Conference on the Neonatal Hearing Screening Porogram In Albania

Neonatal hearing screening is now a part of the routine testing in the maternity hospitals of Tirana since March 2006.  The main objective of this program is the early detection and intervention of the neonates with hearing problems. This will reduce in a considerable way the financial and social cost of hearing handicap and will as well enable an inclusive education for these children.

The data and the progress of the program have been reported in different papers published in the national and international journals. Also TV programs were arranged in order to reinforce the information given to the parents.

At the moment the program is facing a new development stage, aiming to extend with trained personnel and devices; to deliver a better information to the parents; to reduce the percentage of the ‘case leakage’ and to stress more the intervention strategies.
The first conference on the neonatal hearing screening program took place on Saturday, Dec the 8th, at Tirana International Hotel.

           
The backgrounds and representation of the participants were various.  The guest speakers were Prof. Stavros Hatzopoulos, University of Ferrara, Italy and Dr. Marzanna Konopka, Child’ Memorial Institute, Poland.  The head of the ENT clinic, TUHC (prof. Dr. P Radovani), Neonatalogy clinic, TUHC (Dr. Eduart Tushe) and the head of the National Centre of the Child Growth and Development (Migena Bedeni) were also present.  The other of participants were ENT specialists and residents, neonatologists, paediatricians and residents, specialists from the secondary health care, and the national centre of child development, MAGIS. This was an indicator of the interest for the workshop.
           
Overall objectives of the conference

1. The presentation of the status of the project
2. Discussion of the epidemiologic data in the Albanian population, the necessity of such and program and the support and encouragement needed for the parents
3. Identification of the specific role of each institutional partner in the second phase of the project
4. Introduction of successful similar practices and of the advances in the area of screening and intervention.
5. Sensibilisation of the decision making institutions for a national based program
6. Discussion of the issues of the intervention in the paediatric age
7. Setting new objectives for the future of the program

The main issues discussed in the workshop were the actual situation of the children with hearing loss in Albania, the lack of regulations and legislations in our country etc, the demographic data on the birth rate, morbidity and mortality rate in the maternities of Tirana, the risk factors and their distribution in our population, the transition from the pilot stage to the actual program; the analysis of the data from the pilot stage and the problems encountered. A special emphasis was placed the way these problems were faced by the program and, later on the day, the latter topic was completed by a further analyses of the data until recently, expectations and future recommendations.

Prof Hatzopoulos, from Italy, made two presentations. One was a briefing on successful screening programs in our area, what we can learn and how we can adopt solutions. The other was about the advances in the area of screening and intervention, new testing methods and devices, their use and limitations.  The topic was very interesting and raised several discussions and questions in the room, among which an extended debate regarding the database, its tracing possibilities and the necessity of a national database point for merging the data from different studies. 

Dr. Marzanna Konopka, from Poland, apart from an introduction of the program in Poland, which is the first European country which adapted an universal hearing screening program (now screened thousands of babies each year) made an comprehensive speech on the issues of fitting in the paediatric age, the difficulties, challenges, strategies and results.  This presentation was also very interesting, especially for the ENTs. 

The activity of the National Centre of the Child Development and Growth, the target population, the training sections they have done all around the country, the results, was presented by the director of the centre.  A different perspective of the program was also given by Dr. Kolici, from the maternity nr 2. She suggested different ways of how the staff of the maternities can support and motivate the parents to follow up the babies.  Several ideas were proposed in this point by the neonatologiests, like delivery of the leaflet of the program to all the mothers independently from the test, the increase of the number of the posters in the inside of the maternity hospitals.
           

Conclusions and comments

In general the workshop was considered very successful.  The head of NICU units defined the program as; ‘the only screening program functional in Albania and a very good model for other similar programs’. 

The participation of specialists of different areas gave the opportunity to discuss the topic from different points of view and suggested several ways to improve the quality of the services offered up to now.

The workshop came to the conclusion that the NICU coverage is good, though variable from month to month, while well babies are covered only partially. This raise the issue of the increase of the number of the staff and devices used for the screening program.  Also, the option of completing the second TE test on the maternity hospitals, when babies come for a check up or a routine control with the neonatologiests, will probably reduce the percentage of the ‘case leakage’.
           
            Recommendations

The workshop recommended:

1. the preparation, for the Ministry of Health, of a recommendation paper, where the conclusions and the future objectives of the program are clearly stated. The paper will recommend the necessity for the involvement of the governmental structures and the social benefits of such a program.  The paper is actually under preparation. 

1. the broadening of the program at the primary health care structure, in order to cover well babies, which will increase in a considerable way the sensitivity of the screening issues.

1. pressurising the  governmental structure for changing the low regarding the hearing aids, which will in turn facilitate the intervention and habilitation process of the babies diagnosed with hearing loss and their involvement in the future social life.