Early Health and Well-being
Year of Investment and Stage:
2020 | Transitioning to Scale
Transitioning to Scale
Have we reinvested:
HI HOPES (HH) is a high quality home visiting programme providing holistic support to families with children who are deaf or hard of hearing. As they begin to scale, the plan is to digitise the programme and ensure that it is efficient and cost effective. The streamlined process will allow better controls, less opportunity for error and a more accurate data capturing process.
Parents of deaf or hard of hearing children experience anxiety, stress and grief. These can often impact negatively on natural bonding and foundational language development. This damage to the critical bond between parent and child, which causes cognitive and socio emotional delays, is much more difficult to remediate later. This in turn impacts on the child’s feelings of safety, love and acceptance and basic foundations in language and cognition. For this reason, deaf and hard of hearing children have typically entered the schooling system (whether oral or signing schools) with significant delays in various areas.
In these early years, the family has the most profound influence on the child and early intervention should be provided by no later than 6 months of age. The long term economic cost to countries is also high. The World Health Organisation (WHO) estimates that children who do not receive early intervention can cost the state up to $1 million in their lifetime.
Despite the need and outcomes achieved, HH, a free, high quality early intervention programme reaching 6 provinces, has reached only 3% of SA children born with hearing loss in the last 12 years. HH has struggled to transition to scale. Adaptations to the model are required in order to expand reach and to leverage HH’s value proposition to facilitate sustainability.
HH is an early intervention programme providing home-based support by a well-trained early interventionist from the local community. The programme offers families the critical support, information and skills that they need to ensure that the first 3 years of their child’s development are not hindered by their hearing loss. HH is based on the University of Utah’s SKI-HI model of intervention, with an established evidence-base of impact within the United States of America. It has been adapted for use in the South African context.
Home intervention is delivered by a team consisting of a Home Interventionist (HI) and a Deaf Friend (DF). The HI visits the family twice a month, over the course of a year, to deliver the early intervention curriculum. The DF plays a role-modelling and mentoring role. Importantly, the programme does not demonstrate preference for any type of amplification, language or mode of communication; enabling parents to choose a communication modality that best meets the unique needs of their infant with hearing loss.
HH has demonstrated an ability to increase an infant’s language development by 1 month for every month of the intervention. Children exit the programme able to enter school with age-equivalent language levels (or close to it).
The solution the team is currently exploring is a HH App. The HH App is envisioned as a multipurpose innovation to the HH model. The two primary users of the App will be the home visitor and caregivers in the programme. The App is intended to increase efficiency and make communication and sharing of resources with families seamless.
Why we Invested
Scaling quality interventions, and maintaining quality at scale are notoriously difficult. Innovation Edge is up to the challenge. We strongly believe that the value proposition of HH (as the only initiative of its kind in Africa) can be leveraged towards sustainability. With impact front of mind, our organisations are also well- aligned in that the HH team is working to think more innovatively about how they scale sustainably – including looking into income-generating opportunities that mean they are not reliant solely on grant funding.
The focus on a particularly vulnerable group – children with hearing loss and their families – means that HH has the potential for deep impact. The focus on early intervention is also particularly appealing to IE. This involves the identification of potential barriers to learning and swift action, which epitomises our aim to invest early.
The Project Team
Kelahloko Mashiloane is currently the CEO of Hi Hopes at the University of Witwatersrand’s Centre for Deaf Studies where she’s leading the organisation in developing a short and long term growth strategy.
Yvette Vivian is an experienced early interventionist with a particular focus on families and multiple disabilities in babies and young children with complex needs. She has a Masters degree in Early Childhood Intervention with an Honours Degree in Psychology.