GLOBAL TELETHERAPY: ACCESSIBLE SPEECH PATHOLOGY SERVICES FOR ETHIOPIA

#SDGAction43102

Description

The present project aims to bring accessible assessment and treatment for speech and voice disorders and autism, to children at the Sele Enat Mahiber Orphanage, through telepractice. Children at the Orphanage are not presently diagnosed for communication disorders, and some conditions might go unnoticed, for which early therapy would be extremely beneficial. The Hofstra Speech-Language Hearing Sciences Department will collaborate with Sele Enat Mahiber, to make speech pathology care available: we will provide assessment and intervention by telematic devices. Collaborating with NEPAD, we will work to make telepractice a viable solution to receive speech pathology care in Ethiopia.

Expected Impact

April 2019 – June 2019 
- Work with the orphanage to determine which children need assessment and therapy. 
- Staff training: we will work with the Director of the orphanage, to identify local personnel who can assist during the screening and therapy. 
- Select and prepare computer resources and software needed to provide speech pathology care: this stage includes providing to the orphanage telematics resources they need; assuring encryption of data, to be collected and transmitted during the therapies, to protect confidentiality and privacy of the patients. 
- Organize the communication settings for teletherapy. We will set up the video conference environment we will use to give the tests and then the treatments. Assistants from the orphanage will be present on site to help. Paris Huizinga, our collaborator from NJ, speaker of Amharic, will be present to translate in the interaction between the students from our Department, administering the therapies, and the patients. 
- Fundraising initiatives: we will fundraise for the duration of the project. A donor was found, willing to sponsor a sustainable funding for the project: buying small crafts (change purses, necklaces, bracelets, etc.) handmade by women-owned local businesses in Addis Ababa, and sell them here through local sales in the US. 
- Dr. Patrizia Bonaventura will work with Dr. Roberts and Prof. Silverman, to identify students who can administer tests and treatments in a new situation of telepractice. 
- Once the possible disorders of the children are identified, we will discuss with Prof. Silverman, on how to adapt existing tools for assessment and therapy techniques, to this new condition of therapy at a distance 
 
July 2019 - February 2020: 
- Therapies will be administered for the identified disorders. 
- Outcome data on improvements of the children after the therapies will be collected and analyzed, to evaluate the effectiveness of the therapies and of the process of delivery of services at a distance. 
- Outcome data will be discussed together, by the Hofstra Speech-Language Hearing Clinic, the Sele Enat Mahiber Orphanage collaborators and the NEPAD representative. 
- Possibility of applying teletherapy at the Sele Enat Mahiber for other disorders, and to try telepractice in other countries or settings will be also considered.

Capacity

Following recommendations by the American Speech and Hearing Association and the WHO, we could start a pilot training program for local health providers, teachers, parents and other personnel, who could be administering speech pathology care in the future. 
 
Possible interactions with hospitals and other health care facilities could be established, to improve local teletherapy techniques and to transfer the know-how that can be used to reach rural areas where access to speech pathology care is more difficult. Finally, the NEPAD representative can bring the results of the project to the Ethiopian Government, to evaluate the creation of future health care policies, including speech pathology telepractice as a regular standard of practice.

Governed

Dr. Patrizia Bonaventura, Assistant Professor of Speech Pathology in the Department of Speech-Language and Hearing Sciences at Hofstra University and UN-DPI representative, will lead the project, coordinating the activities; maintaining the contacts with the Ethiopian sites and collaborators; selecting, together with Prof. Roberts and Prof. Silverman, the services to be provided and the staff to perform the therapies; and coordinating the interaction with the NEPAD collaborator, Mrs. Chimwemwe Chamdimba. 
 
Dr. Jenny Roberts, Professor and Chairman of the Department of Speech-Language and Hearing Sciences at Hofstra University, will determine the contribution of the members of the Department to the project (students, professors, clinicians and supervisors); also she will contribute to the selection of assessments and therapies more effective for the children in the Orphanage. 
 
Prof. - Wendy Silverman, M.S.C.C.C./S.L.P., Director of Speech-Language Hearing Clinic at Hofstra University, will contribute to the selection of assessments and therapies more effective for the children in the Orphanage; will select and coordinate supervision of some speech pathology students who would administer the assessment tests and the therapies. 
 
Mr. Zelalem Etefa, Vice Director of the Sele Enat Mahiber Orphanage, Addis Ababa, will determine the contribution of the personnel of the Orphanage to the project; identify the children to be interviewed and supervise the telepractice process. 
 
