(511) Hearing Keyword Use in National Health Policies, Strategies, and Plans: A Metric for Policy Implementation

Introduction: Hearing loss impacts a billion people globally, with a greater burden in low and middle-income countries (LMICs) due to limited screening, financial barriers, and inadequate policy implementation. Prior work by Canick et al. analyzed the inclusion of ear and hearing care (EHC) terms in National Health Policies, Strategies, and Plans (NHPSPs). Since that study, additional NHPSPs have been published, enforcing the benefit of reevaluating these policies. Using expanded language inclusion, hearing loss prevalence, and the contextual keyword analysis, this study examined whether policy inclusion correlated with prevalence trends and whether NHPSPs outlined national intent to address hearing loss.

Methods: NHPSPs were accessed from the WHO’s Country Planning Cycle Database. Five EHC-related terms (deaf, ear, ENT, hear, and hearing) were identified and, if needed, translated. Keyword contextual use and frequency were recorded. Hearing loss prevalence (1990-2023) was obtained from the Institute for Health Metrics and Evaluation, and the percentage change was calculated. Multivariable linear regression assessed associations between NHPSP presence, EHC keyword use, prevalence trends, and sociodemographic index (SDI). Logistic regression evaluated predictors of inclusion of EHC terminology.

Results: Of the 164 countries with NHPSPs, 29.3% (48 of 164) used at least one EHC keyword. “Hearing” was the most cited term and was most discussed in reference to general health resources and programs. After SDI adjustment, NHPSP presence was associated with a lower percentage increase in hearing loss prevalence from 1990 to 2023 (β = −9.9; p = 0.006). SDI demonstrated a strong graded association with prevalence trends (p < 0.001). In countries with NHPSPs, EHC keyword inclusion was not independently associated with changes in prevalence.

Conclusions: Despite the growing global burden of hearing loss, broad integration of ear and hearing care within NHPSPs is limited. Bolstering policy-level prioritization may be critical to improving access, workforce development, and equitable hearing health outcomes worldwide.