Deaf Child Worldwide, part of National Deaf Children’s Society
We’re the leading charity dedicated to creating a world without barriers for every deaf child.
TITLE: Cost-benefit analysis of a universal newborn hearing screening and early intervention programme in Indonesia.
DEFINITIONS
By deaf, we mean any level of hearing loss. This includes unilateral hearing loss.
By universal newborn hearing screening, in the context of our work in Indonesia, we mean screening at a coverage of 80% or more.
By early intervention, we mean social and medical support offered to deaf children under the age of 5 and their families, following identification of deafness.
By a cost-benefit analysis, we mean comparing costs and benefits in monetary terms from a society-wide perspective.
BACKGROUND
We know that early identification and intervention is key to ensuring good outcomes for deaf children, which has heavily influenced our Every Moment Counts strategy 20232028.
Through our international work, we believe we can bring about systemic change through global and national influencing, with a focus on universal newborn hearing screening and early intervention. At present, relatively few low- to middle-income countries (LMICs) have introduced newborn hearing screening on a significant scale, meaning that population coverage is zero or very low (Neumann et al., 2020).
Deaf Child Worldwide is considering a 30-month programme in Indonesia’s East Java province to develop an evidence-based universal hearing screening programme for the early identification of hearing loss in children 0-5 years old.
In Indonesia, including East Java, hearing screening is currently embedded within routine maternal and child health services (SDIDTK) at primary care level, relying largely on developmental screening and subjective assessment rather than universal, objective newborn hearing screening. Where relevant and where such information is required, East Java will serve as a pilot context, given its large and diverse population, mixed urban–rural puskesmas and referral hospital settings, and relatively mature health system infrastructure, with programme and administrative data availability is expected to be stronger than in many other provinces, models to national level.
A sub-objective of our programme design would be a cost-benefit analysis of an early identification system in Indonesia at both the East Java and national levels. Nationallevel estimates are expected to be indicative and illustrative, reflecting assumptions required for scale-up beyond the East Java context.
Robust economic data would support evidence-based decisions about funding and implementing an early hearing screening and intervention programme in Indonesia, as well as in other LMICs considering introducing universal early hearing screening and intervention programmes.
THE TASKS AND OBJECTIVES
We seek to commission a cost-benefit analysis of a universal early hearing identification system in Indonesia. The aim of this project is to generate evidence demonstrating the savings to the public purse and benefits to the measured economy if Indonesia invests in early hearing screening and intervention. In addition to stakeholders in Indonesia, we also plan to share these insights to other countries and key international stakeholders.
As a charity that prizes financial diligence, Deaf Child Worldwide is leveraging a full and open procurement to ensure we are using charitable resources effectively. We are open to proposals from anyone, including professionals and consultancy services or from partnerships. We also welcome collaborative approaches.
Specific factors that we’d ideally like the project to consider (but are not limited to):
- Cost-benefit analysis to inform the Government of Indonesia’s consideration of covering early screening and intervention under its national health insurance – specifically, savings and economic benefits that would be realised by universal newborn hearing screening and early intervention.
- Applicants should clearly state and justify the analytical time horizon adopted, recognising that the costs and benefits of early-life interventions accrue over different time periods. Also, where costs and benefits occur over time, proposals should indicate how future values are treated in the analysis.
- Costing of the early identification and intervention model (calculating direct and indirect costs for implementation), to help the government of Indonesia to determine the feasibility of scaling the East Java model nationally. For example:
- Calculation of costs for service provision to remote locations, to include telehealth costs.
- Calculation of costs of screening by training health workers at primary level.
- Trade-offs between 1) increased costs associated with higher referral rates (i.e., costs associated with diagnostics) and doing only a one-stage OAE screening process, and 2) the additional cost of AABR equipment and implementing a two-stage screening protocol.
- Cost implications of screening within the birth setting (for example, hospitals or local healthcare settings before discharge), or at an outpatient clinic.
- Applicants should make clear which major categories of societal costs and benefits are included, in line with the study objectives and data availability, with assumptions explained transparently. The results may be presented using standard cost–benefit metrics such as net benefits, benefit–cost ratios, or return on investment, as appropriate for policy audiences.
- Other possible research objectives.
A critical aspect of this project will be working closely alongside our Indonesian partners. As such, a successful proposal will demonstrate how you will work alongside our partners to incorporate their perspectives and build on insight already collected.
THE SELECTION PROCESS
An internal panel at the National Deaf Children’s Society will review the tenders based on the below selection criteria. The highest-scoring applicant(s) will be asked to participate in a short interview and submit references.
For detailed information, please check the complete version of the advert attached below.