An Intervention to Improve Uptake of Referrals for Children with Ear Disease or Hearing Loss in Thyolo District, Malawi

(1) Introduction : Poor uptake of referral for ear and hearing services in Malawi has been demonstrated in previous research. A multi-component educational intervention was developed to address poor uptake. The aim of this study was to explore the feasibility and acceptability of the intervention. In addition, we aimed to provide a case study of an intervention development and feasibility testing process in preparation for a potential randomised trial. (2) Methods : The intervention included three components: (i) an information booklet; (ii) personalised counselling by a community health worker and an expert mother; (iii) a text message reminder. To assess feasibility, the counselling and information booklet were provided for caregivers of eligible children ( Results : 30 children were recruited, and 53% took up the referral. Interviews found counselling with a booklet was acceptable. It provided motivation, enabled a two-way conversation, and helped dispel fear. It allowed information to be shared with social networks, initiating conversations about raising funds. The text message reminder was reported to be a valued prompt. Challenges to feasibility included low network coverage, and time needed for counselling. Residual barriers included the costs of transportation. The cost was £3.70/camp. (4) Conclusion s : The study found that counselling with an information booklet was feasible and acceptable. The process of testing the feasibility of the intervention identified some adaptations to the intervention components and delivery which could be implemented before it is tested in a trial. This study highlighted the value of the feasibility testing process

Audiology · Conversation · Family medicine · Hearing loss · Intervention (counseling · Outreach · Referral · Emergency and Acute Care Studies · Healthcare Systems and Technology · Medicine · Nursing · Psychology · Telemedicine and Telehealth Implementation

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