Cochlear Implant Program in Rural India


Co-authors: Bela J, Anuragini G, Shruti B

In India, around 6.3% (63 million) people suffer from significant auditory loss, according to WHO (2018). The estimated prevalence of adult-onset deafness in India is 7.6 % and childhood-onset deafness is 2%. 4 in every 1000 children suffer from severe to profound hearing loss.

Hearing impairment is not visible but it has a huge impact on an individual. The consequences of a child born with hearing loss are quite severe. A child with hearing loss cannot develop speech and language abilities and this puts the child at a disadvantage in school, higher education and limits professional opportunities.

Government of India Initiative to Detect Hearing Loss

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To identify hearing loss in the early childhood days, the Government of India has started a Universal Hearing Screening of newborn babies. They are screened with the help of Oto Acoustic Emissions ( OAE ) soon after birth. This helps in early diagnosis and management. But even today this program is put into practice in cities only, without considering that a large number of people in rural areas constitute our population.

When a child is diagnosed with Severe to Profound hearing loss, one of the best management options is a Cochlear Implant. A cochlear implant is an electronic device that is used for people with severe to profound hearing loss who are no longer helped by hearing aids.

Unlike hearing aids, which amplify sound, a cochlear implant bypasses damaged portions of the ear to deliver sound signals to the hearing (auditory) nerve. It consists of two components, the external and internal. The external component is placed on the outer surface that is the ear or on the head and an internal component is surgically placed inside the ear i.e in the cochlea.

A cochlear implant is the latest technology in hearing sciences that helps an individual hear like a normal person and helps  bridge the communication gap. However, one must note that not every case of hearing loss qualifies for a cochlear implant.

Journey After a Cochlear Implant Placement

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After placement of a cochlear implant, an individual needs to undergo auditory-verbal therapy which teaches them to learn, listen and communicate. A Speech-Language Pathologist plays a crucial role in walking along with the individual through their journey of listening. On the other hand, an Audiologist helps the patient in mapping and any technical services needed with the device.

Many other factors like the age of the patient, patient motivation, support from the family and other associated problems play an important role in the improvement of a patient’s hearing.

Following cochlear implant placement, a small group of people may experience reduced balance function or increased tinnitus.

Challenges Overcome by Technology

Technology has helped people who are educated to understand the benefits achieved through the device and they are also able to afford the cost of the surgery but the same is not seen in rural India. The main reason for poor penetration of the surgery in masses in rural areas is the inhibitory cost associated with cochlear implant surgery and the lack of trained manpower to conduct such surgeries.

The other reason is being the government engagement with other pressing health needs of the society. A National Program for prevention and control of Deafness(NPPCD) in 2006 was started with the interest of handling this public health disaster. More recently, the Government of India under its Ministry of Social Welfare’s Assistance to Disabled Persons scheme (ADIP) has launched a cochlear implant programme for individuals who cannot afford a Cochlear Implant.

Key Takeaway!

The focus has now shifted to propagate this technology further at the grass-root level and reach all the remote rural villages across this vast country. The successful Indian IT industry, which provides round-the-clock services to global citizens, has facilitated setting up a network of telemedicine centres with broadband connectivity to offer remote programming and rehabilitation services on the doorstep for cochlear implantees hundreds of miles away from their parent CI centre.

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About the author

Prof. Ashok Gupta is the Director & Head of the Department of ENT, Fortis Hospital, Mohali. He has headed the unit of Otorhinolaryngology & Head-Neck Surgery for six years at the Post Graduate Institute of Medical Education and Research, Chandigarh. Prof. Dr Gupta is considered an eminent medical teacher with significant research contributions and outstanding professional achievements. He has served as a faculty for many national and international conferences.



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