Austria
Germany
- Population (2012 est): 81,305,856
- Percent of Annual Births (2012 est): 677,300
- Birth rate: 8.33 per 1,000
- Percent of GDP spent on health care (2009): 10.5%
- Percent of Health Care expenditures spent by government: 74.6%
- Physician density: 3.531 per 1,000
- Percent of newborns attended by skilled providers: 100%
- Infant Mortality: 3.51 per 1,000
- Literacy (age 15 and over can read and write): 99%
- 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)
In Germany, newborn hearing screening has been mandatory since 1 January 2009. Screening is designed to detect a permanent hearing loss of 35 dBHL or greater. The goal is to diagnose congenital hearing loss before the end of the 3rd month of life and begin therapy before the end of the 6th month of life. Screening is performed binaurally as a TEOAE-AABR two-stage screening or as a one-stage AABR screening. For babies with a risk factor for hearing loss, AABR is required. All parents receive written information on newborn hearing screening, and those who do not want to have their baby screened must sign a form indicating that screening has been refused in the booklet which documents the child’s regular medical check-ups. For healthy babies, screening is recommended by the 3rd day of life and before discharge from the maternity ward (if the baby is born in a clinic), and must occur before the 10th day of life. For severely ill babies, screening should be done as soon as is practical considering the baby’s medical condition, and before the end of the 3rd month of life. For pre-term babies screening should occur by the calculated birth date.
Tracking of screening is done by documenting in the child’s booklet its first occurrence, the results, the occurrence of a second screening (if necessary), and the follow-up to final diagnosis and therapy. The home paediatrician is responsible for initiating any examinations that are lacking. However, the responsibility for the initiation, performance, documentation and quality assurance of the screening is clearly defined for hospitals and practices. Clinics have to provide annual hearing-screening reports, while nationwide evaluations of screening allow for the quality control of the overall newborn hearing screening programme.
In the German State of Hesse, a unique network exists where all 78 birth clinics involved in the newborn hearing screening programme send their data every day directly from the screening device via a telephone line to a central server in the screening centre. The data is then automatically fed into a database that indicates which babies failed the screening or did not receive a complete screen; creates reminder letters for the parents of babies who did not show up for a follow-up; and produces various reports and statistics. These reports include the proportion of invalid measurements to valid measurements, calibration errors, and the quality of the measurements made by the screening personnel. Based on data for 150 000 babies, median age at diagnosis of congenital hearing loss has decreased to 3.7 months, with a median age of 5.8 months at initiation of therapy.
Publications about EHDI Programs in Germany (maximum of 5)
- 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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