The Effectiveness and Cost Analysis of a Pilot Newborn Hearing Screening Program at a Hospital in a Low- to Middle-Income Country.

Background: When a universal newborn hearing screening program is not feasible, particularly in the early stages of its establishment when it requires a great deal of effort and resources, a smaller scale in screening, such as a specific geographical subset or targeted group, is suggested rather than doing nothing. This study aims to pilot a newborn hearing screening program at a hospital in a low- to middle-income country and determine its effectiveness and costs in the context of a lack of qualified audiologists. Methods: All high-risk births at Hatyai Hospital were recruited for newborn hearing screening between January and December 2021. Newborns who failed 2 stages of transient evoked otoacoustic emissions screening were referred for diagnostic assessment and subsequent interventions. The program's effectiveness was assessed based on the standards of the American Academy of Pediatrics. All costs related to screening, diagnostic, and intervention stages were also evaluated. Results: Out of 883 newborns, 792 newborns were screened, resulting in a 95.1% screening coverage. The referral rate regarding the diagnostic stage was 3.9%. Also, 28.3% and 12.9% lost-to-follow-up rates were observed in the secondscreening and diagnostic assessment stages, respectively. Ten children were confirmed as having permanent hearing loss, with a prevalence of 1.3%. The total cost was US$13 611, and the cost (for the screening stage) per case screened was US$4. Conclusion: The program was considered effective with 2 out of 3 benchmarks achieved.