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.
