Although newborn babies in rich countries routinely have their hearing tested, the major global health agencies, such as the World Bank and Unicef, have not prioritized funding for newborn hearing tests in poor countries, writes Dr Bolajoko Olusanya (University of Lagos, Nigeria and University College London, UK) in PLoS Medicine.
"The number of children worldwide with hearing impairment is increasing," says Dr Olusanya, "and these children face a number of obstacles and burdens, given that spoken language is the predominant medium of communication and social interaction." Failure to detect hearing impairment and effectively manage it within the first year of life is linked with significant and irreversible deficits in speech and in linguistic, cognitive, and educational development, says the author.
In her policy paper, Dr Olusanya calls for the creation of new public-private partnerships to increase funding for neonatal hearing tests in developing countries. The inability of governments to cater for diverse health needs with limited budgets, she says, has led to a growing trend towards local public/private partnerships for health-care delivery in low- and middle-income countries, especially for the most vulnerable populations. Studies of pilot programs in countries such as Nigeria, South Africa, Malaysia, Brazil, and Poland have shown the effectiveness of different models of health care service delivery through public/private partnerships.
"However, the sustainability of these initiatives may be undermined by the continued lack of public sector support and the overwhelming preoccupation with fatal diseases by major actors in global health," says the author. "Since infant hearing screening is now routinely provided in developed countries, failure to extend such a program to developing countries where about 90% of children with permanent hearing impairment live will only exacerbate health inequalities between the rich and poor nations of the world."