Western Cape rolls out ‘Little Ears’ to tackle newborn hearing screening gap
By Levy Masiteng
The Western Cape will start rolling out a universal newborn hearing screening programme in three areas later this year.
The Western Cape Department of Health and Wellness has partnered with Hold My Hand on “Little Ears”, an early hearing detection and intervention programme that will initially be rolled out in George, Oudtshoorn and the Khayelitsha sub-district.
Implementation will continue across the respective sites early next year.
The programme comes against evidence of significant gaps in newborn hearing screening nationally.
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A 2026 policy brief by Hold My Hand and Change Ideas, developed with an Early Hearing Detection and Intervention Community of Practice, estimates that fewer than 10% of newborns in South Africa currently receive hearing screening. It says around 17 babies are born with permanent hearing loss each day, or more than 6,000 a year.
More recent Western Cape research has found similar problems closer to where Little Ears is being introduced.
A May 2026 study reviewed records from Red Cross War Memorial Children’s Hospital’s audiology service between August 2019 and August 2024. Of 7,871 children under six seen during the period, 511 had documented newborn or infant hearing screening results.
The researchers found the mean age of initial screening among the study group was 16.3 months — well beyond the newborn period — and said screening in the tertiary setting was delayed, resource-dependent and disproportionately concentrated at higher levels of care.
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The study found 60.7% of children in the sample had been referred from tertiary facilities, while only 10% came through primary healthcare centres. Researchers said strengthening screening at primary healthcare level was essential to improving access and identifying hearing loss earlier.
The Western Cape Department of Health and Wellness says it has prioritised newborn hearing screening through its Start Well portfolio, which focuses on the first 1,000 days of a child’s life.
“This is to ensure all children in the Western Cape thrive and reach their full potential by supporting them in the first 1000 days, with a specific focus on early intervention, particularly in the neonatal period,” said Nicolette Henney, Deputy Director of the Early Life Course Unit at the Western Cape Department of Health and Wellness.
“With the launch of Little Ears, a universal newborn hearing screening programme that integrates early hearing detection and intervention by leveraging public-private partnerships, we have focussed on strategic partnerships, integrated data management, systems strengthening, and civil society engagement,” Henney said.
The provincial department has previously said newborn hearing screening is quick, gentle and painless and that objective screening is the most reliable way of identifying hearing loss early because a baby’s behaviour alone can be misleading.
In a World Hearing Day statement in March, the department said babies may respond to facial expressions rather than sound, making hearing difficulties difficult to identify through observation alone. It encouraged parents with concerns to approach their nearest clinic or community health centre for assessment and referral where necessary.
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The drive for earlier screening has also moved onto the national policy agenda.
Cabinet approved the National Strategy to Accelerate Action for Children in December 2025. Among its priorities are stimulating language and learning in young children and ensuring the timely screening and referral of children with hearing and visual disabilities.
Hold My Hand said that identifying hearing loss early allows families to make decisions about communication and intervention while children are still in the critical early stages of development, including through South African Sign Language, spoken language or both.
In a separate hearing-screening campaign earlier this year, University of Pretoria Professor of Audiology De Wet Swanepoel said: “No child should wait years for a condition that can be identified within hours after birth!”
He added: “No caregiver should leave a facility without knowing whether their baby’s hearing was checked and what to do next if there is a concern.”
Hold My Hand Strategy Lead Dr Noxolo Gqada said Deaf Awareness Month should also be used to challenge assumptions about deaf children and focus on access to language and communication.
“We hope everyone can use this month to learn more about what it means to be Deaf, celebrate Deaf culture and South African Sign Language and back the full inclusion of deaf people in South African life,” Gqada said.
“We are also calling out to parents and caregivers to find out more about hearing screening for their child and remember that bonding does not depend on how they hear, it depends on how you communicate.”
She added: “Healthcare workers, communities and governments, all have a part to play in making sure children with hearing loss get early access to language, communication and the support they need to thrive.”
The focus on language comes three years after South African Sign Language was formally recognised as the country’s 12th official language when President Cyril Ramaphosa signed the Constitution Eighteenth Amendment into law in July 2023. The amendment was intended to advance the cultural acceptance of SASL and strengthen equality and dignity for Deaf and hard-of-hearing South Africans.
The Little Ears rollout also coincides with Deaf Awareness Month in September.
PanSALB launched this year’s observance under the theme “Declaring Deaf People’s Human Rights”, with CEO Dr Keaobaka Seshoka calling for greater access to information and SASL interpretation.
“We must, as a society, come together and ensure that access to quality information becomes a lived reality for the deaf community. We must also make sure that providing South African Sign Language interpretation is not treated as charity; it is a right,” Seshoka said.
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