Brief Country Information

Zimbabwe, officially the Republic of Zimbabwe, is a landlocked country in Southeast Africa, between the Zambezi and Limpopo River, bordered by South Africa to the south, Botswana to the southwest, Zambia to the north, and Mozambique to the east. Zimbabwe has 16 official languages, and that includes Zimbabwean sign language. English, Shona, and Ndebele are the most commonly used languages.

History of Audiology

Aural care emerged as early as 1914 when Emerald Hill School for the Deaf was established by Dominican Sisters in Harare. Nzeve Deaf Trust was established in the year 2000 with focus on improving the lives of deaf children in Manicaland province. In Harare, John Evans Snr, was the only one providing audiological services in the private sector for a long time before the emergence of the current practices established from the 2000s.

In 2003, an ENT doctor, Dr Chidziva established an audiological practice which was named Audiomax Clinic, this was later rebranded to Audiomax 2010 Pvt (Ltd). Audiomax has contributed significantly to professional audiology to date. In 2008, Dr Chidziva and Professor Prescott also established WizEar, a non-profit organization dedicated in making ear and hearing care accessible in the communities through ear camps. In 2015, two Danish audiologists (Dr Jenny Nesgaard Pedersen and Mr Nicolai Pedersen) opened an audiology clinic in Harare (Audiovannah) when they relocated to Zimbabwe after conducting quarterly clinics in Zimbabwe.

In Bulawayo, The Ear Centre was established by an audiologist, Mkhonzeni Sibanda. There are also two clinics that offer both speech therapy and audiology services, SASH therapy (founded by Shaheedah Aufe) and Michelle’s Speech and Hearing Center (founded by Nyasha Michelle Chakanetsa). Aural care services in the government sector were always available, being very basic and conducted by rehabilitation technicians in the hospitals. In 2017, a paediatric ENT, Speech and Audiology unit was established at Sally Mugabe Central Hospital through WizEar. WizEar also equipped 13 district hospitals, 6 provincial and 4 central hospital with equipment and consumables for ear and hearing care. Over 900 health professionals spread across the hospitals were trained in basic ear and hearing health. Although audiologists are available, there are only 2 government hospitals with an audiologist at this time.

The Cochlear Implant Program in Zimbabwe was started in 2016, currently being run in the private sector. Tinashe Nhokwara is a MED-EL certified cochlear implant audiologist who manages the patients through Audiomax. The surgeries are conducted through The ENT Group by Drs Chidziva and Muganda (Otologist) at Harare Eye, Ear, Nose & Throat (HEENT) Institute. To date, only a total of seventeen implants have been done in Zimbabwe due to financial constraints though the need is there. In a bid to increase access to cochlear implant services in the region, the Zimbabwe Cochlear Implant Team partnered with the Botswana ENT, Dr Alakanani Zikhali and conducted their first cochlear implant surgeries in August 2022. The Botswana government partnered with the private sector to achieve this, however, despite the CI program being housed in the private sector, individuals needing the intervention had access to it and were channelled even from the public health institutions. The surgeries were done at the Gaborone Private Hospital and to date, four surgeries were conducted in August 2022, three done in September 2023 and no surgeries were done in 2024.

In Zimbabwe a few individuals left the country for training in ENT, returning to fill the available positions in the state hospitals in Harare. Between them, they formed an ENT society and set out to train local doctors who initially obtained their specialist qualification through the colleges of South Africa. Subsequently, an MMed programme was established in the medical school at the University of Zimbabwe, and currently training is being re-orientated towards the COSECSA scheme to align with training in the region. The numbers of specialists are increasing in Southern Africa and the current challenge is to create positions for them in the state hospitals in the other centres.

Incidence and Prevalence of Hearing Loss

According to Zimbabwe population census (ZIMSTATS, 2022), about 2% (260.839) of the population above 5 years of age have hearing impairment. Illness and ageing accounted for over 58% of hearing impairment. Of these, 20.2 % were congenital cases, 13.3 had unknown causes, 2.7 were work related accidents and 4.4 were other accidents. In Zimbabwe, limited research exists on hearing loss prevalence, with only 4 notable studies. The first study found a 2.4% hearing loss prevalence among 5,528 school children in Manicaland.^[1] Another study reported a high prevalence rate of 32.2% of hearing impairment among children with HIV.^[2] Chadambuka and co-authors documented 37% prevalence of Noise Induced Hearing Loss amongst workers at a mining company in Zimbabwe.^[3] A more recent study highlighted the high burden of unaddressed hearing loss in rural areas where they found 9% of school-based children have hearing impairment. ^[4]

