6th UK and Ireland Implementation Science Research Conference 2023
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PRESENter
authors
Biography
Dr. Andile Sibiya is an ENT surgeon with special interest and expertise in otology and laryngology. As the Academic Head of Otorhinolaryngology at the University of KwaZulu-Natal, she leads teaching, research, and training initiatives. Concurrently, she takes an active role in shaping ENT service design and delivery in KwaZulu-Natal’s public sector. Passionate about improving access to specialised clinical care, Dr. Sibiya has been instrumental in delivering surgical training workshops within the province and has participated as invited faculty in various training courses across South Africa. Dr. Sibiya holds an MBA from Oxford University, which has bolstered her strategic thinking and pragmatic inclination toward research rooted in Implementation and Health Systems Improvement.
Through her multifaceted engagement in education, clinical service design, and public health, Dr. Sibiya is committed to making a meaningful impact on improving the healthcare landscape in KwaZulu-Natal.
background
The sustainability of cochlear implant programmes in LMIC’s is threatened by contextual and ecological system factors. Hearing loss is the most common sensory disability and the third greatest contributor to the global burden of disease. Communication disorders resulting from untreated hearing loss significantly contribute to poverty in LMICs. KwaZulu-Natal (KZN) is the second most populous province in South Africa and the third poorest province in the country. Until 2021, KZN was the only large province without a public sector implant programme.
MEthod
The Dynamic Sustainability Framework (DSF) is used to describe this programme’s design and initial delivery; namely, the fit between Intervention, Practice Setting and Ecological System. A task team consisting of an ENT surgeon, rehabilitationist, audiologist, and Activist for Deaf children, designed a contextually relevant model for service delivery within KZN. Qualitative methods using a case study approach were adopted. Unstructured interviews were conducted with purposively selected existing state programmes affiliated with the South African Cochlear Implant Group (SACIG). Data was analysed using thematic analysis.
results
Pre-emptive and iterative consideration of the intervention, context and ecological characteristics enabled rapid delivery of the programme. Within one year of launch, the programme had developed a team with three implanting surgeons, three specialized Audiologists, as well as a network of radiologists, psychologists, social workers and paediatricians. In the first year alone, the team had successfully implanted 8 patients, with a growing number on the waiting list.
Conclusion
The programme remains a sustainable entity despite staff and mentor emigration; hospital management turnover; prohibitive exchange rate fluctuations; and even major changes in the political landscape. Rational use of limited public health resources was considered at all stages of design and delivery. The sustainability rests in the intentional design that took place where change was considered inevitable, and ongoing responsible patient care was non-negotiable.