate healthcare and other services to address a range of broader needs, so they are less susceptible to abuse and discrimination, and are able to access services to support their development.

Discussion

Think about the case study and a holistic approach to the care of children with developmental disabilities in your setting.

  • What is role does a healthcare professional in supporting a child’s broader needs?
  • Other than healthcare providers, which other services and organisations could you collaborate with in your setting?
  • How could you begin to start working with these organisations to help empower children with developmental disabilities and their families?

It may be helpful to think on the targeted outcomes of the case study programme above – healthcare access, safeguarding, education, empowerment

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This video is from the free online course:

Integrated Healthcare for Children with Developmental Disabilities

London School of Hygiene & Tropical Medicine