Am J Otolaryngol Head Neck Surg | Volume 4, Issue 10 | Research Article | Open Access

Cost Analysis of an Annual School-Based Pediatric Hearing Screening Program in Semi-Rural Kenya

Nicole Kloosterman1*, Kevin N Griffith2, Kristen Yancey3, Asitha DL Jayawardena4 and James Netterville3

1Vanderbilt University School of Medicine, Nashville, TN, USA
2Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
3Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
4Department of Pediatric Otolaryngology-Children’s Minnesota, Minneapolis, MN, USA

*Correspondance to: Nicole Kloosterman 

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Introduction: Approximately 8.9 million children in Sub-Saharan Africa have disabling hearing loss, accounting for 11% of the global child healthcare hearing costs. For children living in Low- and Middle-Income Countries (LMICs), 75% of hearing loss is preventable.
Methods: We evaluate the overall intervention and expansion costs of a humanitarian, pediatric hearing health and screening program in Malindi, Kilifi County, Kenya. A cost analysis is conducted from the provider perspective, identifying the mean cost incurred for each case of newly identified hearing loss. Estimates were made for 3 different cost scenarios. A one-way sensitivity analysis and probabilistic sensitivity analysis using Monte Carlo simulation determined the impact of variations in individual cost parameters. These results were used to project scale-up costs to achieve subcounty expansion of the program.

Results: 155 children ages 5 to 16 years old were screened, of which 5.8% were diagnosed with hearing impairment. The total cost for implementation in four schools was $6,783 USD, thus a mean cost of $212 per diagnosis of hearing loss. The highest proportion of costs were recurrent costs of resident travel (27.9%), capital costs for providing audiometric testing (25.3%), and equipment maintenance (18.7%). Expansion of an exclusively CHW-run program across all 77 primary publicschools in Malindi is projected to be $130,573 (range $119,352 to $142,240).

Conclusion: We provide relevant cost-estimation for an expansion of an intervention which identified higher than average rates of hearing loss. Humanitarian aid plays a key role in the sustainability and feasibility of expanding this program.



Kloosterman N, Griffith KN, Yancey K, Jayawardena ADL, Netterville J. Cost Analysis of an Annual School-Based
Pediatric Hearing Screening Program in Semi-Rural Kenya. Am J Otolaryngol Head Neck Surg. 2021; 4(10): 1161..

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