Chishlo is building Kenya's first national Early Hearing Detection and Intervention infrastructure. This is our blueprint, evidence-based, community-anchored, and designed to scale across all 47 counties.
"Every year, thousands of Kenyan children are born into silence, and most will not be identified until they enter school, five years too late."
Globally, 1 in every 500 newborns has significant permanent hearing loss, making it the most common sensory birth condition. In sub-Saharan Africa, that number is higher due to preventable causes including untreated jaundice, meningitis, and ototoxic medications administered without audiological oversight.
Kenya does not yet have a universal newborn hearing screening program. A national plan for ear and hearing care has existed since 2016, and the Ministry of Health approved a National Ear and Hearing Care Strategy for 2023 to 2028, but routine screening at birth is still the exception rather than the rule. Without it, many children with hearing loss go undetected through birth, immunization clinics, and early childhood development, arriving at school unable to speak or communicate fully. The window for language acquisition narrows significantly by age 3.
The cost of inaction compounds across generations: children who cannot speak cannot learn at grade level, cannot enter formal employment, and remain in poverty cycles. A single child identified and supported early adds decades of economic participation to their community.
Four sequential stages, each with defined actors, timelines, and outcome metrics, built to function within Kenya's existing health infrastructure rather than replace it.
Automated OAE/ABR testing at hospital delivery rooms, Level 4 facilities, and immunization clinics.
Birth to 1 monthFull audiological assessment at Chishlo-partnered diagnostic hubs to confirm type, degree, and laterality.
By 3 monthsFitting hearing aids, cochlear implant referral, and family-centered auditory-verbal therapy enrollment.
By 6 monthsLongitudinal tracking via digitized EHDI records, school liaison, device maintenance, and family support groups.
Ongoing"The 1-3-6 benchmark: screen by 1 month, diagnose by 3, intervene by 6, is the global EHDI gold standard. Chishlo's model is designed around it."
Joint Committee on Infant Hearing (JCIH) Year 2019 Position Statement
Chishlo's operational model rests on three mutually reinforcing pillars, each critical, none sufficient alone.
Community-based screening is the foundation. Chishlo embeds trained hearing health workers into the points of care families already use, removing the barrier of specialized clinic access that keeps rural and low-income children undetected.
OAE machines deployed at Level 4 and Level 5 hospitals. Every newborn before discharge receives automated auditory screening, with results entered into the EHDI digital registry.
Partnering with CHVs (Community Health Volunteers) at Expanded Programme on Immunization clinics, the highest-attendance touch points for children under 1, to screen infants missed at birth.
For older undetected children, Chishlo conducts annual mobile hearing screenings at ECD centers in partnership with county education offices.
Evidence: Integrating hearing screening into existing immunization and primary health touch points is consistently associated with higher detection coverage than standalone audiological clinics in low-resource settings.
Nairobi and Kisumu are the counties where Chishlo has piloted immunization-clinic integration to date; results are still being tracked and are not yet published.
Identification without intervention is incomplete. Chishlo operates a means-blind intervention guarantee: every child identified receives the appropriate audiological solution regardless of their family's ability to pay.
Subsidized behind-the-ear hearing aids fitted and calibrated by licensed audiologists. Includes follow-up maintenance, battery supply, and earmold replacement.
For children with profound bilateral hearing loss, Chishlo manages the referral pipeline to KNH and Aga Khan Hospital, coordinating pre-surgery audiological assessment, surgical scheduling, and post-activation AVT.
Auditory-Verbal Therapy sessions delivered at county-level hubs, supplemented by parent coaching kits enabling home practice. Tele-therapy available for remote families.
Outcome tracking: Chishlo enrolls every child in intervention through its EHDI Digital Registry, recording speech and language milestones over time. Formal outcome results have not yet been published; this will be added once a full cohort completes the 3-year program.
Contact Chishlo directly for the latest internal progress figures.
Chishlo is not building a short-term program. We are building infrastructure, training the workforce, supporting policy, and digitizing records so that Kenya's public health system can sustain EHDI independently over time.
OAE screening training for nurses and CHVs, working toward integration with recognized health training institutions such as the Kenya Medical Training College (KMTC).
A child hearing health tracking system designed to align with DHIS2, Kenya's national health data platform. Records screening results, diagnoses, interventions, and outcomes by county.
Engaging with the Ministry of Health as it implements the National Ear and Hearing Care Strategy (2023 to 2028), advocating for universal newborn hearing screening to be embedded in routine maternal and child health services.
Regional precedent: South Africa's EHDI program, built over roughly a decade using a similar community-health-worker integration model, has significantly expanded newborn screening coverage within its public system. Chishlo's approach draws on this experience, adapted for Kenya's devolved county health system.
Swanepoel et al., 2014-2015, published research on hearing healthcare system-building in sub-Saharan Africa.
Chishlo's current operations are concentrated in Uasin Gishu and Nandi, where we run full screening and intervention services, and Bungoma, where services are being phased in. The remaining 44 counties are not yet reached. Kenya has 47 counties in total.
A clear causal chain connects our resources to generational change. This is how we think about it, and how funders can hold us accountable.
Every component of Chishlo's model is grounded in peer-reviewed evidence. We are practitioners of established science.
Children fitted with hearing aids before 6 months tend to reach speech and language milestones within, or close to, the normal developmental range by age 5.
Moeller, M.P. (2000). Early intervention and language development in children with hearing loss. Pediatrics, 106(3).
Community health worker integration into newborn hearing programs is associated with substantially higher detection rates in low-resource settings.
Swanepoel, D. et al. (2014). Hearing healthcare in sub-Saharan Africa. Bulletin of the World Health Organization, 91(3).
WHO estimates that the economic return from investing in ear and hearing care substantially exceeds the cost of intervention in middle-income country contexts.
WHO. (2021). World Report on Hearing. Geneva: World Health Organization.
Full transparency. Below is what it costs to identify, intervene, and support one child, and where the funding comes from. Ranges reflect real variation in equipment and therapy needs.
Roughly USD 430 to USD 1,370, depending mainly on the hearing aid model fitted. Figures are working estimates for planning purposes and should be confirmed against current supplier and clinic pricing before publishing.
Monthly giving from Kenyan and diaspora donors. KSh 5,000/month helps fund a child's screening, diagnosis, and first hearing aid fitting.
Multi-year grants from international health foundations, WHO, and bilateral development funders.
CSR partnerships with Kenyan corporates. Employee giving schemes and matched donations.
In-kind support from MoH: facility access, CHV networks, DHIS2 integration. Growing toward budget line inclusion.
Monthly giving. Cancel anytime. Receipts provided.
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You have read the blueprint. You understand the system. Now help us build it, one child, one county, one generation at a time.