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1. PROJECT OBJECTIVES
Conduct auditory screening in the pediatric population aged between 2 and 5 years in the municipality of Armenia, Quindío, Colombia, over a one-year period. The objective is to identify potential hearings problems, thereby promoting comprehensive development, socio-educational inclusion, and well-being during childhood. This initiative ensures audiological support for parents and educators, contributes to the implementation of the surveillance protocol for congenital defects particularly related to auditory impartments. Additionally, it aligns with the Comprehensive Healthcare Routes for Early Childhood (RIAS) mandated by the government, aiming to facilitate educational development and prevent dropouts due to unidentified learning disabilities.
2. PROJECT DESCRIPTION
• JUSTIFICATION:
In the Development Plan of the Municipality of Armenia, hearing impartment has not been reported, and there are no records since 2017, indicating a zero indicator. The lack of comprehensive knowledge among the community's medical professionals, educational staff, and parents regarding the importance of early detection of auditory impairments in children necessitates the development of an education and assessment protocol, including auditory screening. This aims to integrate it into the activities of the educational community, in coordination with the Municipal Health and Education Secretariat, the Medical Corps of the health system (contributory and subsidized), the team from the Colombian Family Welfare Institute - ICBF-1, the Rotary Support Group, and the beneficiary children along with their families.
Hearing is the cornerstone of communicative and language development. Early detection of auditory impairments will facilitate timely diagnosis and intervention, enabling the child to achieve language and communicative development aligned with their cognitive age.
The CRITICAL AGE for this developmental maturation is from birthday to 3 years of age; therefore, the assessment of children should be early to achieve efficient and timely guidance, direction, and interventions.
Hearing loss can be mild, moderate, severe or profound and may affect one or both ears. The main causes of this disorder can be congenital or acquired in early childhood; chronic middle ear infections; age-related, noise-induced hearing loss, or due to ototoxic drugs that damage the inner ear.
The consequences of hearing loss are broad and can be profound. They include the loss of the ability to communicate with others, delayed language development in children, leading to social isolation, feelings of loneliness, and frustration. Many of those consequences can be mitigated trough early detection and intervention. This includes special education programs, assistive technologies: hearing aids, cochlear implants, Closed Caption (CC), and other resources through speech therapy, auditory/verbal rehabilitation, which can be helpful for individuals with hearing loss of any age.
Hearing loss and deafness can also result from complications of other diseases such as measles, meningitis, rubella and mumps. Activities aimed at preventing these diseases through vaccination and hygiene programs can have beneficial effects in reducing their occurrence; additionally, immunizing women and adolescents of childbearing age against rubella before pregnancy, as well as preventing cytomegalovirus infections in pregnant women, can reduce the risk of children being born with congenital hearing loss or deafness.
• DIRECT AND INDIRECT BENEFICIARIES:
Hearing screenings will be conducted on approximately 2,460 children aged 2 and 5-year-old, residing in the city of Armenia as part of the Municipal Development Plan. This initiative targets children enrolled in the Institutional Units for Early Childhood -UIPI, aiming to ensure early education, care and nutrition within the framework of comprehensive and differential attention. Additionally, efforts will be made to promote their rights to health, protection, and participation, fostering their physical, emotional and communicative development. Moreover, their families, consisting of (7,500 individuals), the teaching staff of the UIPI (140 teachers), and the medical personnel within the healthcare system will also benefit from this initiative.
• ACTIVITIES TO DEVELOP:
o Information and promotion within Institutional Units for Early Childhood - UIPI, about the importance of preventing learning difficulties and cognitive development issues in preschool-aged children.
o Hearing screenings will be conducted on preschool children between 2 and 5 years, using the Education and Auditory Assessment Protocol, integrating it with the Comprehensive Routes of Early Childhood Health Care (RIAS)-2. This aims to track their overall development in collaboration with Municipal Health Secretariat.
o Based on the registered population in the UIPI of the city of Armenia, an evaluation system is established for a one-year period, an auditory screening protocol will be implemented, acquiring and utilizing audiometric equipment with pure tones at 25 dB HL in frequencies of 500 - 1000 - 2000 - 4000 Hz; results will be categorized as PASS or FAIL and appropriate routes will be applied according to the established protocol:
PASS: Recommendation for auditory care and a one-year follow-up are provided.
FAIL: A referral is given to the health care provider EPS, for clinical assessment, (behavioral audiometry / impedance testing) followed by a 3-month control and intervention, (treatment - amplification - therapies) are administered before the 6 month mark.
• RESOURCES:
- TECHNOLOGICAL EQUIPMENT: Otoscope / Audiometer GSI 18 // AMTAXFLEX
- HUMAN RESOURCES: Audiologist / Speech therapist / Administrator
- PAPERWORK: Screening / Administrative reports
- PROJECT IMPLEMENTATION: mobility of human resources, specialized equipment, and snacks for assessed children.
- LITERATURE / EDUCATIONAL BROCHURES: Information brochures
- EDUCATIONAL TALKS: (Parents / Health and school staff): Video beam / PC
3. SUSTAINABILITY:
With the endorsement from the Municipal Health Secretariat of Armenia and the Colombian Institute of Family Welfare - ICBF-1, aiming to integrate programs for improving the health and well-being of minors into their public policy for early childhood, they will develop an agreement to implement the UIPI of the municipality of Armenia, in coordination with Rotary Club Armenia Palma de Cera.
