(A107) Breaking the Silence: A Systematic Review on the Global State of Newborn Hearing Screening Policies

Introduction: Congenital hearing loss affects 0.1–0.3% of newborns and 2–4% of those admitted to neonatal intensive care units. Early detection of hearing loss is vital for optimal language development and learning outcomes. Many nations lack formal policies for newborn and infant hearing screening (NIHS), posing significant challenges to ensuring early identification and intervention. This systematic review evaluates the existence of NIHS policies, their impact on program implementation, and barriers to policy enactment and program execution.

Methods: Following PRISMA guidelines, this systematic review included studies published between 2014-2024. Comprehensive searches were conducted in PubMed, Embase, Scopus, CINAHL, and Google Scholar. Studies addressing NIHS policy existence, implementation outcomes, and barriers were included. Six reviewers (A.F., M.Z., N.P., J.B., E.P., O.S.) established inter-rater reliability for all included studies. Data extraction focused on policy frameworks, screening coverage, and insights into challenges.

Results: We assessed 578 studies in our review. Preliminary findings identified significant disparities in the presence and implementation of NIHS policies. High-income countries, including China and Italy, demonstrated higher policy coverage and implementation rates, often linked to legislative support and funding. In contrast, low- and middle-income countries, such as the Philippines, faced substantial obstacles, including limited resources and lack of trained personnel. Some shared challenges include insufficient public awareness and lack of access to screening facilities.

Conclusions: The existence of NIHS policies is crucial to the feasibility and sustainability of hearing screening programs. However, significant gaps remain, particularly in LMICs, where systemic and contextual challenges hinder policy enactment and program execution. Addressing these barriers requires coordinated efforts involving policy advocacy, capacity building, and sustainable funding models to improve early hearing loss detection and intervention globally.