# Progress of the Egyptian National Newborn Hearing Screening (ENHS) Program over a Four-Year Period

## TL;DR

This paper tracks the progress of Egypt's newborn hearing screening program over four years, showing improvements in coverage and follow-up rates.

## Contribution

The study provides a detailed evaluation of the Egyptian National Newborn Hearing Screening program's performance and growth over time.

## Key findings

- The coverage rate increased from 39% in 2019 to 82% in 2023.
- The follow-up rate of attendance for a second screening improved from 75.5% to 92.1%.
- The rate of attendance for diagnostic assessment rose from 20% in 2020 to over 65% in 2023.

## Abstract

Universal newborn hearing screening (UNHS) has become widely adopted worldwide as a standard of care for the early detection of congenital hearing loss. The Egyptian UNHS program started as a presidential initiative by the Ministry of Health in November 2019. The program was initiated in 1346 primary health care units (PHCUs) located throughout the 26 governorates. A retrospective study was conducted to assess the performance of the Egyptian Program during the period from November 2019 to July 2023. Quality measures recommended by the Joint Committee on Infant Hearing including coverage rate, rate of referral to a second screening, follow up rate of attendance of second screening, referral for diagnosis rate, and follow up rate of attendance of diagnostic assessment, were analyzed. Over a period of 3 years and 9 months, more than five and half million infants underwent a first screening. The coverage rate was initially 39% and increased to reach 82% in 2023. The rate of referral to a second screen was 7.2% in 2019 and reached 5.2% in 2023. The follow-up rate of attendance of a second screening improved throughout the study period, from 75.5% to 92.1% but did not reach the benchmark of 95%. The rate of referrals for diagnosis was less than 1.7% and rate of attendance of a diagnostic assessment was initially 20% and improved to more than 65% in 2023. The very low rate of attendance of diagnostic assessment in 2020 and 2021 was attributed to the effects of the COVID pandemic.