Global Audiology/Africa/Cameroon

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General Information

Cameroon, officially the Republic of Cameroon, is a country in Central Africa. It shares boundaries with Nigeria to the west and north, Chad to the northeast, the Central African Republic to the east, and Equatorial Guinea, Gabon, and the Republic of the Congo to the south. In addition to numerous traditional languages, the two official national languages, French (80%) and English (20%), reflect the now sovereign republic’s history of governance by France and England after WWI.

History of Audiology

While there is a federally run public healthcare system, access to services and quality of care vary greatly by region. The general health situation in the insecure areas of Cameroon is characterized by a significant decline in the services provided by qualified health personnels. This is exasperated by a general lack of preventive medical and rehabilitative measures specifically with specialty services, like ear and hearing. People with hearing impairment are therefore particularly vulnerable and face social and economic barriers to care.

Hearing Care Services:

Ear and hearing care in Cameroon developed slowly and for many decades existed only as part of general ENT (Ear, Nose, and Throat) services in major hospitals. During the colonial and early post-independence period (1960s–1990s), care focused mainly on treating ear infections and ENT conditions, with no structured audiology services, hearing screening, or national policies.

From the early 2000s, limited specialist ENT services became available in urban referral hospitals, but access to hearing assessment, hearing aids, and rehabilitation remained extremely limited. Not only were there very few trained ENT specialists but also most ENTs in Cameroon focus primarily on nose and throat care and almost no clinicians providing audiology services, especially outside major cities. A major shift occurred in the 2010s, driven largely by NGO and faith-based organizations, particularly the Cameroon Baptist Convention Health Services (CBCHS)[1] with support from Christian Blind Mission (CBM)[2] of Germany. These organizations conducted situational analyses that highlighted large gaps in workforce, equipment, early detection, and policy.

ENT providers most provide nose and throat focused service and there is no licensed profession of Audiology. Around 2020, Cameroon saw its first organized ear and hearing care initiatives, including pilot neonatal hearing screening, basic audiology services, community awareness, and training of primary healthcare workers.[3]

Advanced services such as cochlear implantation were introduced on a very limited scale through international collaboration. This initiative was carried out by the Cameroon Baptist Convention Health.[4]

From 2021 to the present, ear and hearing care has expanded through donor-funded NGO advocacy and national capacity building initiatives. This current period marks the beginning of efforts to develop a national ear and hearing care strategy, integrate services into primary healthcare, and improve early detection and rehabilitation. Overall, ear and hearing care in Cameroon has evolved from ENT-based treatment to early-stage system development, with growing recognition at national level but ongoing challenges in workforce, access, funding, and nationwide coverage.

Incidence and Prevalence of Hearing Loss

Population based studies report the incidence of hearing impairment in Cameroon is between 0.9% - 3.6% of the general population depending on study quality, clinical tests, and diagnostic criteria utilized. Evaluations of childhood hearing loss in the country found that the most common type of loss identified is sensorineural, the most common degree/severity of loss is moderate, and reports of bilateral versus unilateral losses vary drastically between reports. The greatest cause of hearing loss in Cameroon is environment factors (52.6-62.2%) lead by vaccine preventable disease such as meningitis and chronic otitis media and genetic factors account for .8-14.8% though studies report 32.6-37% of cases have unknown origin. Overall, results vary drastically lessening the reliability of data and indicating a need for more standardized evaluation protocols across ear and hearing studies.

Information About Audiology

Audiological services

Overall, services vary by region. Urban areas (especially Yaoundé and Douala) have better access to diagnostics and hearing aids because they hav the most ENT specialists and private hearing centers. Whereas rural and remote areas rely mainly on primary health centers, district hospitals with very limited ear care, and NGO outreach services when available. The availability of treatment and technology is a major challenge in Cameroon. Available services can be classified as screening, diagnosis, or treatment/rehabilitation.

• Screening. Community and clinic-based hearing screening for adults and children is being offered through campaigns and health events, often linked to World Hearing Day and local health outreach activities. Neonatal (newborn) hearing screening has been introduced in some hospitals, with thousands of babies screened using Otoacoustic Emissions (OAE) machines as part of pilot programmes. There are only two facilities that do ABR evaluations if a baby fails two OAE screenings.
• Diagnosis and Clinical Services. ENT services at regional and district hospitals provide basic diagnosis and treatment of ear diseases and hearing problems. Audiology assessment and training are currently being developed through new training programmes to build local capacity for proper hearing diagnostics and referrals.
• Treatment and Rehabilitation. Private centers and service providers offer hearing aid fitting, sales, and basic services in cities like Yaoundé. National hearing aid dispensing programs are emerging, enabling procurement and fitting of hearing aids for people with hearing loss.

