title: A pilot project on hospital-based universal newborn hearing screening: lessons learned.
abstract: OBJECTIVE
  This paper reports the performance of a newly implemented hospital-based universal newborn hearing screening programme and the challenges to the effective implementation.
  
  
  METHODS
  Data of 4437 babies screened from April 2003 to February 2004 at Hospital Universiti Kebangsaan Malaysia was analyzed to measure the performance of the newborn hearing screening programme. Quality indicators, which include the coverage rate, initial refer rate, return for follow-up rate, ages of diagnosis and intervention were calculated. Factors contributing to poor compliance for follow-up were examined through questionnaire survey of 341 parents who did not bring their babies for the initial screening follow-up.
  
  
  RESULTS
  The findings of this study revealed unsatisfactory performance of the hearing screening programme compared to the Joint committee of Infant Hearing recommendation [Joint Committee on Infant Hearing Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs, Pediatrics 106 (4) (2000) 798-817]. The coverage rate, initial refer rate, and return for follow-up rate were 84.64, 11.97 and 56.97%, respectively. The average age of diagnosis was 3.56 months (S.D. 1.33). Only 1 of the 16 babies identified as having hearing loss through the screening programme has been fitted with hearing aids. Delay in coming to audiological certainty was one of the reasons hampering early intervention of these children. The commonly cited reasons for not returning for screening follow-up reflect the need to create public awareness of the importance of early diagnosis and intervention of hearing loss.
  
  
  CONCLUSIONS
  The implementation of the present screening programme needs to be reviewed. Factors contributing to its unsatisfactory performance must be identified and steps must be taken to resolve them so that early identification and intervention of permanent congenital hearing loss can become a reality.
authors.affiliation: Department of Audiology & Speech Sciences, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia. szmais@medic.ukm.my
authors.forename: S Z
authors.initials: SZ
authors.lastname: Mukari
authors.forename: K Y
authors.initials: KY
authors.lastname: Tan
authors.forename: A
authors.initials: A
authors.lastname: Abdullah
mesh_terms: D003266:Continuity of Patient Care; D034381:Hearing Loss / Q000175:diagnosis*; D006320:Hearing Tests / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008296:Malaysia; D015997:Neonatal Screening / Q000458:organization & administration*; D010865:Pilot Projects; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires