Process, outcomes and feasibility of implementing universal newborn screening programme in Sri Lanka

Area of Science:

• Public Health
• Neonatal Care
• Screening Programs

Background:

• Universal newborn screening is recommended by WHO to detect serious conditions early.
• Sri Lanka initiated a pilot universal newborn screening package in 2025.
• The package includes screening for eye abnormalities, congenital hypothyroidism, critical congenital heart disease, and hearing impairment.

Purpose of the Study:

• To describe the implementation process of the universal newborn screening package in Sri Lanka.
• To evaluate the outcomes and feasibility of the pilot screening program.
• To identify challenges and successes in integrating screening into routine newborn care.

Main Methods:

• A descriptive study was conducted in five pilot hospitals from January to March 2025.
• Data collected through maternal interviews, patient records, and post-discharge telephone interviews.
• Neonates with abnormal screening results were identified as 'Refer' for further evaluation.

Main Results:

• High screening coverage (>98%) achieved for congenital hypothyroidism, critical congenital heart disease, and eye abnormalities.
• Congenital hypothyroidism detected in 0.15% (6/3860) of neonates; critical congenital heart disease identified in one neonate.
• Hearing impairment screening coverage was suboptimal (79.1%), with significant 'Refer' rates (10.6% first test, 1.3% second test).

Conclusions:

• Pilot implementation demonstrated operational feasibility for most components of the universal newborn screening package.
• Hearing impairment screening requires addressing logistical and system-level challenges for improved effectiveness.
• Universal newborn screening is a feasible and sustainable intervention for Sri Lanka's health system.