Assessment of hearing screening programmes across 47 countries or regions I: provision of newborn hearing screening

Abstract

Objectives: Newborn hearing screening (NHS) varies regarding number and type of tests, location, age, professionals and funding. We compared the provision of existing screening programmes. Design: A questionnaire containing nine domains: demography, administration, existing screening, coverage, tests, diagnosis, treatment, cost and adverse effects, was presented to hearing screening experts. Responses were verified. Clusters were identified based on number of screening steps and use of OAE or aABR, either for all infants or for well and high-risk infants (dual-protocol). Study sample: Fifty-two experts completed the questionnaire sufficiently: 40 European countries, Russia, Malawi, Rwanda, India and China. Results: It took considerable effort to find experts for all countries with sufficient time and knowledge. Data essential for evaluation are often not collected. Infants are first screened in maternity wards in most countries. Human development index and health expenditure were high among countries with dual protocols, three screening steps, including aABR, and low among countries without NHS and countries using OAE for all infants. Nationwide implementation of NHS took 6 years, on average. Conclusion: The extent and complexity of NHS programmes are primarily related to health expenditure and HDI. Data collection should be improved to facilitate comparison of NHS programmes across borders.

Keypoints to Successful Newborn Hearing Screening. Thirty Years of Experience and Innovations

“…At the present there is controversy about the technical equipment and protocols to be used, but all the programs reduce the age of treatment achieving a better prognosis for hearing and psychosocial adaptation [7][8][9][10]. A universal neonatal screening raises some problems of organization and distribution of tasks related to the responsible hospital service (pediatrics, obstetrics, otorhinolaryngology), health personnel in charge of carrying out the test (pediatrician, nurses, otorhinolaryngologist , etc.…”

“…At the present there is controversy about the technical equipment and protocols to be used, but all the programs reduce the age of treatment achieving a better prognosis for hearing and psychosocial adaptation [7][8][9][10].…”

“…A good performance is needed to avoid the overload of hospital services concerned. There is currently a strong discussion about the more appropriate technical equipment and protocols to be used, but all the programs manage to increase the early detection of congenital deafness in the neonatal period, which has made it possible to reduce the age of treatment and have better clinical prognosis and psychosocial adaptation [7][8][9][10].…”

“…congenital deafness in the neonatal period, which has made it possible to reduce the age of treatment and have better clinical prognosis and psychosocial adaptation [7][8][9][10]. We have systematically applied this practice at the Hospital Clínico in Valencia (Spain) during the last 30 years [11][12][13].…”

Report: EUSCREEN final dissemination meeting in Zaandam on Monday, June 28th and Tuesday 29th

“…Interestingly, the extent and complexity of neonatal hearing screening programs are primarily related to the countries' health expenditure and Human Development Index score. 6 Inger Uhlén (Karolinska Institute, Stockholm) discussed the use of quality measures in neonatal hearing screening: coverage, referral rate and lostto-follow-up rate. Data on these quality measures were not available in many countries.…”