Scope of Practice and Licensing

Professionals providing hearing care services

The current ear and hearing care professionals include; ENT physicians who conduct surgeries, ENT clinicians (primary ear and hearing care nurses) that assess, refer, and conduct minor interventions such as antibiotic prescriptions, ear and hearing care clinical officers who carry out early interventions and management, and audiology technicians (trained via NGO programs) who are able to carry out more advanced tests such as pure tone audiometry and hearing aid fittings. Primary health care providers play a role in early identification and referral to the hospitals. They may also carry out basic procedures such as removal of foreign bodies and ear washing. Ear and hearing care services in Cameroon vary in level of care, availability, and the type of facilities offering care:

• Tertiary / Referral Hospitals, General Hospitals (e.g. Yaoundé, Douala), Central and Teaching Hospitals. Services: ENT consultations, diagnosis, ear surgery, limited audiology tests (ex. ABR), rare cochlear implant procedures as facilitated by NGOs (availability is mainly urban).
• Private Regional Hospitals, Public regional hospitals. Services: ENT clinics, ear disease treatment, basic hearing assessment (availability: selected regions).
• District Hospitals, Government district hospitals Services: Basic ear care, referrals, occasional hearing screening (availability: widespread but of limited scope).
• Mission and Faith-Based Hospitals, Cameroon Baptist Convention Health Services (CBCHS) facilities, other church-run hospitals. Services: ENT care, hearing screening (including newborn screening in some sites), surgeries, hearing aids, community outreach programs (availability: multiple regions; key providers of hearing care).
• Primary Health Care Facilities, Integrated Health Centres (IHCs), Health posts. Services: Basic ear care, health education, early identification, ENT referrals (availability: nationwide but very basic services).
• Private Clinics and Hearing Centres, Private ENT clinics, Audiology/hearing aid centres. Services: Hearing tests, hearing aid fitting and sales (availability: only major cities).
• NGOs and Community-Based Organisations, Disability and hearing-focused NGOs. Services: Community screening, rehabilitation support, awareness, referrals, sign language support (availability: Project-based, selected regions).
• Schools for the Deaf / Special Education Centres, Special schools and inclusive education settings. Services: Communication support, identification of hearing loss, referrals (availability: Limited number nationwide, vary based on language).

Professional and Regulatory Bodies

Laws related to hearing care services

There is no specific law in Cameroon that directly governs ear and hearing care services. However, existing disability and education laws provide a legal basis for the rights of people with hearing loss to access services, education and protection. With the advent and implementation of the "Strengthening ear and hearing care capacities in Cameroon" project, implemented by the Cameroon Baptist Convention Health Services in partnership with the Christian Blind Mission and funding from the German Ministry for Economic Development and Cooperation, a national plan for ear and hearing health is set to be developed by 2028.

Education and Professional Practice

Cameroon currently has no formal university degree program dedicated specifically to audiology. Training for ear and hearing health professionals is mainly short-term, project-based, or embedded within other health disciplines. Available training includes pilot audiology technician programs and short courses organized by NGOs and faith-based institutions (notably CBCHS with CBM support). These focus on basic hearing screening, ear examination, referral, and limited hearing-aid fitting. Workshops and in-service training are also provided for nurses, primary health workers, and clinicians to strengthen basic ear care and early identification of hearing problems. Audiology is not yet formally regulated in Cameroon, and therefore there is no audiology defined education criteria, regulatory body, of defined scope of practice. Research in the ear and hearing field has been conducted primarily by ENT physicians and covers the incidence of disease and prevalence of hearing loss in country.

Ongoing audiology research

Recently, research on hearing care in Cameroon has focused on addressing diagnostic practices and the challenges faced by individuals with hearing impairments. Key areas of focus include:

• Diagnostic practices, attitudes and equipment availability.
• Etiological profile of childhood deafness.
• Prevalence and causes of hearing impairment.
• Social and healthcare challenges and stigma.

Challenges, Opportunities and Notes

"The Strengthening ear and hearing care capacities in Cameroon" project, implemented by the Cameroon Baptist Convention Health Services in partnership with the Christian Blind Mission and funding from the German Ministry for Economic Development and Cooperation. The aim of the planned project is to improve the quality of life of people with hearing loss or at risk of hearing loss in the following target regions: Northwest, Centre, Littoral. The project will focus on three areas of intervention: Capacity building of existing health professionals through continuing education, access to consulting and treatment services and, development of a national plan to strengthen ear and hearing health care. The aim of the planned project is to improve the quality of life of people with hearing loss or at risk of hearing loss in the following target regions: Northwest, Centre, Littoral.

Audiology Charities

• The German Federal Ministry for Economic Cooperation and Development (BMZ)
• Christian Blind Mission (CBM)
• Cameroon Baptist Convention (CBC) Health Services
• Sound Seekers (UK)

References

Contributors to the original text

Aisha Kinyuy

Author

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Madison Saunders

Contributor

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