Quality-controlled newborn hearing screening in Ghana: Outcomes and challenges from a pilot project

Neonatal hearing impairment affects 1-2 per 1000 live births in high-income countries, making early detection and habilitation critical before 6 months of age to ensure optimal language and communication development. Ghana currently lacks national legislation supporting universal newborn hearing screening (UNHS).

This multicentre, hospital-based pilot study analysed newborn hearing screening data from four facilities between July 2023 and January 2025. Screening was conducted by trained staff using transient-evoked otoacoustic emissions and automated auditory brainstem response. Infants requiring follow-up were referred to the diagnostic centre at Korle-Bu Teaching Hospital. Results were documented, communicated to caregivers, and securely transferred to a centralised tracking system (pathTrack). Data analysis was performed using Microsoft Excel and SPSS version 20.0.

Of 29 075 live births, 11 107 (38.2%) were registered in the screening database, and 11 058 (99.6%) underwent screening at a median age of 13 days. Of these, 9007 (81.5%) passed the initial screening. Among 10 019 infants completing the process, three were diagnosed with permanent congenital hearing loss. Challenges included low coverage due to limited personnel, restricted diagnostic access, financial hardship, stigma, and barriers to follow-up. Caregivers demonstrated high acceptance of the screening process.

This pilot demonstrates that newborn hearing screening in Ghana is feasible but constrained by systemic challenges. Strengthening infrastructure, expanding the trained workforce, ensuring sustainable funding, and increasing public awareness are essential to scaling up and sustaining a national UNHS programme.

This study provides the first quality-controlled evidence of newborn hearing screening feasibility in Ghana, demonstrating high parental acceptance while revealing systemic barriers such as limited personnel, restricted diagnostic access, financial hardship, and high loss to follow-up. By documenting outcomes and challenges across multiple hospitals, the research highlights critical pathways for scaling up UNHS in resource-limited settings. These insights align with JCMSA's mission to strengthen clinical practice, public health systems, and medical education across Africa by providing context-specific evidence to guide policy integration, workforce development, and sustainable programme implementation.