An exploratory study of nurses' knowledge, skill, and training requirements for newborn hearing screening in a public-sector program in South India
Santhana Keerthi S 1, B-C,E-F
Vidya Ramkumar 1, A,C-F
Shuba Kumar 2, A,C-E
More details
Hide details
Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research, India
District Differently Abled Welfare Office, State Resource Cum Training Centre, India
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Submission date: 2022-07-21
Final revision date: 2023-03-12
Acceptance date: 2023-03-15
Online publication date: 2023-04-28
Publication date: 2023-04-28
Corresponding author
Vidya Ramkumar   

Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research, Porur, 600116, Chennai, India
J Hear Sci 2023;13(1):35-42
A pilot newborn hearing screening (NHS) program was established at 11 Corporation Maternity Hospitals in Chennai, a city in South India, to aid in the early detection of hearing loss. Nurses were trained how to screen newborns using both otoacoustic emissions (OAEs) and automated auditory brainstem responses (AABRs). The purpose of this qualitative study was to explore nurses’ perceptions of the NHS program and the challenges they faced in implementing it.

Material and methods:
Semi-structured interviews were conducted with 11 nurses, one from each hospital, who performed NHS in Corporation Maternity Hospitals. Interviews were conducted using guides and probes developed and validated by experts.

Four general themes that covered the nurses’ responses were identified: their understanding of NHS and skills in its execution; gaps in their understanding of the NHS program, constraints faced in implementing the screening program, and additional needs for support.

Addressing gaps in training needs, providing full documentation, and overcoming poor adherence to NHS protocols would help the program grow. The lessons learnt are also transferable to programs conducted in similar low–middle income countries.