Mrs. Chimwemwe Chamdimba, NEPAD Principal Programme Officer, and Policy Specialist, will contribute by creating liaisons with the Ethiopian Government, to assure that local regulations in terms of health care provision, are complied with; and will oversee the project, from the perspective of feasibility of use of the telepractices, to assure access to quality essential health-care services to people in Ethiopia and Africa. 
 
Mrs. Noura Huizinga, previous volunteer at the Sele Enat Mahiber, and native speaker of Amharic (language spoken in Addis Ababa), will be in contact with the personnel of the Orphanage, will explain the tasks and participate in the process of identification of children needing screening for speech disorders; she will also contribute to translation of the speech therapy materials, from English to Amharic. 
 
Ms. Paris Huizinga, daughter of Mrs. Noura Huizinga, and native speaker of Amharic, was volunteer for two years at the Orphanage, and will be the liaison with the personnel of the Institution, translating and making possible the administration of the teletherapy.

Partners

- Hofstra University, Department of Speech-Language and Hearing Sciences and Saltzman Center's Speech-Language-Hearing Clinic
- New Partnership for Africa's Development Agency (NEPAD)
- Sele Enat Mahiber Orphanage

SDGS & Targets

Goal 3

Ensure healthy lives and promote well-being for all at all ages

3.1

By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

3.1.1

Maternal mortality ratio

3.1.2

Proportion of births attended by skilled health personnel

3.2

By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

3.2.1

Under-five mortality rate

3.2.2

Neonatal mortality rate

3.3

By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

3.3.1

Number of new HIV infections per 1,000 uninfected population, by sex, age and key populations

3.3.2

Tuberculosis incidence per 100,000 population

3.3.3

Malaria incidence per 1,000 population

3.3.4

Hepatitis B incidence per 100,000 population

3.3.5

Number of people requiring interventions against neglected tropical diseases

3.4

By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

3.4.1

Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease

3.4.2

Suicide mortality rate

3.5

Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

3.5.1

Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders

3.5.2

Alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol

3.6

By 2020, halve the number of global deaths and injuries from road traffic accidents

3.6.1

Death rate due to road traffic injuries

3.7

By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

3.7.1

Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods

3.7.2

Adolescent birth rate (aged 10-14 years; aged 15-19 years) per 1,000 women in that age group

3.8

Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

3.8.1

Coverage of essential health services

3.8.2

Proportion of population with large household expenditures on health as a share of total household expenditure or income

3.9

By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

3.9.1

Mortality rate attributed to household and ambient air pollution

3.9.2

Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (exposure to unsafe Water, Sanitation and Hygiene for All (WASH) services)

3.9.3

Mortality rate attributed to unintentional poisoning

3.a

Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

3.a.1

Age-standardized prevalence of current tobacco use among persons aged 15 years and older

3.b

Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all

3.b.1

Proportion of the target population covered by all vaccines included in their national programme

3.b.2

Total net official development assistance to medical research and basic health sectors

3.b.3

Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis

3.c

Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

3.c.1

Health worker density and distribution

3.d

Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks

3.d.1

International Health Regulations (IHR) capacity and health emergency preparedness

3.d.2

Percentage of bloodstream infections due to selected antimicrobial-resistant organisms

SDG 14 targets covered

Name	Description

Deliverables & Timeline

01 January, 1970

Report on number of children with communication disorders identified at the Sele Enat Mahiber Orphanage; Telematic resources available for the project; Schedule of assessments, and materials and personnel available for the speech pathology assessment and therapy.

01 January, 1970

Final report presenting 1) outcome data from assessment and therapy of the identified speech and voice disorders and autism; 2) evaluation of outcomes and conclusions on effectiveness of therapy in the telepractice conditions tested 3) evaluation of the telepractice in terms of adequacy of settings, and quality of care (including feedback from patients) 4) Discussion and conclusions on feasibility of extension of teletherapy practice to other settings and African countries.

Resources mobilized

Financing (in USD)

49211

Staff / Technical expertise

Supervisors for students at the Hofstra Saltzman Center, providing teletherapy; assistants in Ethiopia to help translate and administering the therapies

Other, please specify

Travel to Ethiopia in summer 2019 to meet the children and the staff at the Selel Enat Mahiber orphanage, with whom we have been working by teletherapy for 6 months

Partnership Progress

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Feedback

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Timeline

01 April 2019 (start date)

01 February 2020 (date of completion)

Entity

Hofstra University, Department of Speech-Language and Hearing Sciences, Hempstead, NY

SDGs

Geographical coverage

Hempstead, USA ; Midrand, South Africa; Addis Ababa, Ethiopia

More information

To be built soon

Countries

N/A

Contact Information

Patrizia Bonaventura, Assistant Professor

patrizia.bonaventura@hofstra.edu