Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 06 06 1557 1557 Chaithra Chandrashekar Junior research fellow Puttaraju Sahana Assistant Professor Puttabasappa Manjula Professor 2026 04 15 2026 06 03 Background and Aim: Cochlear implants (CI) offer significant benefits in speech-language and auditory development for children with severe to profound sensorineural hearing loss. However, in countries like India, barriers to accessing CI surgery persist, influenced by  factors including financial constraints and societal perceptions.. Therefore, the study aimed to investigate barriers and facilitators to CI uptake  in Karnataka. Methods: A cross-sectional questionnaire-based study was conducted among parents of children who underwent cochlear implantation (CI group, n=82) and those who did not (non-CI group, n=102),  in Karnataka, India (n = 184). The questionnaire was developed through expert focus group discussion, literature review, and pilot testing, and included  sections on facilitators and barriers to CI uptake. Content validity was established using expert ratings (CVR and CVI), and demographic variables included parental education and socioeconomic status. Results: The logistic regression model was significant [χ²(4) = 71.25, p < 0.001]. Higher parental education (aOR = 0.56, p < 0.001) and earlier age at recommendation (<3 years; aOR = 0.26, p = 0.001) were significant predictors of CI uptake, while income and gender were not (p > 0.05). Key barriers were financial burden, concerns about surgical complications, family opposition, caregiving responsibilities, and pandemic-related disruptions. Conclusion: Facilitating CI uptake requires  financial support, tailored counselling, and early detection initiatives. Government initiatives should be supplemented with subsidized  CI spare parts.  . Addressing parental concerns and increasing awareness among healthcare professionals and policymakers are crucial to improve accessibility and  outcomes for children with hearing loss. https://avr.tums.ac.ir/index.php/avr/article/view/1557 https://avr.tums.ac.ir/index.php/avr/article/download/1557/687