Ramkumar V. A review of neonatal hearing screening practices in India. J Hear Sci, 2017; 7(1): 9–15. https://doi.org/10.17430/90259....
Korver AMH, Konings S, Dekker FW, Beers M, Wever CC, Frijns JHM, et al. Newborn hearing screening vs later hearing screening and developmental outcomes in children with permanent childhood hearing impairment. JAMA, 2010; 04(15): 1701–8. https://doi.org/10.1001/jama.2....
Olusanya BO, Newton VE. Global burden of childhood hearing impairment and disease control priorities for developing countries. Lancet, 2007; 369(9569): 1314–7. https://doi.org/10.1016/S0140-....
Yoshinaga-Itano C. Universal newborn hearing screening programs and developmental outcomes. Audiol Med, 2003; 1(3): 199–206. https://doi.org/10.1080/165138....
Finitzo T, Grosse S. Quality monitoring for early hearing detection and intervention programs to optimize performance. Ment Retard Dev Disabil Res Rev, 2003; 9(2): 73–8. https://doi.org/10.1002/mrdd.1....
DiCicco-Bloom B, Crabtree BF. The qualitative research interview. Med Educ, 2006; 40(4): 314–21. https://doi.org/10.1111/j.1365....
Gill P, Stewart K, Treasure E, Chadwick B. Methods of data collection in qualitative research: interviews and focus groups. Br Dent J, 2008; 204: 291–95. https://doi.org/10.1038/bdj.20....
Shulman S, Besculides M, Saltzman A, Ireys H, White KR, Forsman I. Evaluation of the universal newborn hearing screening and intervention program. Pediatrics, 2010; 126 (Suppl 1): S19–S27. https://doi.org/10.1542/peds.2....
Khoza-Shangase K, Harbinson S. Evaluation of universal newborn hearing screening in South African primary care. Afr J Prim Health Care Fam Med, 2015; 7(1): 769. https://doi.org/10.4102/phcfm.....
Guest G, Bunce A, Johnson L. How many interviews are enough? Field Methods, 2006; 18(1). https://doi.org/10.1177/152582....
Clarke V, Braun V. Successful Qualitative Research: A Practical Guide For Beginners. Thousand Oaks: Sage; 2013.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care, 2007; 19(6): 349–57. https://doi.org/10.1093/intqhc....
Kanji A, Khoza-Shangase K, Moroe N. Newborn hearing screening protocols and their outcomes: a systematic review. Int J Pediatr Otorhinolaryngol, 2018; 115: 104–9. https://doi.org/10.1016/j.ijpo....
Sahoo KC, Dwivedi R, Athe R, Bhattacharya D, Rajsekhar K, Pati S. Stakeholders’ perspective for improved Universal Newborn Hearing Screening Uptake in Odisha, India. J Trop Pediatr, 2021; 67(3): fmaao62. https://doi.org/10.1093/tropej....
Paul AK. Centralized newborn hearing screening in Ernakulam, Kerala: experience over a decade. Indian Pediatr, 2016; 53(1): 15–7. https://doi.org/10.1007/s13312....
Gupta S, Sah S, Som T, Saksena M, Yadav CP, Sankar MJ, et al. Challenges of implementing universal newborn hearing screening at a tertiary care centre from India. Indian J Pediatr, 2015; 82(8): 688–93. https://doi.org/10.1007/s12098....
Vignesh SS, Jaya V, Sasireka BI, Sarathy K, Vanthana M. Prevalence and referral rates in neonatal hearing screening program using two step hearing screening protocol in Chennai: a prospective study. Int J Pediatr Otorhinolaryngol, 2015; 79: 1745–7. https://doi.org/10.1016/j.ijpo....
Cavalcanti HG, de Melo LPF, Buarque LFSFP, Guerra RO. Overview of newborn hearing screening programs in Brazilian maternity hospitals. Braz J Otorhinolaryngol, 2014; 80: 346–53. https://doi.org/10.1016/j.bjor....
Meier S, Narabayashi O, Probst R, Schmuziger N. Comparison of currently available devices designed for newborn hearing screening using automated auditory brainstem and/or otoacoustic emission measurements. Int J Pediatr Otorhinolaryngol, 2004; 68: 927–34. https://doi.org/10.1016/j.ijpo....
Augustine AM, Jana AK, Kuruvilla KA, et al. Neonatal hearing screening: experience from a tertiary care hospital in Southern India. Indian Pediatr, 2014; 51: 179–83. https://doi.org/10.1007/s13312....
De Ceulaer G, Daemers K, Van Driessche K, et al. Neonatal hearing screening with transient evoked otoacoustic emissions: a learning curve. Audiology, 1999; 38: 296–302. https://doi.org/10.3109/002060....
Mukari SZ, Tan KY, Abdullah A. A pilot project on hospitalbased universal newborn hearing screening: lessons learned. Int J Pediatr Otorhinolaryngol, 2006; 70: 843–51. https://doi.org/10.1016/j.ijpo....
Schmeltz LR, Fritzler J. EHDI information management. In: A Resource Guide for Early Hearing Detection and Intervention (eBook, Chapter 31). National Center for Hearing Assessment and Management, Utah State University, 2011. https://www.infanthearing.org/....
Dimitriou A, Perisanidis C, Chalkiadakis V, Marangoudakis P, Tzagkaroulakis A, Nikolopoulos TP. The universal newborn hearing screening program in a public hospital: the importance of the day of examination. Int J Pediatr Otorhinolaryngol, 2016; 91: 90–3. https://doi.org/10.1016/j.ijpo....
Olusanya BO, Swanepoel DW, Chapchap MJ, et al. Progress towards early detection services for infants with hearing loss in developing countries. BMC Health Serv Res 7, 2007; 14. https://doi.org/10.1186/1472-6....
Sarpomaa KK, Isaac O, Alexei DJ, Karikari OV. Challenges of screening and early detection of hearing impairment among children in some selected hospitals in Kumasi Metropolis. Saudi J Med Pharm Sci, 2017; 3: 1330–4. https://doi.org/10.21276/sjmps...
Journals System - logo
Scroll to top