India

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India

  • 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)

India faces the challenge of a very large population and a high annual birth rate approaching 25 babies per 1000. Moreover, 75% of the population live in rural areas and over 50% of births occur at home and are frequently attended by a trained birth attendant. However, India also has a well-developed health care delivery system, right down to the grassroots/village level, and a well-established immunization programme.

In 2006, India launched the National Programme for Prevention and Control of Deafness. This programme is currently running in over 60 districts of the country and its aim is to identify babies with bilateral severe-profound hearing losses by 6 months of age and initiate rehabilitation by 9 months of age. Under this programme, the following two-part protocol for infant hearing screening is being implemented:

  • Institution-based screening – to screen every baby born in a hospital or admitted there soon after birth using OAE. Those who fail the test are re-tested after 1 month. Those who fail the second screening are referred for ABR testing at the tertiary-level centres.
  • Community-based screening – to screen babies who are not born in hospitals. Such screening is carried out using a brief questionnaire and behavioural testing. The screening is performed when the baby attends for immunization at 6 weeks of age and onwards. A trained health care worker at the subcentre administers immunization and conducts the hearing screening. The protocol is repeated at every immunization. Any baby failing the screening is referred for formal OAE screening to the district hospital, and if they fail OAE they are then sent for ABR testing.

The programme includes:

  • training of existing human resources using standardized training programmes and other materials;
  • provision of the equipment required for behavioural testing and for OAE at the respective centres;
  • provision of suitable audiological personnel for diagnosis and for rehabilitation at the district hospitals;
  • creating awareness of the importance of detecting childhood hearing loss amongst parents and the general population through the use of posters, flipcharts, fliers, handouts and other suitable materials; and
  • provision of a referral slip to aid patient compliance and simplify the visiting process.

Once an individual is identified as hearing impaired, they are referred for hearing aid fitting and for suitable therapy at the district hospital.

Identified problems include the need for patients/parents to make repeated visits and to visit different centres. In addition, even though OAE is provided at all centres, there is a shortage of centres where ABR is done. There is also a shortage of audiological personnel and a heavy burden placed on health care workers.

At present, the programme has been initiated in more than 60 districts of India, training has been undertaken in most districts, and awareness material developed and provided to all centres. OAE machines have been made available and human resource development and deployment efforts are under way. A cost-benefit analysis of the programme, and an assessment of its validity and workability, will be available in 2011 once the protocol has been completely field-tested.

Demographics

  • Population (2012 est): 1,205,073,612
  • Percent of Annual Births (2012 est): 24,824,500
  • Birth rate: 20.6 per 1,000
  • Percent of GDP spent on health care (2009): 4.2%
  • Percent of Health Care expenditures spent by government: 32.4%
  • Physician density: 0.599 per 1,000
  • Percent of newborns attended by skilled providers: 47%
  • Infant Mortality: 46.07 per 1,000
  • Literacy (age 15 and over can read and write): 61%

Publications about EHDI Programs in India (maximum of 5)

  1. Kumar, S., and Mohapatra, B. 2010. Status of newborn hearing screening program in India. International Journal of Pediatric Otorhinolaryngology 75:20-26.
  2. Nagapoornima, P., Ramesh, A., Srilakshmi, Rao, S., Patricia, P.L., Gore, M., Dominic, M., and Swarnarekha. 2007. Universal hearing screening. Indian Journal of Pediatrics 74 (6):545-549.
  3. 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.
  4. 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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