Advancing Person-Centered Care in South Africa Through Ida Workshops
When our Senior Audiologist, Cherilee Rutherford, was an 18-year-old student living in George, SA, her admiration for journalists like Christiane Amanpour had her gazing towards a life in journalism. She was drawn to the search for truth and to stories of our humanity. But instead of following a path to writing, Cher found herself in the beautiful, tree-lined town of Stellenbosch, SA, studying speech-language pathology and audiology. After graduating, and spending 15 productive years in the UK, she returned to South Africa and eventually joined us here at the Ida Institute. She now uses her skill with active listening, open-ended questions, empathy, understanding, and her years of experience as an audiologist, to teach others how to bring out stories and find the truth in their patients.
This summer, she’ll lead five workshops across South Africa to help hearing care students, educators and practitioners develop person-centered care.
We asked her about audiology and person-centered care in South Africa and what role workshops like Ida’s play in developing hearing care in the country.
What does audiology in South Africa look like?
South Africans span a wide range of economic and employment realities and audiology access here is equally varied. About 16% of the population has health insurance and can access private healthcare, but most people rely on public health services which suffer the effects of underfunding. We don’t yet have universal newborn hearing screening, although good progress is being made towards that goal. While rural locations struggle with resources, inspiring audiology work is being done, especially by more well-funded tertiary hospitals like the Red Cross Children’s Hospital, Tygerberg Hospital, and Baragwanath. There have also been great accomplishments in the field, like a surgery team from Pretoria University using the world’s first 3-D printed middle-ear bones to enable hearing, the development of the KudoWave to conduct accurate hearing tests without a sound booth, and the HearX group’s app for hearing screening—which includes Ida tools! There are also two strong and dedicated professional organizations in South Africa—SAAA and SASLHA—that continue to move the profession forward.
Is person-centered care integrated into healthcare there?
In South Africa, person-centered care is endorsed by both the Constitution and a 1997 document called the Batho Pele White Paper. Batho Pele, roughly translated from the Sotho language, means “people first” and contains a set of eight principles which are closely aligned to person-centered principles. However, the unfortunate reality is that person-centered care is not yet part of routine clinical practice. This is not unique to SA, but something we see and hear from most countries around the world.
How do the universities prepare audiology students for their career? Is PCC part of the curricula?
There’s been a lot of hard work by unsung heroes in academic institutions to transform the audiology curriculum to better suit the needs of the local population. Audiology education in South Africa is very good and there are five universities that offer degree courses. Different universities approach teaching PCC in different ways, but perhaps colleagues will agree that more can be done to better balance teaching the technical aspects of audiology and the human dynamics of hearing care like PCC and communication. That of course isn’t unique to South Africa. There’s great commitment and enthusiasm for PCC training in SA, all of which bodes well for future clinicians for whom PCC will be the norm rather than the exception.
This summer, you’re teaching five workshops on PCC across the country. Why are workshops like these important?
In order for PCC to become a reality in day to day practice, we need to target education and continued professional development at the same time. Workshops like these place PCC at the front of people’s minds and professional agendas. They provide very practical, hands-on opportunities for academics and clinicians to reflect, make plans, and share their experiences with students and peers. The workshops are also very important vehicles for feedback to Ida in terms of how tools and resources are used and adapted for local relevance.
Can you tell us about the workshops?
Yes! We have an exciting few months of workshops coming up!
The first workshop in May is with the speech pathology and audiology department of Baragwanath Hospital in Soweto. Bara is the world’s third largest hospital and the speech-language pathology and audiology team consists of approximately 40 staff members. At the workshop, we will introduce PCC and discuss opportunities for colleagues to build PCC more actively into their routine practice.
The second workshop in May is with WITS, University of Pretoria, and Sefako Makgatho University in the northern part of the country. This is a follow-up to one we did at the beginning of the year where we tried to find ways of making supervision more student centered and enable PCC in the student and university clinics.
In June there will be another follow-up workshop with partner university, UCT. UCT’s academic staff committed to participating in the Inspired by Ida program and I’m looking forward to hearing how this is influencing their teaching and clinical supervision, and to what the next steps are for integrating PCC into the curriculum.
Workshops four and five will be done for Gauteng and Western Cape members of the South Afican Audiology Association, one of our professional organization partners. These August and September workshops offer continued professional development opportunities for professionals and we will provide a day of reflective practice and sharpening our focus on PCC. We’ll think about PCC from a patient perspective, consider patient engagement using Ida Telecare, and provide some active worktime for clinicians to make their own plans for better implementation of PCC into their practices. We will also be joined by Sakhile Nkosi who will share his experiences with Ida Tools and PCC from a resource-constrained, rural perspective.
These workshops provide a unique opportunity for us to work with key actors to develop PCC and influence future generations of audiologists in South Africa. They also allow us to learn from our participants and bring a global perspective to the Ida Institute.