Progress of the Egyptian National Newborn Hearing Screening (ENHS) Program over a Four-Year Period
Eman Abdelbadei1,2, Ahmed Mustafa1,2, Abir Omara1,2
1Hearing and Speech Institute, Cairo 12511, Egypt.
Insights
Egypt's universal newborn hearing screening program, established in 2019, has significantly improved coverage rates for early hearing loss detection. Despite challenges, including the COVID-19 pandemic, the program shows progress in screening and diagnostic follow-up.
Area of Science:
- Public Health
- Pediatrics
- Audiology
Background:
- Universal newborn hearing screening (UNHS) is crucial for early detection of congenital hearing loss.
- Egypt launched a national UNHS program in November 2019, a presidential initiative.
- The program operates across 1346 primary health care units in all 26 governorates.
Purpose of the Study:
- To evaluate the performance of the Egyptian UNHS program from November 2019 to July 2023.
- To analyze key quality indicators recommended by the Joint Committee on Infant Hearing.
- To assess the program's effectiveness in early detection and management of hearing loss in newborns.
Main Methods:
- Retrospective study design.
- Analysis of quality measures: coverage rate, referral rates, and follow-up attendance for screening and diagnosis.
- Data collected from over five and a half million infants screened.
Main Results:
- Screening coverage increased from 39% to 82% between 2019 and 2023.
- Referral rate for a second screen decreased from 7.2% to 5.2%.
- Follow-up attendance for second screening improved from 75.5% to 92.1%, below the 95% benchmark.
- Referral for diagnosis remained below 1.7%.
- Diagnostic assessment attendance improved from 20% to over 65%, with a noted dip during 2020-2021 due to COVID-19.
Conclusions:
- The Egyptian UNHS program demonstrates significant progress in coverage and follow-up attendance.
- Continued efforts are needed to meet the 95% benchmark for second screening attendance.
- The program effectively identifies infants with hearing loss, with improvements in diagnostic follow-up, despite pandemic-related challenges.
Abstract:
Universal newborn hearing screening (UNHS) has become widely adopted worldwide as a standard of care for the early detection of congenital hearing loss. The Egyptian UNHS program started as a presidential initiative by the Ministry of Health in November 2019. The program was initiated in 1346 primary health care units (PHCUs) located throughout the 26 governorates. A retrospective study was conducted to assess the performance of the Egyptian Program during the period from November 2019 to July 2023. Quality measures recommended by the Joint Committee on Infant Hearing including coverage rate, rate of referral to a second screening, follow up rate of attendance of second screening, referral for diagnosis rate, and follow up rate of attendance of diagnostic assessment, were analyzed. Over a period of 3 years and 9 months, more than five and half million infants underwent a first screening. The coverage rate was initially 39% and increased to reach 82% in 2023. The rate of referral to a second screen was 7.2% in 2019 and reached 5.2% in 2023. The follow-up rate of attendance of a second screening improved throughout the study period, from 75.5% to 92.1% but did not reach the benchmark of 95%. The rate of referrals for diagnosis was less than 1.7% and rate of attendance of a diagnostic assessment was initially 20% and improved to more than 65% in 2023. The very low rate of attendance of diagnostic assessment in 2020 and 2021 was attributed to the effects of the COVID pandemic.
