Brazil

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Brazil

  • Percent of children screened for hearing loss:
  • Incidence of permanent hearing loss among newborns:


Current Status of Early Hearing Detection and Intervention for Children (500 Word Limit)

The Brazilian Public Health Care System implemented a National Policy for Attention to Hearing Health Care in 2004. This policy specifies the procedures and actions to be taken for all people in Brazil based on levels of complexity. It ranges from prevention and identification (including newborn hearing screening) to diagnosis and intervention (including hearing aids and cochlear implants). Brazil has approximately 3.1 million babies born per year and less than 10% currently receive hearing screening. The challenge is to develop a high-quality newborn hearing screening and intervention programme for the entire country. There is agreement that the newborn hearing screening programme should be part of the larger Public Health Care System, and should represent only the beginning of a process from identification to diagnosis and intervention. Such a programme will require complex procedures and qualified professionals, governmental quality assurance and database tracking.


In organizing the newborn hearing screening programme, it will be important to take advantage of other related programmes already in existence in the country – such as phenylketonuria screening. This is a very well-organized programme in Brazil with good results. By linking newborn hearing screening and phenylketonuria screening, information can be coordinated for those babies who did not have one of the tests prior to hospital discharge, or who need a second-stage test. Another programme being implemented in Brazil that will be coordinated with newborn hearing screening is the Kangaroo Mother Care Programme that organizes the follow-up for low-birth-weight infants. In this approach, the infant health booklet is used to report newborn hearing screening results. This is potentially very helpful for hearing follow-up because other professionals can access the results and motivate and support families to take part in diagnosis and intervention activities.


The results of exploratory studies in Brazil have shown that hospital-based hearing screening using an “at-risk” protocol can be very successful as a starting point for universal newborn hearing screening. This approach can be useful in organizing follow-up, maintaining an integrated database, and training community health workers to follow up on hearing and speech development. These studies have also demonstrated that although there is no significant cost difference between OAE and AABR, the false-positive and referral rates are significantly lower for AABR.

Demographics

  • Population (2012 est): 205,716,890
  • Number of Annual Births (2012 est): 3,596,000
  • Birth rate: 17.48 per 1,000
  • Percent of GDP spent on health care (2009): 8.4%
  • Percent of Health Care expenditures spent by government: 44.0%
  • Physician density: 1.72 per 1,000
  • Percent of newborns attended by skilled providers: 98%
  • Infant Mortality: 20.5 per 1,000
  • Literacy (age 15 and over can read and write): 88.6%


Publications about EHDI Programs in Brazil (Maximum of 5)

  1. Bevilacqua, M.C., Alvarenga, Kde. F., Costa, O.A., and Moret, A.L. 2010. The universal newborn hearing screening in Brazil: From identification to intervention. International Journal of Pediatric Otorhinolaryngology 74 (5):510-515.
  2. Olusanya, B.O., Swanepoel, D.W., Chapchap, M.J., Castillo, S., Habib, H. Mukari, S.Z., Martinez, N.V., Lin, H.C., and McPherson, B. 2007. Progress towards early detection services for infants with hearing loss in developing countries BMC Health Service Research 7:14.
  3. World Health Organization. 2010. Newborn and infant hearing screening- current issues and guiding principles for action. WHO Report 2010:1-39.

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