Vulnerable to Impairment
Studies have revealed that women and girls are at a disadvantage with regard to availing ear care services as they are tied up in traditional environment facing stigma and discrimination
BY DR SUNEELA GARG, DR RITESH SINGH & DEEKSHA KHURANA
Gender acts as a barrier to access of ear care services with the result that women continue to disproportionately bear the burden of hearing morbidities across the globe. The prevalence of hearing loss as per WHO’s global estimates is 360 million out of which a significant 145 million (44%) are females.
According to the Global Burden of Disease study, hearing loss is responsible for 27.4 million years lived with disability (YLD). This accounts for 4.8% of the total YLD due to all causes in males and 4.3% in females. The study ranked hearing loss as the third leading cause of YLD among males and females.
Several studies conducted across countries have highlighted that prevalence of ear morbidities among females is high and they are at a disadvantage with regard to availing ear care services.
An analysis of 42 studies on prevalence of hearing loss in 29 countries was published in 2011. The analysis defined hearing loss as hearing thresholds above 35 dB in the better hearing ear in adults and children. The overall prevalence of hearing loss (above 35 dB in the better hearing ear) was determined to be 12.2% in males as compared to 9.8% in females.
A US-based study established that the prevalence of hearing impairment differs according to gender. During the study, overall prevalence of hearing loss was found to be 10.5% for males and 6.8% for females. While males at all ages were more likely than females to be deaf or hard-of-hearing, the gap widens after the age of 18 years.
Another study was carried out in the Italian population in year 2003 to evaluate the prevalence of prelingual deafness. A prelingual deafness refers to congenital deafness or hearing loss occurring before the infant reaches one year when it begins to speak its first words. The study concluded that hearing impairment prevalence differs according to sex with overall prevalence being 0.78 per 1,000 for males and 0.69 per 1,000 for females.
A study in rural southern coastal India
Hearing loss is measured by finding out the hearing threshold in decibels (dB) at which a signal is just barely heard.
The pitches are graphed in audiogram
|
Mild hearing loss |
26-45 dB
(Difficulty in hearing sound from a distance) |
|
Moderate hearing loss |
46-65 dB
(Conversational hearing becomes difficult) |
|
Severe hearing loss
Profound hearing loss |
66-85 dB
(Hearing possible of voice at very high pitch and very close range only) |
| Not hearing at all |
Data on the prevalence of hearing loss among males and females
|
Among children of school-entry age revealed that hearing impairment was detected in 11.9% children. Prevalence of hearing impairment was slightly higher among girls (12.1%) as compared with 11.8% among boys. The prevalence was also higher among children belonging to low socio-economic strata and those who were born of consanguineous marriages.
Hearing impaired women are multiple- disadvantaged and experience exclusion on account of their gender and their disability. Disabled women, including hearing impaired, are particularly vulnerable to abuse.
A survey in Odisha, India, in 2004 observed that 100% of the disabled women and girls were beaten at home. Twenty-five percent of mentally challenged women had been raped while 6% of disabled women had been forcibly sterilized. Another study carried out in rural India also highlighted that disabled girls, unlike other girls, have less access to opportunities for education and are less likely to go to school. They are also less likely to seek medical help, less likely to receive treatment and services than disabled boys with similar impairments.
Ear care seeking is negligible among females in developing countries thereby accounting for increased number of ear morbidity cases. There is a general lack of awareness, especially among females, about issues relating to deafness and hearing impairment across all parts of the society.
Time constraints and dependency syndrome have negative implication on the uptake of ear care services, particularly in the case of women. Women’s workload at home and their care-giving roles to other family members are also significant factors in delaying decisions to seek treatment. In areas where there is limited mobility, they may also be unable to travel to health care facilities.
Moreover, delays and procedures in the provision of ear care services at the
Time constraints and dependency syndrome have negative implication on the uptake of ear care services, particularly in the case of women. Women’s workload at home and their care- giving roles to other family members are also significant factors in delaying decisions to seek treatment health care facility and the complex system of referral in cases of involvement of multiple departments dissuades women. There is also the stigma and discrimination faced by women who suffer from ear ailments.
In order to address the issues of hearing loss from gender perspective, gender equality should form part of the overall objectives, wherever possible, while formulating programmes and projects. The strategy should be such that both women and men are involved in designing and implementing those programmes as well, especially because hearing loss is a hidden ailment. Moreover, the gender strategy should also be practical.
