Questions/Answers
Question 1
Veuillez décrire brièvement l’initiative, le problème ou défi qu’elle cherche à résoudre, et spécifiez ses objectifs. (300 mots maximum)
Early detection and effective intervention are the best practical strategy to develop speech and language competences of the newborn with hearing loss problem. The incidence of newborn with hearing loss is about 1-3 per 1000 newborn worldwide and this incidence is even rising in the newborn with high risk factors such as birth asphyxia, hyperbilirubinemia and perinatal infection. Annually, Rajavithi hospital reports of 3,800-4,000 newborns. The newborn hearing screening project was initiated in 2010 with the coverage rate of 100% of the newborns in Rajavithi Hospital. The project was thereafter continuous and developed continuously. In 2019, double protocol of newborn hearing screening program was introduced in Rajavithi hospital, in which the otoacoustic emission (conventional) and automated auditory brainstem response (AABR) techniques were applied. The accuracy rate and cost-effectiveness were thorough studied. Thereafter, the model of early screening and early intervention of the newborn with hearing loss problem of Rajavithi hospital has been implemented through government hospitals nationwide. Presently, the small project of Rajavithi hospital is turned to be a national service plan, which is conducted the Ministry of public health of Thailand. The objective of the service plan is to include not less than 95% of the newborn in Thailand in hearing loss screening and intervention program.
Question 2
Veuillez expliquer en quoi l’initiative est corrélée à la catégorie sélectionnée. (100 mots maximum)
By improving the process management of newborn hearing screening and intervention. The result impact of more accuracy and more cost-effectiveness. The system of newborn hearing screening operate by in-patient nurse with double protocol hearing screening technique combine with the service of ENT department of Rajavithi hospital. The department is consisted of otolaryngologist, audiologist, ENT-nurse and speech therapist. Intervention and habilitation program includes hearing aid usage and cochlear implantation to provide all sustainable service and quality.
Question 3
a. Veuillez spécifier quels sont les ODD et les cibles que l’initiative soutient, et décrivez concrètement comment l’initiative a contribué à leur mise en œuvre. (200 mots maximum)
SDG 3: Good health and well-being by early detection and early intervention of newborn with hearing loss problem will improve quality of life of the affected child. They can use auditory–verbal communication instead of sign language.
SDG 10: By the program of universal hearing screening and intervention which is conducted by the Ministry of public health and other related foundation and organization, all the newborns will access to the service of early detection equally without any socio-economic boundary.
b. Veuillez décrire ce qui rend l’initiative durable en terme social et environnemental. (100 mots maximum)
Question 4
a. Veuillez expliquer comment l’initiative répond à un déficit important en termes de gouvernance, d’administration publique ou de service public dans le contexte d’un pays ou d’une région donnés. (200 mots maximum)
The policy advocacy from universal hearing screening and intervention project of Rajavithi hospital has been implemented in to the national service plan and gradually extended to the provincial hospitals of Thailand. Every newborn with hearing loss problem will have right to receive the service without asking.
b. Veuillez expliquer comment votre initiative aborde l’inégalité des genres dans le contexte du pays en question. (100 mots maximum)
None
c. Veuillez décrire le(s) groupe(s) ciblé(s), et expliquez comment l’initiative a amélioré leur situation. (200 mots maximum)
(Quantity)
Hearing loss screening of the newborn: 2016-2018 = 11,237 cases
Cochlear transplantation and speech habilitation: 2016-2018 = 29 cases
(Quality)
About 70 % of the enrolled patient have gained the CAP score of more than 5 within 2 years.
(Output)
The percentage of hearing loss newborn with habilitation that attend regular school.
2016-2018 = 79%
(Impact)
Decrease burden of sign language communication people in Thai population and decrease number of children of deafness in sign language special school 2016 = 3,443 cases, 2017 = 3,252 cases, 2018 = 3,061 cases respectively.
Question 5
a. Veuillez décrire comment l’initiative a été mise en œuvre en incluant les développements et les étapes clés, les activités de suivi et d’évaluation, ainsi que la chronologie. (300 mots)
A: The implementation is conducted through the ministry of public health mechanism. National service plan is responsible by otolaryngologist in each public health region. National clinical practice guideline for newborn hearing screening program was determined by the collaboration of otolaryngologists. The national service plan committee was established to implement the program to the provincial hospitals in every health region all over the country.
b. Veuillez expliquer clairement les obstacles rencontrés et comment ils ont été surpassés. (100 mots)
B: In Thailand, about 300,000 out of 600,000 newborns are given birth in non-government hospital. Our next step plan is to initiate a co-creation with private and other non-government hospitals and implement the same program nationwide.
