Gender disparities in accessing treatment for age-related hearing loss among the elderly: a study in Ngwaqa, KwaZulu-Natal, South Africa.

Abstract

Age-related hearing loss (ARHL) significantly impacts quality of life, communication, and social integration among the elderly, particularly in rural South Africa. While both genders experience ARHL, evidence suggests that disparities exist in diagnosis, treatment access, and healthcare outcomes, compounded by socio-economic challenges and cultural beliefs. This study investigates these gender disparities in accessing treatment for ARHL and their implications for elderly individuals in Ngwaqa, KwaZulu-Natal. The primary objectives of this study are to explore cultural beliefs and attitudes of the elderly towards ARHL, examine gender differences in accessing healthcare services, assess the psychological well-being of individuals with ARHL, and understand the caregiving dynamics as experienced by the caregivers of the elderly. A phenomenological qualitative research design and a case study approach were employed to collect rich and in-depth data detailing the lived experiences of the elderly with ARHL. Data was gathered using participant observation and semi-structured interviews with 44 participants, including older men and women with ARHL, their caregivers, and healthcare professionals. Thematic analysis was utilized to identify key patterns, themes, and insights from the interview data. The findings reveal that women and men experience ARHL differently and have different experiences in healthcare settings. While some men reported feeling disrespected by healthcare workers, similarly, other women expressed frustration over being overlooked, dismissed, and having their symptoms downplayed. Conversely, other older men and women have positive and beneficial healthcare-seeking experiences. Participants also reported stigma, social isolation, and emotional distress as significant challenges associated with ARHL. Although access to hearing health remains limited, those who utilized hearing aids reported improved quality of life. Significant barriers to treatment access were identified, including financial constraints, transportation issues, and cultural stigma, which hindered timely diagnosis and intervention. This study underscores the urgent need for gender-sensitive healthcare approaches to address the disparities in ARHL treatment access among the elderly. It highlights the importance of integrating cultural considerations and promoting community awareness to facilitate better health outcomes. Improving access to hearing healthcare and fostering social engagement can significantly enhance the quality of life for the elderly experiencing ARHL, advocating for policy reforms and public health initiatives tailored to these unique challenges.