Hearing care services

Hearing care services are still developing in Zimbabwe, however, intensive awareness amongst the community and medical practitioners are required. Services are available in the government and private sector from primary healthcare facilities to tertiary institutions although the level of services vary. Hearing care services in Zimbabwe include prevention, promotion, treatments and rehabilitation. Health personnel such as nurses, doctors and rehabilitation technicians offer basic hearing care services at all health institutions. These include treatment of infections, identification and referral of persons with hearing impairment. Some hospitals who have equipment and trained personnel offer hearing screening and hearing aid services. Awareness activities are also conducted in the community through IEC materials, radio and television information dissemination. Prevention and promotion programs are often supported by NGOs in partnership with ministry of health. Hearing care services are also available in the education sector. The special needs department of the education ministry offers hearing care services through special needs schools. They offer hearing screenings and referrals. There is an audiologist who performs diagnostics and hearing aids services to children with hearing impairment identified at school. Hearing care services are also provided for occupational safety through the National Social Security Authority (NSSA).Companies have a mandate to provide regular hearing screenings and hearing protection for workers who are exposed to loud noises during work.

Audiological services

Audiologists, trained technicians, rehabilitation technicians, trained nurses, and teachers provide audiology services. Services vary depending on the institution and individual offering service. Most government facilities only offer pure tone air-conduction audiometry and tympanometry. Private institutions offer a wider range of services due to availability of equipment and audiologists. Services and tests offered include the following:

Pure Tone Audiometry (PTA)
Tympanometry
Hearing screening
Otoacoustic Emissions (OAE)
Auditory Brainstem Response
Auditory Steady State Response
Acoustic Reflex Threshold
Eustachian Tube Function Test
Play Audiometry Assessment
Visual reinforcement Audiometry
Hearing aid fitting
Custom earmold making and fitting
Hearing aid verification and validation
Tinnitus management
Custom made hearing protective devices (Noiseban) fitting
Vestibular Assessment and therapy

Clients may walk in, or they may be referred by ENT, paediatricians or general medical practitioners. Most facilities require a booking including some government facilities. Audiology services are covered by health insurance and services are free for children under 5 years at government facilities. A substantial cost gap exists between private and government-owned institutions, with private centers charging over 300% more for their services. Costs of services also differ substantially in the private sector.

Development and Expansion of Audiology Services

Audiology services in Zimbabwe were provided at Parirenyatwa Group of Hospitals by Faith Matarutso Muchongwe between 2009 and 2016. In Bulawayo, audiology-related services have also been offered by Bridget Wolhuter, who is dually qualified in audiology and speech therapy, with a primary focus on speech therapy practice.

Several institutions contributed to the development of formal audiology training in Zimbabwe. The University of Cape Town and the Christian Blind Mission (CBM), alongside the Ministry of Health, WizEar, and other stakeholders, were involved in the development of the Bachelor of Science (Honours) degree curriculum in Audiology and Speech Therapy.

In addition to clinical and academic services, several non-governmental organisations have supported hearing health and disability services in the country. These include the Zimbabwe Deaf Trust, Jairos Jiri Trust, World Vision, and Plan International, all of which operate disability-focused programmes that include support for individuals with hearing loss.

From 2024 onwards, audiology posts have been progressively established within the public healthcare system. Government audiology positions have been filled at the following hospitals:

Parirenyatwa Group of Hospitals (from December 2025)
Sally Mugabe Central Hospital (from December 2025)
United Bulawayo Hospital (from December 2025)
Ingutsheni Central Hospital (from December 2025)
Chinhoyi Provincial Hospital (from April 2025)
Chitungwiza Central Hospital (from March 2024)

Role of primary health care providers and community health workers in hearing care

The role of primary health care providers and community health workers in hearing care is mainly identification and referral. Community health workers are trained to spread awareness, identify and refer cases who need hearing health treatment or support. They refer to the nearest district or mission hospital who often can provide basic assistance such as medication and screening. District hospitals refer to the provincial hospital cases in need of ENT consultation and hearing assessments.

Laws related to hearing care services

There are no specific laws related to hearing care services. Hearing care services are guided by the general medical laws of Zimbabwe stipulated by the Medical Services Act (2018). There are no medical guidelines related to hearing care services in Zimbabwe. Guidelines are adopted from South Africa, our neighbouring country where the bulk of those who set up audiological services in Zimbabwe, trained from. However, guidelines are available in the industrial sector where the NSSA offers a mandate for companies to provide for hearing safety for workers.