In order to facilitate this strategy, consultation from social and gender analysis experts should be sought in the process of programme development. Adequate and relevant sex- disaggregated baseline information should be collected and gender sensitive indicators and monitoring processes should be used as a minimum standard for design, implementation, monitoring and evaluation of programmes and policies.
(The writers belong to the Department of Community Medicine at Maulana Azad Medical College, New Delhi)
Dr Suneela Garg
compared to 9.8% in females.
A US-based study established that the prevalence of hearing impairment differs according to gender. During the study, overall prevalence of hearing loss was found to be 10.5% for males and 6.8% for females. While males at all ages were more likely than females to be deaf or hard-of-hearing, the gap widens after the age of 18 years.
Another study was carried out in the Italian population in year 2003 to evaluate the prevalence of prelingual deafness. A prelingual deafness refers to congenital deafness or hearing loss occurring before the infant reaches one year when it begins to speak its first words. The study concluded that hearing impairment prevalence differs according to sex with overall prevalence being 0.78 per 1,000 for males and 0.69 per 1,000 for females.
A study in rural southern coastal India
Hearing impaired women are multiple- disadvantaged and experience exclusion on account of their gender and their disability. Disabled women, including hearing impaired, are particularly vulnerable to abuse
Hearing loss is measured by finding out the hearing threshold in decibels (dB) at which a signal is just barely heard. The pitches are graphed in audiogram.
|
Mild hearing loss |
26-45 dB
(Difficulty in hearing sound from a distance) |
|
Moderate hearing loss |
46-65 dB
(Conversational hearing becomes difficult) |
|
Severe hearing loss
Profound hearing loss |
66-85 dB (Hearing possible of voice at very high pitch and very close range only) |
|
Not hearing at all |
|
Data on the prevalence of hearing loss among males and females
Deeksha Khurana Dr Ritesh Singh
among children of school-entry age revealed that hearing impairment was detected in 11.9% children. Prevalence of hearing impairment was slightly higher among girls (12.1%) as compared with 11.8% among boys. The prevalence was also higher among children belonging to low socio-economic strata and those who were born of consanguineous marriages.
Hearing impaired women are multiple- disadvantaged and experience exclusion on account of their gender and their disability. Disabled women, including hearing impaired, are particularly vulnerable to abuse.
A survey in Odisha, India, in 2004 observed that 100% of the disabled women and girls were beaten at home. Twenty-five percent of mentally challenged women had been raped while 6% of disabled women had been forcibly sterilized. Another study carried out in rural India also highlighted that disabled girls, unlike other girls, have less access to opportunities for education and are less likely to go to school. They are also less likely to seek medical help, less likely to receive treatment and services than disabled boys with similar impairments.
Ear care seeking is negligible among females in developing countries thereby accounting for increased number of ear morbidity cases. There is a general lack
of awareness, especially among females, about issues relating to deafness and hearing impairment across all parts of the society.
Time constraints and dependency syndrome have negative implication on the uptake of ear care services, particularly in the case of women. Women’s workload at home and their care-giving roles to other family members are also significant factors in delaying decisions to seek treatment. In areas where there is limited mobility, they may also be unable to travel to health care facilities.
Moreover, delays and procedures in the provision of ear care services at the
Time constraints and dependency syndrome have negative implication on the uptake of ear care services, particularly in the case of women. Women’s workload at home and their care- giving roles to other family members are also significant factors in delaying decisions to seek treatment
health care facility and the complex system of referral in cases of involvement of multiple departments dissuades women. There is also the stigma and discrimination faced by women who suffer from ear ailments.
In order to address the issues of hearing loss from gender perspective, gender equality should form part of the overall objectives, wherever possible, while formulating programmes and projects. The strategy should be such that both women and men are involved in designing and implementing those programmes as well, especially because hearing loss is a hidden ailment. Moreover, the gender strategy should also be practical.
In order to facilitate this strategy, consultation from social and gender analysis experts should be sought in the process of programme development. Adequate and relevant sex- disaggregated baseline information should be collected and gender sensitive indicators and monitoring processes should be used as a minimum standard for design, implementation, monitoring and evaluation of programmes and policies.
(The writers belong to the Department of Community Medicine at Maulana Azad Medical College,
New Delhi)
Caring for the
Elderly