Bridging the Access Gap: The Telepractice Experience of Speech Therapists and Audiologists at a Public Health Care Facility in South Africa




Audiology, Public healthcare, Speech therapy, South Africa, Telepractice


South Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient- centered care.



Bolarinwa, O. A., Claassens, M. M., Cowden, R. G., Day, C. T., Ezekannagha, O., Ginindza, T. G., Iwu, C. C. D., Iwu, C. J., Karangwa, I., … Naghav, M. (2022, January 19). Health trends, inequalities and opportunities in South Africa’s provinces, 1990–2019: Findings from the Global Burden of Disease 2019 Study. Journal of Epidemiology & Community Health, 76, 471-481. https://doi:10.1136/jech-2021-217480

Adebayo, P. B., Oluwole, O. J., & Taiwo, F. T. (2021). COVID-19 and teleneurology in Sub-Saharan Africa: Leveraging the current exigency. Journal Frontiers in Public Health, 8(574505), 1-6.

Annie, T., Pleasants, S., Hultman, G., Lindemann, E., Thompson, J. A., Billecke, S., Badlani, S., & Melton, G. B. (2020). Rapid implementation of a COVID-19 remote patient monitoring program. Journal of the American Medical Informatics Association, 27(8), 1326-1330.

Balton, S., Vallabhjee, A. L., & Pillay, S. C. (2022, August 8). When uncertainty becomes the norm: The Chris Hani Baragwanath Academic Hospital's Speech Therapy and Audiology Department's response to the COVID-19 pandemic. South African Journal of Communication Disorders, 69(2).

Banks, L., Davey, C., Shakespeare, T., & Kuper, H. (2021). Disability-inclusive responses to COVID-19: Lessons learnt from research on social protection in low- and middle-income countries. World Development, 137, 105178.

Benson, N. (2020). Teleaudiology amid COVID-19: Optimizing available equipment. Hearing Journal, 73(10), 10-13.

Camden, C., & Silva, M. (2021). Pediatric teleheath: Opportunities created by the COVID-19 and suggestions to sustain its use to support families of children with disabilities. Physical & Occupational Therapy in Pediatrics, 41(1), 1-17.

Cheng, C., Manji, K., Appel, L., & Smith, C. (2022). Patient experiences with a remote monitoring pathway for COVID-19. Cureus, 14(6), e26263.

Chitungo, I., Mhango, M., Mbunge, E., Dzobo, M., Musuka, G., & Dzinamarira, T. (2021). Utility of telemedicine in sub-Saharan Africa during the COVID-19 pandemic. A rapid review. Human Behavior and Emerging Technologies, 3(5), 843-853.

Cleffi, C., Su, W-C, Srinivasan, S. M., & Bhat, A. (2022). Using telehealth to conduct family-centered movement intervention research in children with autism spectrum disorder during the COVID-19 pandemic. Pediatric Physical Therapy, 34(2), 246-251.

Coco, L. (2020). Teleaudiology: Strategies, considerations during a crisis and beyond. Hearing Journal, 73(5), 26-29.

Dlamini Zuma, N. (2020). Declaration of a national state of disaster [Government Gazette].

Gefen, N., Steinhart, S, Beeri, M, & Weiss, P.L. (2022). Lessons learned during a naturalistic study of online treatment for pediatric rehabilitation. International Journal of Environmental Research and Public Health, 18(2), 6659.

Govender, S., & Mars, M. (2018, April). The perspectives of South African academics within the disciplines of health sciences regarding telehealth and its potential inclusion in student training. African Journal of Health Professions Education, 10(1), 38.

Hall, B. J., & Luechtefeld, J. T. (2021). Pediatric physical therapy telehealth and COVID-19: Factors, facilitators, and barriers influencing effectiveness - a survey study. Pediatric Physical Therapy: The Official Publication of the Section on Pediatrics of the American Physical Therapy Association, 33(3), 112-118.

HPCSA. (2014). General ethical guidelines for good practice in telemedicine.

HPCSA. (2021, December). General ethical guidelines for good practice in telemedicine. Booklet 10. Developed by the Human Rights, Ethics and Professional Practice Committee.

HPCSA 1. (2020). Guidelines on telemedicine in SA.

HPCSA 2. (2020, March 9). Guidance on the application of telemedicine guidelines during the COVID-19 pandemic.

HPCSA 3. (2020, April 3). Notice to amend telemedicine guidelines during COVID-19.

