Progress towards early detection services for infants with hearing loss in developing countries

Bolajoko O Olusanya¹ , De Wet Swanepoel² , Mônica J Chapchap³ , Salvador Castillo⁴ , Hamed Habib⁵ , Siti Z Mukari⁶ , Norberto V Martinez⁷ , Hung-Ching Lin⁸ and Bradley McPherson⁹

¹Institute of Child Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria

²Department of Communication Pathology, University of Pretoria, Pretoria, South Africa

³Hospital Sao Luiz, Sao Paulo, Brazil

⁴Audiology and Phoniatrics Department, México Children's Hospital, 'Federico Gómez" Dr. Márquez 162, Colonia Doctores, 06726 México City, Mexico

⁵Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

⁶Department of Audiology & Speech Sciences, Faculty of Allied Health Sciences Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia

⁷Better Hearing Institute, Manila, Philippines

⁸Department of Otolaryngology, Hearing and Speech Centre, Mackay Memorial Hospital, Taipei, Taiwan

⁹Division of Speech and Hearing Sciences, Faculty of Education, University of Hong Kong, Hong Kong, China

author email corresponding author email

BMC Health Services Research 2007, 7:14doi:10.1186/1472-6963-7-14


Published:	31 January 2007

Abstract

Background

Early detection of infants with permanent hearing loss through infant hearing screening is recognised and routinely offered as a vital component of early childhood care in developed countries. This article investigates the initiatives and progress towards early detection of infants with hearing loss in developing countries against the backdrop of the dearth of epidemiological data from this region.

Methods

A cross-sectional, descriptive study based on responses to a structured questionnaire eliciting information on the nature and scope of early hearing detection services; strategies for financing services; parental and professional attitudes towards screening; and the performance of screening programmes. Responses were complemented with relevant data from the internet and PubMed/Medline.

Results

Pilot projects using objective screening tests are on-going in a growing number of countries. Screening services are provided at public/private hospitals and/or community health centres and at no charge only in a few countries. Attitudes amongst parents and health care workers are typically positive towards such programmes. Screening efficiency, as measured by referral rate at discharge, was generally found to be lower than desired but several programmes achieved other international benchmarks. Coverage is generally above 90% but poor follow-up rates remain a challenge in some countries. The mean age of diagnosis is usually less than six months, even for community-based programmes.

Conclusion

Lack of adequate resources by many governments may limit rapid nationwide introduction of services for early hearing detection and intervention, but may not deter such services altogether. Parents may be required to pay for services in some settings in line with the existing practice where healthcare services are predominantly financed by out-of-pocket spending rather than public funding. However, governments and their international development partners need to complement current voluntary initiatives through systematic scaling-up of public awareness and requisite manpower development towards sustainable service capacities at all levels of healthcare delivery.