National Deaf Children’s Society invitation to tender for research
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TITLE
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Successes and challenges from implementing newborn hearing screening and early intervention in LMICs
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ABOUT
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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.
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DEFINITIONS
By deaf, we mean any level of hearing loss. This includes unilateral hearing loss.
By newborn hearing screening, we mean screening at a coverage of at least 50%, with progress shown to increase this to universal coverage at 85% or more.
By early intervention, we mean support offered to deaf children under the age of 5.
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. We seek to highlight the importance of combining both medical and social models of disability, where both identification of deafness and family intervention can lead to improved livelihoods for deaf children and their families. At present, relatively few LMICs have introduced newborn hearing screening on a significant scale, meaning that population coverage is zero or very low (Neumann et al., 2020).
From our research and experience, we know there are significant challenges involved in introducing newborn hearing screening in LMICs including (but not limited to):
- competing health priorities
- children not always being born in hospitals (and so missing out on hospitalbased newborn hearing screening)
- lack of infrastructure (including trained staff and screening equipment) and lack of funding
- lower referral follow-up rates (for example, because parents cannot travel to hospitals for formal identification or because of stigma around disability)
- limited understanding of deafness among decision-makers.
There are also significant opportunities. Successful pilots have emerged in a number of countries and, whilst not always reliable, the growing use of telehealth is also having a significant impact.
We already know from our work in the UK that newborn hearing screening is not in itself a silver bullet – it is important to make sure there is effective family-centred early intervention support in place. In many countries, there is a willingness to introduce newborn hearing screening but the early intervention pathway is not yet present or needs to be resourced or the approach is overly medicalised.
Our insight tells us that, despite the significant challenges, a number of low-and-middle income countries have already introduced universal newborn hearing screening and early intervention or have made significant progress in doing so. We want to learn more about their experiences in doing so.
THE TASK AND OBJECTIVES
We would like to commission research which helps us to better understand the experiences, successes and challenges that have come from developing and implementing a high coverage of newborn hearing screening and early intervention in low- and middle-income countries, or from those countries that have made significant progress in doing so.
As part of the task, you will need to identify and select 5-10 countries appropriate for further investigation, preferably with geographical variation.
A key focus is understanding the enabling and success factors that led to progress being made, actors involved in bringing about the screening and early intervention, the methods used, and any wider lessons learnt, particularly in terms of the outcomes and sustainability of the intervention or policy.
We hope to use these learnings to inform our own work at both national and global level, to increase the likelihood of success and be sensitive to contextual differences. We would also like to showcase these learnings to other countries and to key international stakeholders.
Specific research questions about the successes and challenges faced include:
- What was the landscape for ear and hearing care before implementing universal newborn hearing screening and early intervention?
- Who were the key stakeholders and what was their role?
- What were the key conditions that led to success or progress? What were the strategies deployed (for example, any campaigning work or implementation work)?
- If any, what are the issues and challenges faced when developing, campaigning for and implementing NBHS and early intervention? How were these overcome?
- What does the programme look like now?
- What wider lessons can be taken from these countries’ experiences?
We are open to proposals from anyone, including professionals and services or from partnerships. We also welcome collaborative approaches.
THE SELECTION PROCESS
An internal panel at the National Deaf Children’s Society will review the tenders.
It is intended that a decision will be made primarily on the quality of the tenders received. However, we may carry out short interviews remotely if there are a high number of strong applicants.
For detailed information, please check the complete version of the advert attached below.