Tech Transfer: What should a hearing aid/device be in Low and Middle Income Countries

Transcription

1 Tech Transfer: What should a hearing aid/device be in Low and Middle Income Countries Katherine D. Seelman, Ph.D. Associate Dean and Professor Rehabilitation Science and Technology University of Pittsburgh, USA Ad Hoc Consultation on hearing device technology transfer to LMI Countries Geneva, Switzerland 12.March 2013 World Health Organization 3/18/2013 1

2 We have hearing loss? What do we need? Ask us. 3/18/2013 2

3 What gives our lives meaning : A function of need and hearing loss Whom, what and where? We really want to communicate. Language development for my child Inclusion in social life with my family and community Learning and inclusion in school Get a job and communicate at work Maintain good health 3/18/2013 3

4 What do end users need? Technology and services and public education about hearing loss Awareness Identification & Assessment Training Support for users Provision Evaluation WHO 3/18/2013 4

5 Train us; train local community workers who will train health workers, teachers and teach the public Hearing-related Advocacy skills Making and repairing aids Create a primary care health service with includes hearing care Causes and prevention Learn to communicate with people with hearing loss Audiologist trains local audio tech workers (train the trainer) Hearing Learn about hearing and use of hearing aids Identifying, Treating & managing disease and injury Conducting hearing tests Delivering hearing equipment Providing support, repair, maintenance 3/18/2013 5

6 What we need: Affordability for end users; which technology? Procure high quality, low cost hearing aids, batteries and services for us Choose aids that meet international technical performance and best practice service criteria Leapfrog the grid with rechargeable batteries and chargeable and/or plug-in rechargers or use zinc batteries. Distribute product and deliver services near point of care. Community-based rehabilitation in the community Health services units Schools At home 3/18/2013 6

7 What we need: Availability for end users; which technology? Distribute product and deliver services near where we live, learn and work-- point of care. Community-based rehabilitation in the community Health services units At home Audio technician with audio kit 3/18/2013 7

8 Why do we adopt a hearing aid? Adoption and acceptance factors for end users. Which hearing technology? Technical features Hearing technology that helps to restore meaning to my life High quality sound (tech. specs) Listening utility (sounds, gatherings, worship, phone) Simple to use No whistling/feedback, a volume control Durable and reliable Sustainable repairs, maintenance, replacement Warranties 3/18/2013 8

9 Why do we adopt a hearing aid? Adoption and acceptance factors for end users. Which technology? Psychosocial factors I am a parent yearning to communicate with my child; to help him develop language and learn in school. My government and my culture may support my use of a hearing aid but sometime they do not. Some people believe that hearing loss is caused by bewitchment. Others believe that home remedies are an effective cure for earache or ear infection. Public attitudes sometime assume that I am dumb. People with hearing loss are unable to live independently and contribute to the running of the household I feel ashamed when I am teased and bullied because I cannot hear or I wear a hearing aid. 3/18/2013 9

10 But tech transfer is not only about individuals Organizational structures and relationships with the purpose of coordinating and steering availability, affordability and adoption Facilitators, barriers and actors involved in the organization framework. Mapping activities that produce access for the end user. WHO. Health Tech Assessment /2011/ _eng.pdf 3/18/

11 A model of technology transfer adapted to medical devices Original: Frost & Reich (2008). Access: How do good Health technologies get to poor people and poor countries? Harvard U. Press 3/18/

12 Innovation New industry configurations: Apple, Omron, Intricon, CEA, consumer electronics, ICT, telecom New technology: amplification apps on cell phones, ipod-style bodyworn hearing aid New Delivery systems: Telerehabilitation and teleaudiology; on-line hearing tests Hearing environments 3/18/

13 Toward a roadmap Values (Development model, concern for equity & equality; end user participation, safety, effectiveness) Measures Product example Value chain example (Manufacture, purchase and procure, distribute, deliver service, use, evaluate) Affordable (social investing, appropriate donation solicitation and provision innovation) Under US$100 Market New industries, companies and products enter market Solar hearing aid, battery, re-charger Mobile hearing mold kit Instant custom ear mold Manufacture & design: materials R&D, no patent, made by people with disabilities Procurement: NGO market buys in bulk Distribution: Directly to project location Delivery: Point of care Available (Re-mapping value chain of manufacturing, purchase, distribution, delivery, use) Adoptable (Quality of life; incentives for provider incentives; evidencebased) HA brands Rechargeable battery brands HA Mold delivery systems, trainees, employment Feasibility study (end users and providers) acceptance & use studies Ear Molds DIY ( Do It Yourself ); Mobile hearing tech Kit WHO research, AIFO research, INAHTA research People with disabilities assemble, sell and distribute. Local service delivery: Itinerant trained workers Direct delivery to end user NGO and international organizations; adopt; government adoption; provider adoption; end user adoption. Sustainable (local capacity Economic, World Wide Hearing CBR model: Build local skill capacity building, increased ADLs, education, (WWHI) assembling, service delivery and repair, learning, working ) employment and maintenance, replacement; evaluation participation 3/18/2013 measures 13