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Limitations and drawbacks of the hospital-based universal neonatal hearing screening program: First report from the
Arif Ali Kolethekkat1, Rashid Al Abri1, Omar Hlaiwah1
1ENT Division, Department of Surgery, SQU Hospital, Oman.
Insights
Oman
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Universal neonatal hearing screening programs are crucial for early detection of hearing loss.
- Effective screening programs aim to identify infants with hearing impairment shortly after birth.
- Early intervention is vital for language development and overall well-being.
Purpose of the Study:
- To evaluate the effectiveness of Oman's universal neonatal hearing screening program.
- To identify challenges and reasons for program deficiencies.
- To provide recommendations for program improvement.
Main Methods:
- Retrospective analysis of 12,743 infant hearing screenings (2016-2018).
- Comparison with Joint Committee on Infant Hearing (JCIH) standards.
- Prospective parent interviews to identify barriers to screening and intervention.
Main Results:
- True hearing loss prevalence: 4.0 per 1000 live births.
- Screening coverage: 90% (first stage), 88.04% (second stage).
- Diagnostic confirmation: 22.8%; Amplification compliance: 30.2%.
- Delays noted in screening (7.98 weeks) and diagnosis (17.3 weeks).
- Parent-reported issues: communication, appointment delays, poor follow-up tracking.
Conclusions:
- Program coverage (90%) and performance indicators fall below the 95% benchmark.
- Communication, appointment scheduling, and tracking systems are key areas for improvement.
- Enhanced communication and robust tracking are essential for program success.
Objectives:
To assess the efficacy of the current universal neonatal hearing screening program in a tertiary medical institution in Oman, identify its limitations and drawbacks, and explore their causative factors.
Methods:
A retrospective review was carried out to analyse the hearing screening of 12,743 live babies born between January 2016 and December 2018. Screen coverage, drop outs, follow up rate, and age at completion of screening, diagnosis, and intervention were analysed. The results were compared with the Joint Committee on Infant Hearing (JCIH) performance quality indices. Prospective questionnaire-based telephonic interviews were then conducted with the parents or caregivers of neonates with hearing loss. Finally, the causes of loss to follow up or delays in hearing screenings, diagnosis, and/or early intervention were studied.
Results:
The true prevalence of hearing loss was 4.0 in 1000. The coverage of first-stage screening was 90% whereas the compliance with the second stage was 88.04%. 22.8% of the patients eventually obtained final diagnostic confirmation. The overall compliance with amplification was 30.2%. The completion ages of primary screening and final confirmation were 7.98 and 17.3 weeks respectively. The importance of hearing screening is well received by parents, but problems related to communication, delays in the appointment system, and inefficient follow up tracking were identified as the main limitations and drawbacks of the program.
Conclusion:
The coverage of the neonatal hearing screening program had not yet reached the required goal of 95%. The performance indicators also fell below the international benchmark. There is a need to address the identified causative factors. Effective communication and well-maintained tracking systems need to be implemented.
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