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An Intervention to Improve Uptake of Referrals for Children with Ear Disease or Hearing Loss in Thyolo District, Malawi: Acceptability and Feasibility

Author

Listed:
  • Antonia Baum

    (International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1 E7HT, UK)

  • Wakisa Mulwafu

    (Department of Surgery, College of Medicine, University of Malawi, Blantyre, Malawi)

  • Mwanaisha Phiri

    (Audiology Department, Queen Elizabeth Central Hospital, Blantyre, Malawi)

  • Sarah Polack

    (International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1 E7HT, UK)

  • Tess Bright

    (International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1 E7HT, UK)

Abstract

(1) Introduction : Poor uptake of referral for ear and hearing services in Malawi has been demonstrated in previous research. A multi-component educational intervention was developed to address poor uptake. The aim of this study was to explore the feasibility and acceptability of the intervention. In addition, we aimed to provide a case study of an intervention development and feasibility testing process in preparation for a potential randomised trial. (2) Methods : The intervention included three components: (i) an information booklet; (ii) personalised counselling by a community health worker and an expert mother; (iii) a text message reminder. To assess feasibility, the counselling and information booklet were provided for caregivers of eligible children (<18 years) at ear and hearing outreach camps in Thyolo. Text message reminders were sent to caregivers after the camps. After 4 weeks, all caregivers were revisited and completed a structured questionnaire and a subset were interviewed in-depth. (3) Results : 30 children were recruited, and 53% took up the referral. Interviews found counselling with a booklet was acceptable. It provided motivation, enabled a two-way conversation, and helped dispel fear. It allowed information to be shared with social networks, initiating conversations about raising funds. The text message reminder was reported to be a valued prompt. Challenges to feasibility included low network coverage, and time needed for counselling. Residual barriers included the costs of transportation. The cost was £3.70/camp. (4) Conclusions : The study found that counselling with an information booklet was feasible and acceptable. The process of testing the feasibility of the intervention identified some adaptations to the intervention components and delivery which could be implemented before it is tested in a trial. This study highlighted the value of the feasibility testing process.

Suggested Citation

  • Antonia Baum & Wakisa Mulwafu & Mwanaisha Phiri & Sarah Polack & Tess Bright, 2019. "An Intervention to Improve Uptake of Referrals for Children with Ear Disease or Hearing Loss in Thyolo District, Malawi: Acceptability and Feasibility," IJERPH, MDPI, vol. 16(17), pages 1-16, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:17:p:3144-:d:261919
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    References listed on IDEAS

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    1. Ksoll, Christopher & Lilleør, Helene Bie & Lønborg, Jonas Helth & Rasmussen, Ole Dahl, 2016. "Impact of Village Savings and Loan Associations: Evidence from a cluster randomized trial," Journal of Development Economics, Elsevier, vol. 120(C), pages 70-85.
    2. Lena Morgon Banks & Hannah Kuper & Sarah Polack, 2017. "Poverty and disability in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-19, December.
    3. Jane Wilbur & Tess Bright & Thérèse Mahon & Shaffa Hameed & Belen Torondel & Wakisa Mulwafu & Hannah Kuper & Sarah Polack, 2018. "Developing Behaviour Change Interventions for Improving Access to Health and Hygiene for People with Disabilities: Two Case Studies from Nepal and Malawi," IJERPH, MDPI, vol. 15(12), pages 1-21, December.
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