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

Authors

DOI:

https://doi.org/10.5195/ijt.2022.6517

Keywords:

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

Abstract

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.

  

References

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. https://doi.org/10.3389/fpubh.2020.574505

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. https://doi.org/10.1093/jamia/ocaa097

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). https://doi.org/10.4102/sajcd.v69i.913

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. https://doi.org/10.1016/j.worlddev.2020.105178

Benson, N. (2020). Teleaudiology amid COVID-19: Optimizing available equipment. Hearing Journal, 73(10), 10-13. https://doi.org/10.1097/01.HJ.0000719784.51319.87

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. https://doi.org/10.1080/01942638.2020.1825032

Cheng, C., Manji, K., Appel, L., & Smith, C. (2022). Patient experiences with a remote monitoring pathway for COVID-19. Cureus, 14(6), e26263. https://doi.org/10.7759/cureus.26263

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. https://doi.org/10.1002/hbe2.297

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. https://doi.org/10.1097/PEP.0000000000000872

Coco, L. (2020). Teleaudiology: Strategies, considerations during a crisis and beyond. Hearing Journal, 73(5), 26-29. https://doi.org/10.1097/01.HJ.0000666404.42257.97

Dlamini Zuma, N. (2020). Declaration of a national state of disaster [Government Gazette]. www.gov.za/sites/default/files/gcis_document/202003/43096gon313.pdf

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. https://doi.org/10.3390/ijerph18126659

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. https://doi.org/0.7196/AJHPE.2018.v10i1.957

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. https://doi.org/10.1097/PEP.0000000000000800

HPCSA. (2014). General ethical guidelines for good practice in telemedicine. https://www.hpcsa.co.za/Uploads/Professional_Practice/Conduct%20%26%20Ethics/Booklet%2010%20Telemedicine%20September%20%202016.pdf

HPCSA. (2021, December). General ethical guidelines for good practice in telemedicine. Booklet 10. Developed by the Human Rights, Ethics and Professional Practice Committee. https://www.hpcsa.co.za/Uploads/Professional_Practice/Conduct%20%26%20Ethics/Booklet%2010%20Telemedicine%20September%20%202016.pdf

HPCSA 1. (2020). Guidelines on telemedicine in SA. https://www.hpcsa.co.za/Uploads/Press%20Realeses/2020/Guidelines_to_telemedicine_in_South_Africa.pdf

HPCSA 2. (2020, March 9). Guidance on the application of telemedicine guidelines during the COVID-19 pandemic. https://www.hpcsa.co.za/Uploads/Press%20Realeses/2020/Guidelines_to_telemedicine_in_South_Africa.pdf

HPCSA 3. (2020, April 3). Notice to amend telemedicine guidelines during COVID-19. https://www.hpcsa-blogs.co.za/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). https://doi.org/10.1371/journal.pone.0256425

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. https://hdl.handle.net/10520/EJC35514

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. https://doi.org/10.5195/ijt.2021.6376

Krumm, M., & Symms, M. J. (2011, December). Teleaudiology. Otolaryngologic Clinics of North America, 44(6), 1297-304. https://doi.org/10.1016/j.otc.2011.08.006

Mars, M. (n.d.). Telerehabilitation in South Africa –Is there a way forward? International Journal of Telerehabilitation, 3(1), 11-18. https://doi.org/10.5195/ijt.2011.6069

Mars, M. (2013). Telemedicine and advances in urban and rural healthcare delivery in Africa. Progress in Cardiovascular Diseases, 56(3), 326-335. https://doi.org/10.1016/j.pcad.2013.10.006

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. https://doi.org/10.7196/SAMJ.2019.v109i11b.14245

Moonasar, D., Pillay, A., & Leonard, E. (2021). COVID-19: Lessons and experiences from South Africa’s first surge. BMJ Global Health, 6(e004393). https://doi.org/10.1136/bmjgh-2020-004393

NDP (2017). Understanding the context of the National Development Plan (NDP). South African Government. http://www.nstf.org.za/wp-content/uploads/2017/07/The-NDP-part1-FINALFeatured-SET-Policy.pdf

Parliament of South Africa. (2022, March 27). https://www.parliament.gov.za/

Overview of Chris Hani Baragwanath Academic Hospital. Parliament of South Africa. https://www.parliament.gov.za/storage/app/media/Pages/2022/3-march/22-03 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. https://doi.org/10.7196/samj.2022.v112i4.16382

Pillay, M., Tiwari, R., Kathard, H., & Chikte, U. (2020). Sustainable workforce: South African audiologists and speech therapists. Human Resources for Health, 18(1), 13. https://doi.org/10.1186/s12960-020-00488-6

Protection of Personal Information Act (POPI Act). (2019). https://popia.co.za/

Rabe, M. (2022). Telehealth in South Africa: A guide for healthcare practitioners in primary care. South African Family Practice, 64(1), e1-e6. https://doi.org/10.4102/safp.v64i1.5533

SAHRC. (1999). I know my rights. maHp. http://www.mahpsa.org/wp-content/uploads/2017/09/Pamphlet_-_Accessing_healthcare_services_at_Gauteng_.pdf

South African Government. (2020). South African Government: Social grants Coronavirus Covid -19. South African Government. https://www.gov.za/services/social-benefits/social-relief-distress

StatsSA (Statistics South America). (2011). https://www.statssa.gov.za/?page_id=4286&id=11317

StatsSA (Statistics South America) (2021). Statistical Release P0302 mid-year population estimates 2021. https://www.statssa.gov.za/publications/P0302/P03022021.pdf

Swanepoel, D., & Hall, J. W. (2010). A systematic review of telehealth applications in audiology. Telemedicine Journal and e-Health, 16(2), 181-200. https://doi.org/10.1089/tmj.2009.0111

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. https://doi.org/10.1097/PHM.0000000000001571

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. https://journals.co.za/doi/abs/10.7196/SAJBL.2020.v13i2.725

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.

Downloads

Published

2022-12-13

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). https://doi.org/10.5195/ijt.2022.6517

Issue

Vol. 14 No. 2 (2022)

Section

Country Reports

License

Copyright (c) 2022 Shelissa Govender, Annika L. Vallabhjee, Chenay R. Charles, Darike Roesch, Sadna Balton

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
    with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
  4. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
  5. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
  6. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
  7. The Author represents and warrants that:
    1. the Work is the Author’s original work;
    2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
    3. the Work is not pending review or under consideration by another publisher;
    4. the Work has not previously been published;
    5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
    6. the Work contains no libel, invasion of privacy, or other unlawful matter.
  8. The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.

Revised 7/16/2018. Revision Description: Removed outdated link.