Exploring the perceived barriers and facilitators for accessing audiology services in Malaysia by adults with hearing loss: a qualitative study using the COM-B model.

Abstract

This study explored barriers and facilitators to accessing audiology services among adults with hearing loss in Malaysia, using the COM-B model. A qualitative study with semi-structured interviews. Twenty-two adults with self-reported hearing loss were recruited from public hospitals, private hearing centres and community outreach across urban and rural areas, including those who had not accessed audiology services. Key barriers included lack of awareness and knowledge about hearing loss and services (psychological capability), financial constraints (physical opportunity), and stigma related to hearing aids (social opportunity). Facilitators included family support (social opportunity), community outreach (physical opportunity), and availability of public funding to access hearing services (physical opportunity). Improving access to audiology services requires addressing interacting personal, social, and systemic factors. Strategies such as public awareness initiatives, improved professional training, and expanded eligibility for publicly funded hearing care may enhance service uptake. Findings are relevant to Malaysia and may also inform efforts to improve access to hearing care in other low- and middle-income countries facing similar challenges.