Canada

Canada

• Percent of children screened for hearing loss:
• Incidence of permanent hearing loss among newborns:

Current Status of Early Hearing Detection and Intervention for Children (500 word limit)

Canada is a nation of 10 provinces and 3 territories with an estimated population of 33 million, and is ranked globally between 30th and 35th for medical care. About 70% of the cost of health care is covered by the government through an expenditure of about 16.7% of its revenue. There is considerable variation across provinces in the extent to which health care costs are covered once the required basics are provided. Nevertheless, all Canadians enjoy excellent-quality health care.

In 2006–07, there were 352 848 births recorded. Universal hearing screening of those children could not be “mandated” by the Canadian government because such screening is beyond the basic coverage mandated by the health care system, and each province must decide whether to fund newborn hearing screening as an additional service. Even so, the federal government has provided a directive that “Universal newborn hearing screening shall be offered”. Four provinces are in compliance with full coverage and two are nearing compliance. This means that over two thirds of the country has implemented an early detection of hearing impairment programme which includes screening all neonates by 1 month, diagnosis of hearing loss by 3 months, and intervention by 6 months. The various programmes essentially mirror the United States Joint Committee on Infant Hearing recommendations.

Reported problems have focused on:

• the need to provide screening coverage 7 days a week because some babies leave the hospital over the weekend;
• the placing of universal newborn hearing screening into an overall programme which includes screening for phenylketonuria, congenital hypothyroidism, etc.; and
• the need for central oversight at the provincial level as opposed to fragmented control by local hospitals and clinics.

Programme success depends on consistency of procedures; rigorous evidence-based protocols; diagnostic and intervention training; outcome measures; family-centred services; and a sufficient, stable and dependable budget.

In Canada, newborn hearing screening is a health issue but not a medically controlled service. Most hearing-impaired children require educational, audiological and counselling services, and medical treatment as needed. As a result of all the above considerations, it should be emphasized that successful early hearing detection and intervention is a team process.

Demographics

• Population (2012 est): 34,300,083
• Number of Annual Births (2012 est): 352,600
• Birth rate: 10.28 per 1,000
• Percent of GDP spent on health care (2009): 9.8%
• Percent of Health Care expenditures spent by government: 69.5%
• Physician density: 1.913 per 1,000
• Percent of newborns attended by skilled providers: 100%
• Infant Mortality: 4.85 per 1,000
• Literacy (age 15 and over can read and write): 99%

Publications about EHDI Programs in Canada (maximum of 5)

1. World Health Organization. 2010. Newborn and infant hearing screening- current issues and guiding principles for action. WHO Report 2010:1-39.

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