Empowering Schools for Inclusive Hearing Care: A Public Health Approach to Early Detection and Prevention of Hearing Loss in Nepal

Abstract

Background: Hearing loss is a neglected public health concern in Nepal, affecting an estimated 16.6% of the population, with significant implications for children, occupational groups, and underserved communities. Despite its prevalence, ear and hearing care remain underprioritized in national health policy. This study aimed to assess the burden of hearing impairment in Nepal and evaluate interventions to inform inclusive and context-sensitive strategies.

Methods: A systematic literature review was conducted using databases such as PubMed, Google Scholar, and ResearchGate, following PRISMA guidelines. Sixteen studies meeting the inclusion criteria were synthesized, encompassing cross-sectional surveys and randomized trials. Quantitative analyses included Q-Q plots, P-P plots, and forest plots to assess prevalence distributions and intervention outcomes.

Results: It revealed hearing loss prevalence ranging from 5.4% to 49.6% across different populations, with conductive hearing loss due to chronic otitis media being most common. Children in monastic schools and rural areas, workers exposed to occupational noise, and patients at tertiary hospitals were disproportionately affected. Surgical interventions like tympanoplasty showed high success rates, while telemedicine emerged as a promising tool for remote care. School-based programs and community outreach initiatives demonstrated potential but faced barriers such as low awareness, cultural stigma, and economic constraints.

Conclusion: The study addressing hearing loss in Nepal requires a multifaceted approach that integrates early screening, community engagement, surgical capacity-building, and telemedicine. Inclusive and sustainable ear care interventions, especially in schools, are essential to reduce the burden of preventable hearing impairment in low-resource settings.