World Hearing Day: Experts want mandatory screening of hearing for newborns. Will the government listen?

The Indian government is still ignorant about the country's most neglected form of disability — hearing impairment.

ByChetana Belagere

Published Mar 03, 2023 | 10:30 AMUpdatedMar 03, 2023 | 10:30 AM

Why is Newborn hearing screening important to detect hearing problems?Representative pic only (Wikimedia)

The National Programme for Prevention and Control of Deafness (NPPCD) has identified 2,00,305 hearing-impaired and 35,418 severely hearing-impaired people in the last five years — in Karnataka alone.

Of these, 2,381 are children under five years with severe hearing loss.

The World Health Organisation (WHO) estimates that 430 million people are suffering from hearing loss worldwide, and the number will go up to 700 million by 2050.

In India, it is estimated that five-six babies out of every 1,000 have some form of hearing loss.

“The numbers are increasing every single day, but the Indian government is still ignorant about the country’s most neglected form of disability — hearing impairment,” says ENT doctor Dr Prasanna GN, who runs a private clinic in Bengaluru.

“Just one single policy — compulsory screening of newborns — can reduce the number of children with hearing impairment,” he told South First.

If the government would only listen!

Related: Budget says state aims to create ‘Hearing Impairment Free Karnataka’

Hospitals screen for deformities, but not hearing

Doctors South First spoke to stressed on the importance of having a policy on compulsory hearing screening of newborn babies.

Many parents are not aware that a one-day-old child can get a hearing test done to detect any congenital hearing loss. Many parents believe that they themselves can identify hearing loss, if any.

“Early identification of hearing loss will lead to better outcomes and treatment for children. Their speech and language can be good. They will have better social and economic outcomes. This test is non-invasive and painless,” explains Dr Mohan Rao, ENT specialist at Sagar Hospitals in Bengaluru.

Why is Newborn hearing screening important to detect hearing problems?Representative pic only

Why is Newborn hearing screening important to detect hearing problems?Representative pic only (Wikimedia)

Countries like Australia and the US have mandatory newborn hearing screening. They follow what is called the 1,3,6 Model: The baby is screened in the first month, the problem is pinpointed by the third month, and interventions start by the sixth month, which could result in a complete cure for most kinds of hearing ailments.

Some developed countries have, in fact, moved to a 1,2,3 Model where all of this will be done in just three months.

For some years now, the Indian Academy of Pediatrics (IAP) has been recommending to the Indian government to make screening for hearing loss in newborn babies mandatory before they go home from the hospital.

Unfortunately, even healthcare providers tend to ask the parents to wait for few more years “for the speech to develop” and fail to guide them to a proper screening of the child’s hearing ability.

“In hospitals, they ensure that all screenings are done for deformities, but screening for hearing gets missed. The problems inside the ear are not visible, unlike other deformities. Only the Otoacoustic Emissions (OAE) test, which measures sound waves produced in the inner ear, can help identify the problem,” explains a doctor at a government hospital in Mysuru.

What causes hearing problems?

Anyone who cannot hear sounds below 20 decibels is defined as having earing loss. It can occur at any age and for a variety of reasons.

The causes for hearing loss are genetic, loud noise, infection, chronic diseases like TB, cancer, infections in pregnant women, due to long-term medication, consanguineous marriages, problems during delivery, premature birth, growth not according to age, due to blows to the ears, putting a stick, pencil or any other object in the ear and so on.

However newborn screening can detect possible hearing loss in the first few days of a baby’s life.
“Problems with not being able to hear will hinder a baby’s language and development. Appropriate early intervention services by age six months can develop good language and learning skills,” added Dr Mohan.

Government programmes

Interestingly, two programmes under the Ministry of Health and Family Welfare — the Rashtriya Bal Swasthya Karyakram (RBSK) and one by NPPCD itself — do not include hearing screening for newborns.

Experts have demanded that these flagship government programmes must include hearing screening for newborns.

The Mysuru-based All India Institute of Speech and Hearing ( AIISH), a pioneering and autonomous organisation fully funded by the Ministry of Health and Family Welfare, on 24 February conducted a workshop with various stakeholders — including advisors of RBSK and NPPCD, and the vice president of the Federation of Obstetric and Gynaecological Societies of India (FOGSI) — to plan strategies to implement newborn screening for hearing.

“The average age of hearing loss identification in India is two to four years. Unfortunately, we can never get the child to his full potential when we start treatment after those years. If treated within six months, the child’s ability to hear would be the same as any other normal child,” a senior doctor told South First, stressing the reason why experts are pushing for screening of newborns.

Also Read: K’taka traffic cops have their noses, ears examined. Here’s why

Hire more audiologists!

Representative pic of audiologist checking a girl's year. In Karnataka the checks are usually delayed and hence identification of hearing loss too gets delayed.

Representative pic of audiologist checking a patient. Identification of hearing loss to get delayed. (Wikimedia Commons)

While the delay in identifying the problem is a major concern, another worry is that there are simply not enough audiologists in the country to do the screening programmes.

Which is not surprising in itself. For instance, there are no positions for audiologists in government hospitals!

“If the government can have an audiologist position in every hospital, then automatic screening for newborns for hearing will definitely happen,” said a doctor.

Meanwhile, the doctor says there are very few trained ENT surgeons who can perform cochlear implant surgery.

115 surgeries under cochlear implant scheme

Karnataka’s cochlear implant scheme was introduced to address severe hearing loss in children under six years of age. Under this initiative, 115 children have been operated on in the last year and the remaining 577 beneficiaries are in various stages of preparation for cochlear surgery.

In a statement to the media, Karnataka Health Minister Dr K Sudhakar, said the theme of this year’s World Hearing Day is: “Ear and Hearing care for all, let’s make it a reality.”

However, doctors South First spoke to were worried over the slow pace of cochlear implant surgeries. The Karnataka government, in the 2022-23 budget, had allocated ₹32 core to provide cochlear implants to 500 congenitally deaf children. So far only 115 have been done.

It is unfortunate that due to various procedural issues like tenders etc, several potential beneficiaries are waiting. The implants can be done at 24 empanelled private and government hospitals. The delay is not just from the government’s side, but also from parents who postpone the operation.

“Timing is everything. Babies will have the best chance for normal language development if any hearing loss is discovered and treated by the age of six months. The earlier the better,” explains Dr Mohan.