Education of professionals working in hearing care services

In 2018, the University of Zimbabwe got it first intake of students into the Bachelor of Science Honours degree in Audiology as well as in Speech Therapy. This was a crucial step facilitated by WizEar Trust and the Ministry of Health towards building sustainable services in the country. These two programs are currently being run by Tinashe Nhokwara (Audiologist) and Wadzanai Makanza (Speech Therapist) who were part of the process in developing and establishing these two programs. The first class of 13 audiologists and 3 speech therapist graduated in 2022. Four cohorts have graduated to date. Mid-level workers, known as Rehabilitation Technicians are trained locally at Marondera Rehabilitation Technicians' Training School which offers a Diploma certification. This cadre provides basic occupational therapy, physiotherapy, speech therapy and audiology.

Professional and Regulatory Bodies

The Health Professions Authority (HPA) is the health professions regulatory body in Zimbabwe. The Medical Rehabilitation Practitioners Council of Zimbabwe is established in terms of the Health Professions Act Chapter 27:19 Section 57. The major responsibilities of the Medical Rehabilitation Practitioners Council of Zimbabwe (MRPCZ) are the registration of health practitioner, the regulation of services provided by such health practitioners and to offer any such support as prescribed to ensure safe and effective rehabilitation services in the best interest of the general public. The Medical Rehabilitation Practitioners Council of Zimbabwe keeps registers for the following rehabilitation professionals: Audiologists, Auxillary Therapists (Massage Therapists, Arts Therapists, Sports Therapists, Music Therapists), Biokineticists, Chiropodists, Occupational Therapists, Orthopaedic Technologists and Technicians, Physiotherapists, Rehabilitation Technicians and Speech Therapists. The Professional association is called Zimbabwe Association of Audiologists and Speech Pathologists (ZAASP). It provides guidelines for best practice in the fields of audiology and speech and language pathology.

Audiology research

Audiology research in Zimbabwe is gaining momentum. There have been only a few published studies. However, students at the University of Zimbabwe conduct research studies as part of their education. Efforts are being made to publish these studies, with some manuscripts already submitted for review.

Audiology Charities

There are a several charities known to support ear and hearing care services in Zimbabwe. These are the following:

WizEar Trust: offers hearing health services including ENT assessment and management, hearing screenings, diagnostic audiology and hearing aids fitting and validation. WizEar works in partnership with the Ministry of Health to provide services, training, infrastructure and capacity building. WizEar also advises the Ministry with national hearing health related matters such as Hearing Health National Strategies. WizEar also works hand in hand with the University of Zimbabwe in training of audiologists and speech therapist regarding clinical teaching and practice.
Christian Blind Mission (CBM): CBM provide ear and hearing care services as part of their community based rehabilitation programs that are implemented in the communities.
Nzeve Deaf Trust: This is an institution that has been operating for over 20 years aimed at improving lives of children with hearing impairment through Sign Language services and hearing aids.
Zimbabwe Deaf Trust: is a voluntary organization that promotes the rights and interest of the Deaf and Hard of Hearing (DHH) people in Zimbabwe. They do not offer direct audiology services but conduct more advocacy work in the society.
Deaf Women Included: this is a grassroots organization aimed at empowering deaf women to access healthcare services, education, and employment opportunities.
JF Kapnek: provides ear and hearing care services such as screenings, diagnostics and hearing aids through their community-based rehabilitation program.
CAMFED: Supports ear and hearing care services for young girls and women to empower them for a brighter future.

Challenges, Resource constraints remain the main barrier to making ear and hearing care services accessible to all. Opportunities and Notes

Zimbabwe faces significant challenges in providing adequate ear and hearing healthcare, including limited access to specialized services, inadequate infrastructure, and a shortage of trained healthcare professionals. Additionally, financial constraints, lack of awareness about hearing health, and cultural barriers hinder early detection and treatment of hearing loss amongst the general population have. Hearing aids are quite expensive due to unavailability of local options. Shipping and customs clearance costs add to the high costs of hearing aids which results in inaccessibility by the general public Furthermore, the scarcity of clinical training sites, with fewer than 5 available centers, severely limits students' clinical learning opportunities. Addressing these challenges requires sustained investment in healthcare infrastructure, workforce development, and community-based initiatives to promote ear and hearing health.