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10/27/2018  |   10:30 AM - 11:30 AM   |  Kramer Lecture Theater 2

Developing a Qualitative Study Framework to Understand Current State of Otolaryngology and Perspectives from Local Health Professionals in Sub-Saharan Africa

Ear diseases and hearing impairment are highly prevalent in sub-Saharan Africa (SSA) with less than 5% of the population having access to timely and affordable otologic surgeries. There has been a recent increase in awareness of need for global health programs to improve access to otolaryngology care in SSA among otolaryngologists. In this study, we propose to provide a literature review of quantitative data available on the current workforce of otolaryngology in SSA and to develop a theory-driven model of a qualitative research study that seeks to understand perceptions of otolaryngology and barriers to otolaryngology training in SSA among local health professionals. Otolaryngologist density remains significantly lower in SSA ranging from 0.11/1 million (Malawi) to 4.39/1 million (South Africa) in comparison to a significantly higher 30.78/1 million in the U.S. Previous literature based on survey questions and anecdotal views reported various reasons for poor training in SSA including lack of high-cost equipment, poor training and aural rehabilitation facilities, and low awareness of the burden of ENT pathology in the medical field. In order to better understand the unmet need for otolaryngology training in SSA, we developed a conceptual model of a focus group study targeting local medical students, residents, and faculty. We used Social Cognitive Theory which explains human behavior using three-way, reciprocal key constructs of personal, environmental, and behavior factors to guide focus groups questions: 1) personal: what are the advantages/disadvantages of practicing otolaryngology in SSA? 2) environmental: do you have any support from your peers or facility to practice otolaryngology? 3) behavior: what activities do you do to promote otolaryngology? The proposed qualitative study will provide better understanding of the perspectives of the local professionals in a systematic way using validated research methods and assist prioritizing limitedly available resources in SSA to effectively improve the standard of care and training.

  • Participants will be able to recognize the low otolaryngological density in SSA in comparison to developed countries.
  • Participants will be able to learn about available qualitative methods to explore barriers to otolaryngology training and practice in SSA.
  • Participants will be exposed to preliminary results from our pilot study of focus groups that will be implemented in Malawi and Ethiopia this year.


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Janet Choi (POC,Primary Presenter,Author), University of Southern California,;
Janet S. Choi, MD MPH is an Otolaryngology-Head and Neck Surgery resident physician at the University of Southern California. Her research interests include global perception of hearing loss and listening devices, and development of an accessible hearing health care intervention for local and global population.


Financial -

Nonfinancial -


Financial - No relevant financial relationship exists.