Objective: To determine the feasibility and outcomes of a community-based hearing aid fitting model designed for low-income communities facilitated by community health workers (CHWs).

Method: Using Bowen’s framework, feasibility was evaluated according to service delivery and patient outcomes. A total of 25 (six male) participants were fitted with bilateral GoPrime preset, over-the-counter (OTC) hearing aids by CHWs in Khayelitsha, a low-income community in Cape Town, South Africa. Benefit and satisfaction were measured using the International Outcome Inventory for Hearing Aids (IOI-HA). An open-ended survey used to obtain their perceptions on the impact of the hearing aids on communication, the mHealth program  , and willingness to purchase the hearing aids was analyzed using inductive thematic analysis.

Results: Pure Tone Average across participants was 57.3 dB HL (11.5 SD) in the left ear and 54 dB HL (14.2 SD) in the right ear. The majority of participants self-reported positive outcomes while using hearing aids, including good hearing in background noise. IOI-HA showed above standardized average scores of 3.91 for daily use, 4.46 for benefit, and 4.58 for satisfaction. 92% of participants reported the hearing aids as extremely helpful, with 87.5% recommending hearing aids for others with hearing loss. Additionally, participants reported positive experiences with the mHealth support program and described the program as clear and helpful.

Conclusion: The community-based hearing aid fitting model is feasible and demonstrated positive hearing aid outcomes in a low-income community. This approach, supported by mHealth technologies and CHWs, presents a promising solution to address the hearing care gap in low- and middle-income countries (LMICs).