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UNHS_Nepal_Advanced_Teaching_Policy.pptx
- 1. Universal Newborn Hearing Screening(UNHS) • Clinical • Policy • Teaching Perspective • Context: Nepal
- 2. Nepal-Specific Clinical Vignette •A term baby born in a district hospital in Karnali Province passes routine newborn checks. • No hearing screening done. • At 3 years, child presents with absent speech. • Diagnosis: Bilateral severe sensorineural hearing loss.
- 3. Vignette: If UNHSHad Been Available • OAE screening at birth → REFER • ABR confirmation by 1 month • Hearing aids by 3–4 months • Speech outcomes near normal by school age
- 4. Exam-Oriented: Definition • UniversalNewborn Hearing Screening: • Systematic screening of all newborns for hearing loss before 1 month of age.
- 5. Exam-Oriented: Screening Tools •OAE: • • Screens cochlear (outer hair cell) function • • Fast, inexpensive • AABR: • • Assesses auditory pathway to brainstem • • Detects auditory neuropathy
- 6. Exam-Oriented: JCIH 1–3–6Rule • Screen by 1 month • Diagnosis by 3 months • Intervention by 6 months
- 7. Exam-Oriented: Why Universal, NotRisk-Based • Up to 50% of congenital hearing loss has no identifiable risk factors.
- 8. WHO Perspective • WHOrecognises hearing loss as a major global health issue. • Early identification and intervention are key strategies to reduce disability.
- 9. JCIH Recommendations • UNHSfor all newborns. • Use physiologic screening methods (OAE/AABR). • Ensure tracking, follow-up, and early intervention.
- 10. Evidence from TheLancet • Early detection of hearing loss improves language, educational, and social outcomes. • Delays increase lifelong disability burden.
- 11. Nepal: Why UNHSMatters • High birth rate • Geographic barriers • Limited access to rehabilitation • Early screening prevents lifelong inequity
- 12. References • 1. WHO.World Report on Hearing, 2021. • 2. Joint Committee on Infant Hearing. Position Statement, 2019. • 3. The Lancet Commission on Hearing Loss, 2017 & 2021.
- 13. Take-Home Messages • UNHSis evidence-based and feasible. • Early detection changes lives. • Nepal can implement UNHS stepwise.
- 14. Questions & Discussion •Thank you
Editor's Notes
- #2 Explain missed early window. Contrast with outcome if UNHS and early intervention were available.
- #3 Emphasise time-sensitive neuroplasticity and equity implications.
- #4 Key exam phrase: universal, systematic, before 1 month.
- #5 Frequently asked in ENT and audiology exams.
- #6 High-yield postgraduate exam content.
- #7 Common viva question justification.
- #8 Aligns UNHS with Sustainable Development Goals and disability prevention.
- #9 Reference: Joint Committee on Infant Hearing Position Statement.
- #10 Lancet Commission on Hearing Loss.
- #11 Tie back to vignette and national responsibility.
- #12 These references are acceptable for academic, policy, and exam use.
- #13 End with integrated message for all audiences.