Improving access to hearing care services and professionals in Africa through task sharing: The Malawian experience

  • Wakisa Mulwafu
  • Johannes Fagan
Keywords: audiology, otorhinolaryngology, ENT, hearing loss, conductive hearing loss, myringoplasty, task sharing, community health workers, mobile health units, Malawi


A task sharing model to improve access to audiology and ENT services is presented that has been successfully introduced in Malawi to overcome the shortage of specialist care. The Malawian experience also clearly demonstrates that with appropriate training, endoscopic myringoplasty can be successfully performed by mid-level health workers. Based on the Malawian experience, we recommend that developing countries with skills shortages should embrace task sharing with mid-level health workers assuming roles traditionally reserved for medical doctors, audiologists and otolaryngologists, including endoscopic myringoplasties, to improve access to hearing care services.