Summary

Ear and hearing health is vital for overall health and quality of life. Ear disease and associated hearing loss can have long-lasting impacts on education, wellbeing and employment.

Aboriginal and Torres Strait Islander children are more likely than non-Indigenous children to experience ear and hearing problems. A number of factors contribute to the poorer ear and hearing health of Indigenous children, including lack of access to health services, household overcrowding and second-hand smoke exposure.

Since 2012, the Australian Government has funded the Northern Territory Government to deliver hearing health outreach services to Indigenous children and young people aged under 21 in the Northern Territory – mainly through the National Partnership on Northern Territory Remote Aboriginal Investment (for children aged under 16); and through the Healthy Ears – Better Hearing, Better Listening Program. These outreach services include audiology services, ear, nose and throat (ENT) services, and Clinical Nurse Specialist (CNS) services.

This report presents new data for hearing health outreach services provided in 2020, and includes time trends for the period July 2012 to December 2020.

How many children received services?

  • In 2020, 116 training sessions for hearing health education, promotion and prevention activities were provided to health-care staff.
  • A total of 1,802 Indigenous children and young people received at least 1 audiology, Clinical Nurse Specialist (CNS), or ear, nose and throat (ENT) teleotology service in 2020. From July 2012 to December 2020, a total of 33,672 services were provided to more than 8,700 children and young people.
  • In 2020, 2,010 outreach audiology services were provided to 1,772 Indigenous children and young people. From July 2012 to December 2020, a total of 18,561 services were provided to a total of 8,632 children and young people.
  • 701 ENT teleotology services were provided to 639 Indigenous children and young people in 2020. From July 2012 to December 2020, a total of 7,542 services were provided to a total of 3,904 children and young people.
  • In 2020, CNSs conducted 1,004 visits to 926 children. From July 2012 to December 2020, a total of 7,569 services were provided to a total of 5,015 Indigenous children.

Figure 1: Number of Indigenous children and young people who received audiology, CNS or ENT teleotology service in 2020

The infographic shows that in 2020, 1,772 children and young people received audiology services, 926 received CNS services and 639 received ENT teleotology services.
Sources: Tables S2.1, S2.3 and S2.5

Hearing health is improving among children and young people who received outreach services between 2012 and 2020

The percentage of Indigenous children and young people with at least 1 ear condition decreased by 8 percentage points, from 66% (483 of 727 children and young people) to 58% (1,037 of 1,802 children and young people).

Among children and young people who received audiology services, the proportion with hearing loss decreased by 12 percentage points, from 55% (388 of 710 children and young people) to 43% (768 of 1,772 children and young people).

Figure 2: Ear and hearing health improvements between 2012 and 2020

The infographic shows that, between 2012 and 2020, the proportion of children with at least 1 hearing conditions decreased from 66%25 to 58%25. In the same time period, the proportion of children and young people with hearing loss decreased from 55%25 to 43%25.
Sources: Tables S3.1 and S3.6

Among 3,890 Indigenous children and young people who received at least 2 audiology services between 2012 and 2020, 2,811 had hearing loss at their first service, and of those, 1,712 (61%) had improved – this is a change from bilateral to unilateral hearing loss or from unilateral hearing loss to no hearing loss.

Between 2012 and 2020, among 1,800 Indigenous children who received at least 2 services and had hearing impairment at their first service, 1,272 (71%) had improved – moving to a lower degree of hearing impairment or to no hearing impairment.

Many children and young people are still waiting for hearing health services

At December 2020, there were 3,109 Indigenous children and young people on the audiology waiting list. Among them, 1,407 were new referrals and 1,702 were recalled for further follow-up after receiving an initial audiology service. There were 2,000 children and young people on the waiting list for ENT teleotology services. Among them, 770 were new referrals and 1,230 were recalled for further follow-up after receiving initial ENT teleotology services.

What was the impact of COVID-19?

Across audiology, CNS and ENT, the number of services received dropped slightly between 2019 and 2020. This was largely due to a decrease in services between March and April 2020, coinciding with the introduction of restrictions imposed to control the spread of COVID-19. For example, the number of audiology checks for Indigenous children and young people in February 2020 was 284 – decreasing to 204 in March 2020, and then less than 5 services in April 2020.

Figure 3: Impact of COVID-19 on number of services

The infographic shows that between 2019 and 2020, the number of services dropped slightly across all service types. In 2019, 2,155 audiology services were received by children and young people, compared to 2,010 in 2020. In 2019, 1,119 CNS services were received by children and young people, compared to 2,004 in 2020. In 2019, 770 ENT teleotology services were received by children and young people, compared to 701 in 2020.
Sources: Tables S2.1, S2.3 and S2.5

Is the Hearing Health Program meeting its benchmarks?

Service delivery benchmarks for hearing health are set in the Northern Territory Remote Aboriginal Investment (NTRAI) Health Implementation Plan for audiology, CNS and health promotion and training activities. These are measured by the number of services per year. From 2015 to 2020, targets for these services were either met or exceeded.

Health outcomes in this program are measured every 3 years (July 2012 – June 2015, July 2015 – December 2018 and January 2019 – December 2021). All benchmarks in the first 2 periods were met. For the third period, data for 2 of the 3 years are available (that is, for 2019 and 2020). Data for these 2 years provide an indication of progress towards the targets, but cannot be used to determine whether the targets have been met (since 2021 data are not yet available). Based on 2019 and 2020 data, the hearing impairment target is on track to be met. Of the 4 targets related to middle ear conditions, progress towards 1 target – children aged 6–15 with chronic suppurative otitis media (CSOM) – is on track, though by a small margin (0.2 percentage points).

Progress against benchmarks is presented in Table 1.

Table 1: Progress against benchmarks, 2020
TargetOutcome

Service delivery targets

At least 1,700 audiology services per year

2,010 audiology services provided in 2020

At least 700 children receiving CNS services per year

926 children received CNS services in 2020

At least 60 hearing health promotion or training services/activities per year

116 hearing health promotion or training services and activities provided in 2020

Health outcome targets – hearing impairment

Less than 7.5% of children tested with moderate/severe conductive hearing impairment, Jan 2019– June 2021

3% of children tested with moderate/severe conductive hearing impairment, Jan 2019–Dec 2020

Health outcome targets – middle ear conditions

Less than 7% of children (0–5) with CSOM, Jan 2019– June 2021

7.8% of children (0–5) with CSOM, Jan 2019–Dec 2020

Less than 7% of children (6–15) with CSOM, Jan 2019–June 2021

6.8% of children (6–15) with CSOM, Jan 2019–Dec 2020

Less than 5% of children (0–5) with dry perforation, Jan 2019– June 2021

6.9% of children (0–5) with dry perforation, Jan 2019–Dec 2020

Less than 9% of children (6–15) with dry perforation, Jan 2019– June 2021

13.9% of children (6–15) with dry perforation, Jan 2019–Dec 2020

CNS = Clinical Nurse Specialist; CSOM = chronic suppurative otitis media