Hui, K. Y., Haines, C., Bammann, S., Hallandal, M., Langone, N., Williams, C., & McEvoy, M. (2021, August 19). To what extent is telehealth reported to be incorporated into undergraduate and postgraduate allied health curricula: A scoping review. PLOS ONE, 16(8).

Kautzky, K., & Tollman, S. M. (2008, January 1). A perspective on primary health care in South Africa: Primary health care: In context. Sabinet, 2008(1), 17-30.

Khoza-Shangase, K., Moroe, K., & Neille, J. (2021). Speech-language pathology and audiology in South Africa: Clinical training and service in the era of COVID-19. International Journal of Telerehabilitation, 13(1), e6376.

Krumm, M., & Symms, M. J. (2011, December). Teleaudiology. Otolaryngologic Clinics of North America, 44(6), 1297-304.

Mars, M. (n.d.). Telerehabilitation in South Africa –Is there a way forward? International Journal of Telerehabilitation, 3(1), 11-18.

Mars, M. (2013). Telemedicine and advances in urban and rural healthcare delivery in Africa. Progress in Cardiovascular Diseases, 56(3), 326-335.

Mathews, S. C., Goga, A., Loveday, M., Zembe, W., Daviaud, E., Siegfried, N., & Lewin, S. (2019). Moving towards universal health coverage: Strengthening the evidence ecosystem for the South African health system. South African Medical Journal, 109(11b), 8-14.

Moonasar, D., Pillay, A., & Leonard, E. (2021). COVID-19: Lessons and experiences from South Africa’s first surge. BMJ Global Health, 6(e004393).

NDP (2017). Understanding the context of the National Development Plan (NDP). South African Government.

Parliament of South Africa. (2022, March 27).

Overview of Chris Hani Baragwanath Academic Hospital. Parliament of South Africa. 2022_National_Council_of_Provinces_Provincial_Week/Gauteng/Chris_Hani_Baragwanath_Academic_Hospital_Site_Profile.pdf

Paruk, F., Pillay, U, Rech, D, Maimela, G., Matsebula, T., Harris, & Roseanne. (2022). Telehealth opportunities for South Africa have been brought into focus by the COVID-19 pandemic. SAMJ: South African Medical Journal, 112(4), 251.

Pillay, M., Tiwari, R., Kathard, H., & Chikte, U. (2020). Sustainable workforce: South African audiologists and speech therapists. Human Resources for Health, 18(1), 13.

Protection of Personal Information Act (POPI Act). (2019).

Rabe, M. (2022). Telehealth in South Africa: A guide for healthcare practitioners in primary care. South African Family Practice, 64(1), e1-e6.

SAHRC. (1999). I know my rights. maHp.

South African Government. (2020). South African Government: Social grants Coronavirus Covid -19. South African Government.

StatsSA (Statistics South America). (2011).

StatsSA (Statistics South America) (2021). Statistical Release P0302 mid-year population estimates 2021.

Swanepoel, D., & Hall, J. W. (2010). A systematic review of telehealth applications in audiology. Telemedicine Journal and e-Health, 16(2), 181-200.

Swanepoel, D. W., Olusanya, B. O., & Mars, M. (2010). Hearing health-care delivery in sub-Saharan Africa–a role for tele-audiology. Journal of Telemedicine and Telecare, 16, 53-56.

Tenforde, S. A., Borgstrom, H., Polich, G., Steere, H., Davis, S. I., Cotton, K., O'Donnell, M., & Silver, K. J. (2020). Outpatient physical, occupational, and speech therapy synchronous telemedicine: A survey study of patient satisfaction with virtual visits during the COVID-19 pandemic. American Journal of Physical Medicine & Rehabilitation, 99(11), 977-981.

Townsend, A. B., Mars, M., & Scott, R. E. (2020). The HPCSA's telemedicine guidance during COVID-19: a review. South African Journal of Bioethics and Law, 13(2), 97-102.

Wales, D., Skinner, L., & Hayman, M. (2017). The efficacy of telehealth-delivered speech and language intervention for primary school-age children: A systematic review. International Journal of Telerehabilitation, 9(1), 55-69.




How to Cite

Govender, S., Vallabhjee, A. L., Charles, C. R., Roesch, D., & Balton, S. (2022). Bridging the Access Gap: The Telepractice Experience of Speech Therapists and Audiologists at a Public Health Care Facility in South Africa. International Journal of Telerehabilitation, 14(2).



Country Reports