The Municipal Health Secretariat, in fulfilling its role of educating and promoting early childhood care programs, supports the "Early Detection Program for Potential Hearing impairments in preschool children in the city of Armenia", they provide backing and maintenance throughout the project's execution until its completion committing to ensuring continuity, follow up, and intervention for the identified children even after the project concludes.
The economic sustainability for the project's development is achieved through financial support provided by our club and other entities endorsing this initiative. This project does not demand subsequent financial resources as it will be integrated into the program with the RIAS-2 through the General System of Social Security in Health (SGSSS)-3. The latter becomes the subsequent manager of the program upon receiving our auditory screening protocol, along with the guidelines ensuring the its continuity through the trained medical team.
1- INSTITUTO COLOMBIANO DE BIENESTAR FAMILIAR (ICBF): The Colombian government entity working for the comprehensive prevention and protection of early childhood, and adolescence, as well as strengthening of youth and families in Colombia. Its mission is to provide special attention to those facing threats, neglect, or violation of their rights.
2- RUTAS INTEGRALES DE SALUD DE PRIMERA INFANCIA (RIAS): Actions for diagnosis, treatment, rehabilitation, palliative care, and health education. It allows guiding and organizing the management of comprehensive health care by actors within the SGSSS continuously and consistently with the situation and characteristics of each territory. Additional it involves intersectoral management to address the social determinants of health.
3- SISTEMA GENERAL DE SEGURIDAD SOCIAL: Its objective is to regulate essential public health service and create access conditions for the entire resident population of the country at all levels of care.
4. BUDGETS: Approximate exchange rate USD 1 = $ 4.000
- TECHNOLOGICAL EQUIPMENT: USD 4,750
2 Otoscopes $ 5'000.000 COP = USD 1.250
Audiometer GSI 18 // AMTAX FLEX $ 10'000.000 COP = USD 2.500
Video Beam $ 4'000.000 COP = USD 1.000
- HUMAN RESOURCE: USD 32.820 Human Resource / year
2 days/week = 8 days/month = 8 months/year: Assessment only, the rest of the time for Promotion, Educational Workshops, Reports, Statistics, Monitoring.
Audiologist $ 60.000 COP= USD 15 h/W $ 46,080,000 COP/year = USD 11,520
Speech therapist $ 50.000 COP= USD 12,5 h/W $ 38,400,000 COP/year = USD 9,600
Administrator $ 50.000 COP= USD 12,5 h/W $ 38,400,000 COP/year = USD 9,600
Accountant $ 8.400 COP= USD 2,1 h/W $ 8,400,000 COP/year = USD 2,100
- STATIONERY and OFFICE EQUIPMENT:
Screening / Administrative Reports $ 1.000.000 COP = USD 250
- PROJECT IMPLEMENTATION:
Mobility of Human Resources and Equipment $ 1.280.000 COP/year = USD 320
- LITERATURE / EDUCATIONAL BROCHURES:
Information brochures 6000 brochures $ 2.400.000 COP = USD 600
- SNACKS:
For children valued 2460 children* $ 16.000.000 COP/child = USD 4.000
* with training included
- EDUCATIONAL TALKS / OPENING AND CLOSING
(Parents / Health / School Personnel): $ 6.800.000 COP / year = USD 1700
- BANKING EXPENSES: $ 800.000 COP/ year = USD 200
- UNFORESEEN: (8.5% of the budget) USD 3.795
USD 4.750 Technological Equipment
USD 32.820 Human Resource / year
USD 250 Stationery and Office Equipment / year
USD 320 Project Implementation
USD 600 Literature / Educational Brochures / year
USD 4.000 Preschool Snacks / year
USD 1.700 Educational Talks / Opening and Closing
USD 200 Banking Expenses
USD 3.795 Unforeseen (8,5%)
USD 48.435 $ 193'740.000 COP Value of the Project
5. FINANCING OF THE PROJECT:
Value of the Project USD 48.435 $193'740.000 COP
Local Club USD 500
District 4281 USD 1.500
CR Monterrey -Mx USD 500
International Club/s USD 10.540
International District/s USD 19.000
Rotary Foundation USD 16.400
6. THANKS:
We express our gratitude for your support, willingness and accompaniment in the development process of this project:
• CADRE:
Dr HILDA MONTRULL, PhD Clinical Pharmacology
National University of Cordoba
PGD 2012-2013
Rotary Cadre Technical Advisor 2015-2023
The Rotary Foundation 2013-2016
Honorary member R.C. Innova Rio Tercero
Dr. GRACIELA JARA PEREIRA
TRF Cadre of Technical Advisers (2013-2014, 2014-2024)
The Rotary Club Asunción Norte - Presidente 2024
• ICBF:
Dra. ADRIANA ECHEVERRI, Directora Instituto Colombiano de Bienestar Familiar - Seccional Quindío.
Dra. LUZ MARY MONTOYA, Psicóloga Instituto Colombiano de Bienestar Familiar - Seccional Quindío
• SECRETARIA DE SALUD MUNICIPAL:
Dra. LILIANA QUINTERO, Médico Epidemióloga,
Secretaria de Salud Municipal. - Armenia, Quindío.
7. CONTACT:
C.R. ARMENIA PALMA DE CERA Audiologist, Mónica López de Mesa Nicholls.
monicalopezdemesa@hotmail.com
cel.: +57 3227908461 Md, Jorge Raúl Ossa Botero
jorgeossa@gmail.com
cel.: +57 310 3734188
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