Perception and acceptance of Universal Neonatal Hearing Screening among pregnant women attending a Nigerian Teaching Hospital

Keywords: Early Intervention, Hearing Impairment, Neonatal Hearing Screening, Pregnant women


Background: Nigeria reportedly has one of the highest incidences of congenital hearing loss and the Universal Neonatal Hearing Screening (UNHS) offers a potential for early detection and intervention.

Objectives: To determine the awareness and acceptability of newborn hearing screening among the antenatal clinic attendees of a Nigerian Teaching Hospital.

Methods: This study was a cross-sectional survey among the pregnant women attending the antenatal clinic. Data were obtained using semi-structured interviewer-administered questionnaire

Results: A total of 114 women aged 18 and 45 years participated in the survey; 51/114 (44.7%) were aware of hearing screening with most of them 39/51 (76.5%) having health workers as their first source of knowledge. A high acceptance rate was obtained among 97/114 (85.1%), and this was notably independent (p = 0.399) of awareness; 14/114 (12.2%) rejected UNHS and the commonest reason for rejection was lack of enough information among 10/14 (71.4%) on the existence and use of UNHS. Health care workers were the commonest source of information [39/51(76.5%)]. A majority [51/58 (87.9%)] thought that the best time to initiate treatment is early in life, before speech development, only 4/114 (3.5%) had relatives who had ever undergone UNHS and all were done abroad.

Conclusions: Less than half of the participants attending ANC were aware of hearing screening and acceptance was high despite this low awareness rate. Parental awareness appeared to depend on contact with healthcare workers. Community education may increase awareness and demand for UNHS.


1. Moeller MP. Early intervention and language development in children who are deaf and hard of hearing. Pediatrics 2000; 106(3):1–9.

2. Yoshinaga-Itano C. Levels of evidence: Universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI). J Commun Disord 2004; 37:451–65.

3. Olusanya BO, Ruben RJ, Parving A. Reducing the burden of communication disorders in the developing world: An opportunity for the millennium development project. JAMA 2006; 296: 441–4.

4. Mehl A, Thomson V. Newborn hearing screening: The great omission. Pediatrics 1998; 101(1):1–6.

5. Olusanya BO, Newton VE. Global burden of childhood hearing impairment and disease control priorities for developing countries. Lancet 2007; 369: 1314–7.

6. Olusanya BO, Ruben RJ, Parving A. Reducing the burden of communication disorders in the developing world: An opportunity for the millennium development project. JAMA 2006; 296: 441–4.

7. Bieber FR, Nance WE. Hereditary hearing loss. In: Jackson LG, Schimke RN, eds. Clinical Genetics: A sourcebook for physicians. New York: Wiley; 1978:443–9.

8. Arnos Kathleen. Ethical and social implications of genetic testing for communication disorders. J Commun Disord 2008; 41: 444–57.

9. Bluestone CD. Clinical course, complications and sequelae of acute otitis media. Pediatr Infect Dis J 2000; 19: S37–S46

10. Williams AL, van Drongelen WV, Lasky RE. Noise in contemporary neonatal intensive care. J Acoust Soc Am. 2007; 121 (5Pt1): 2681-90.

11. Peixoto PV, Balbino FS, Chimirri V, Pinheiro EM, Kakehashi TY. Internal noise levels in neonatal intensive care unit incubators. Acta Paul Enferm 2011; 24(3): 359-64.

12. Engelman D. "The Status of Neonatal Hearing Screening in Sub-Saharan Africa: A Systematic Review" (2014). CUNY Academic Works. ( Accessed on 19/10/2017.

13. Ogunkeyede SA, Adebola SO, Salman A, Lasisi AO. Childhood hearing loss; a need for primary health care. Int J Pediatr Otorhinolaryngol 2017; 94: 117-120.

14. Williams TR, Alam S, Gaffney M. Centers for Disease Control and Prevention (CDC). Progress in identifying infants with hearing loss-United states, 2006-2012. MMWR Morb Mortal Wkly Rep.2015. 10.64 (13):351-6.

15. Swanepoel D, Louw B, Hugo R. A novel service delivery model for infant hearing screening in South Africa. Int J Audiol.2007; 46(6): 321–7.

16. Kish L. Survey Sampling. New York: John Wiley and Sons. Inc. 1965.

17. Botelho FA, Bouzada MC, de Resende LM, SilvaCF, Oliveira EA. Prevalence of hearing impairment in children at risk. Braz J Otorhinolaryngol 2010; 76(6): 739-44.

18. Federal Republic of Nigeria. National Policy on Education. 4th Edition. 2004. NERDC Publishers.

19. International Standard Classification of Occupations.ISCO-08/International Labour Office. Geneva, ILO, 2012 (>publication>wcms 172572). Accessed on 15th June 2018.

20. Okhakhu AL, Ntaji MI, Onyeagwara NC, Olusanya BO. Universal Neonatal Hearing Screening: Awareness and Attitude of Mothers Attending the Ante Natal Clinic in a Tertiary Health Facility in Benin City, Nigeria. Ann Biomed Sci 2014; 13(1): 61-7.

21. Govender SM, Khan NB.Knowledge and Cultural Beliefs of Mothers Regarding the Risk Factors of Infant Hearing Loss and Awareness of Audiology Services. J Public Health Afr. 2017; 8(1): 557.

22. Pynnonen MA, Handelsman JA, King EF, Singer DC, Davis MM, Lesperance MM. Parent perception of Newborn Screening: Result of a US National Survey. JAMA Otolaryngol Head Neck Surg 2016; 142(6): 538-43.

23. Fulcher A, Purcell A, Baker E, Munro N. Listen up: children with early-identified hearing loss achieve age-appropriate speech/language outcomes by 3 years-of-age. Int J Pediatr Otorhinolaryngol 2012 76(12): 1785-94.

24. NIH, Early identification of hearing impairment in infants and young children. NIH Consensus statement. 1993; 11(1): 1-24.

25. Kaspar A, Newton O, Kei J, Driscoll C, Swanepoel DW, Goulios H. Parental knowledge and attitudes to childhood hearing loss and hearing services in the Solomon Islands. Int J Pediatr Otorhinolaryngol 2017; 103: 87-92.
Original Research