Question 6
a. Veuillez expliquer en quoi l’initiative est innovatrice dans le contexte de votre pays ou région. (100 mots maximum)
For the sustainable and effective newborn hearing screening program, Rajavithi hospital introduced the model of hearing-loss screening by in-patient nurse. Nurses of obstetrics and newborn ward were trained. Every newborn is screened within 48 hours, the screening process will be performed at ward by the nurse instead of waiting for any specialist. This can improve the coverage and cost-effectiveness when compare with other hospitals.
b. Veuillez décrire, si cela est pertinent, comment l’initiative s’est inspirée d’une autre initiative fructueuse dans d’autres régions, pays ou localités (100 mots maximum)
This newborn hearing screening and intervention program has been delivered to the national service plan which conduct by the ministry of public health. The program is expanding throughout the country as "Universal Newborn Hearing Screening".
c. Si des technologies émergentes et de pointe ont été utilisées, veuillez indiquer comment elles ont été intégrées à l’initiative et / ou comment l’initiative a adopté le gouvernement numérique. (100 mots maximum)
All database from the screening program will be collected as the national data platform. These data will be integrated into the digital government.
Question 7
a. A votre connaissance, l’initiative a-t-elle été transposée et/ou adaptée à d’autres contextes (par ex. d’autres villes, pays ou régions) ? Si oui, veuillez expliquer où et comment. (200 mots maximum)
The model of universal hearing screening was firstly implemented for system test at Inburi general hospital (Singburi province), Chaiyapoom general hospital (Chaiyaphoom province), and Bangsapan hospital (Prajuabkirikan province). The double protocol of newborn hearing screening were adapted and fine-tuned according to limitation of each test site.
b. Si l’initiative n’a pas été transposée/adaptée à d’autres contextes, veuillez décrire le potentiel de sa transférabilité. (200 mots maximum)
No
Question 8
a. Quelles ressources (financières, humaines ou autres) ont-elles été utilisées pour mettre en œuvre l’initiative ? (100 mots maximum)
Most expenses are supported by the national health security office. Special nurse training course taken place at Rajavithi hospital with the financial support by the hospital foundation. Sixty nurses are trained annually. Audiologists will be increasingly trained annually by the co-operation with the speech- rehabilitation association and the medical schools.
b. Veuillez expliquer ce qui rend l’initiative durable dans le temps, en termes financiers et institutionnels. (100 mots maximum)
The Newborn Hearing loss: Screening and habilitation program had been launched as a policy. All the expenses will be able to reimburse from the national health security office.
Question 9
a. L’initiative a-t-elle fait l’objet d’une évaluation formelle interne ou externe ?
Oui
b. Veuillez décrire comment elle a été évaluée et par qui. (100 mots maximum)
The internal process within Rajavithi hospital was accredited by the Healthcare Accreditation Institute (HAI) of Thailand on 5 May 2021. Disease specific certification was granted and valid until May 2024
The Key Performance Indicators are
• The coverage of newborn hearing screening >95%
• The positive screening rate <4%
• The positive cases receive intervention within 6 month >90%
The outcome of these indicators are all above standard.
c. Veuillez décrire les indicateurs et les outils utilisés. (100 mots maximum)
The screening and CAPS score after 2 years of treatment are used as the main indicators.
d. Quels étaient les conclusions principales de l’évaluation (par exemple l’adéquation des ressources mobilisées pour l’initiative, la qualité de la mise en œuvre et des défis auxquels vous avez été confrontés, les résultats principaux, la durabilité de l’initiative, les impacts) et comment cette information est utilisée pour mettre en place l’initiative. (200 mots)
The results after the Newborn Hearing loss: Screening and habilitation program are evaluated mainly with habilitation success rate.
Hearing loss newborn were detected and included into the program in 2018 - 2020: 8, 7 and 6 cases respectively. Cochlear implantation and speech habilitation were fully success in 6, 6 and 5 cases (2018-2020) ; while 2, 1 and 1 cases were rehabilitated with hearing aid equipment.
Question 10
Veuillez décrire comment l’initiative s’inscrit dans le paysage institutionnel adéquat (par exemple, comment elle se situe par rapport aux agences gouvernementales pertinentes, et comment les relations institutionnelles avec ces dernières ont été menées). (200 mots maximum)
The Royal college of otolaryngologists Thailand has established the guideline and implemented in the institute for otolaryngology training. Policy and knowledge management in provincial hospital are monitored and supported by the medical school network. Audiologist training program in medical schools for increasing the audiologists who are the key persons in diagnosis and hearing aid fitting is in progression.
Question 11
L’agenda 2030 pour le développement durable met l’accent sur la collaboration, l’engagement, les partenariats et l’inclusion. Veuillez décrire quels acteurs ont été engagés dans la conception, la mise en œuvre et l’évaluation de l’initiative et comment cet engagement a eu lieu. (200 mots maximum)
The otolaryngologist and healthcare team in each health provincial regions are the main stakeholder of the key success. Process implementation, data collection, problem management and network connection are controlled by the ministry of public health. The national service plan committee are composed of otolaryngologist from health provincial regions are established.
Question 12
Veuillez décrire les leçons clés apportées par cette expérience, et comment votre organisation prévoit d’améliorer l’initiative. (200 mots maximum).
The data collection and analysis about newborn hearing screening is not synchronized in every health provincial region. Each region uses their own tool and method. Single health data system has to be developed. Data collection sheet and platform used by each region have to be studied and concerned.