Culturally-Appropriate Delivery of ENT Services Improves Child Hearing

A NSW project which employs Indigenous health workers to act as “health brokers” has dramatically reduced waiting lists of Aboriginal and Torres Strait Islander children needing treatment for hearing issues.

The Hearing EAr health and Language Services (HEALS) program accelerated children in need of care through the often-labyrinthine path of health services, waiting lists and interventions with the assistance of Aboriginal health officers employed by Aboriginal Community-Controlled Health Services (ACCHS).

The multi-faceted and culturally appropriate approach to treating Indigenous children with hearing issues has seen waiting times for specialist appointments fall sharply, and in some hospitals, surgery wait lists clear completely.

“It’s imperative that children have access to the treatments they need, but families often feel isolated and unsupported when accessing external specialist services,” said Associate Professor Hasantha Gunasekera, Clinical Academic General Paediatrician at Sydney Children’s Hospitals Network (Westmead) who established and manages HEALS.

“It changes a child’s life when they can hear and communicate – they become more engaged at school, they want to learn more. The more you want to learn, the better you do at school.”

To ensure uptake of specialist services, HEALS worked directly with multiple ACCHS to employ Indigenous health workers to support children and their families.

“These health brokers are the essential missing link in the pathway from diagnosis to therapy,” said Associate Professor Gunasekera.

Child speech therapy session
Child audiology assessment

Originally funded by NSW Health in 2013, HEALS has since delivered 8000 speech therapy sessions and over 300 ENT operations to Aboriginal and Torres Strait Islander children in six metropolitan centres in NSW at no cost to the families.

With the assistance of Sydney Health Partners, Associate Professor Gunasekera is now conducting an evaluation of the program to demonstrate quantitatively what has already been established qualitatively: that HEALS was successful in its objective to improve ENT health of Aboriginal and Torres Strait Islander children.

“Parents who had previously described negative experiences when accessing specialist health services, including discrimination and difficulties understanding health information, felt that they could rely on the HEALS Aboriginal Project Officer for guidance and clarification if they needed it.”

On the ground, ACCHS workers expressed support for delivering specialist services to families in partnership with the ACCHS, rather than leaving them to navigate the services on their own.

“If this money had been given to the hospital and they just said, come here for your appointments, and [the families] weren’t supported, I don’t think you would have even got half the people,” said one senior ACCHS Administrator.