Early Hearing Detection and Intervention (EHDI) in Latin America

Latin America refers to the region of the Americas where Spanish and Portuguese are spoken primarily. This includes Mexico, most of Central (Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica, and Panama) and South America (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela), plus Cuba, the Dominican Republic, and Puerto Rico in the Caribbean.

To find a country’s Early Hearing Detection and Intervention summary click on that country on the following map.

Argentina

Population (mid-2008): 39.7 million (1)
Annual number of births (2007): 693,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000-07): 99% (2)
Gross national income (GNI) at purchasing power parity(PPP) per capita (US$) 2007: 12.990 (1)
Infant mortality rate: 13.3 per 1,000 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
Passed in 2001, this legislation stipulates that all newborns have the right to be screened for hearing loss and receive timely and appropriate treatment when needed. It also indicates that adequate diagnostic evaluation should be provided before an infant is 3 months of age. More information about this legislation can be found at http://msal.gov.ar/htm/site/hipoacusia/resolucion-ministerial.pdf.

EHDI Program Information:
Argentina has a formal group dedicated to promoting the early identification of and enrollment in intervention services for children with hearing loss. This group, which is referred to as Consenso Argentino de Detección Temprana de la Hipoacusia, COADITHI (Argentinean Consensus for Early Detection of Hearing Loss), was created in 2005 and assists with the implementation of EHDI legislation.

The following entities are members of COADITHI:
AFA—Asociación Fonoaudiológica Argentina
AFOCABA—Asociación Fonoaudiólogos de la Ciudad de Buenos Aires
ASALFA—Asociación Argentina de Logopedia, Foniatría y Audiología (http://www.asalfa.org.ar/)
ASARA—Asociación Argentina de Audiología (http://www.asara.org.ar/)
CEIDHI—Centro de Identificación de la Hipoacusia Infantil
FASO—Departamento de Fonoaudiología de la Federación Argentina de Sociedades de Otorrinolaringólogos (http://www.faso.org.ar/quienes_somos.asp)

EHDI Publications:
Neustadt de Kohan N, Cammareri B, Chevalier B. Programa de detección universal de audición en neonatos. Revista Fonoaudiológica [Internet]. 1998 [cited March 3, 2009]; 44(2): 6-13. Available from http://www.asalfa.org.ar/uploads/articulos/Articulo%2033.pdf

Other EHDI Resources:
Ministerio de Salud de la Provincia de Buenos Aires:
Information about infant hearing loss from the Ministry of Health (in Spanish) http://www.msal.gov.ar/index.php/component/content/article/48-temas-de-salud-de-la-a-a-la-z/380-hipoacusia
Sitio de Sordos: Website with information (e.g. news, events, networking) for deaf people in Argentina (in Spanish) http://www.sitiodesordos.com.ar/

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Bolivia

Population (mid-2008): 10.0 millions (1)
Annual number of births (2007): 263,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel (2000/7): 57% (2)
Gross national income (GNI) at purchasing power parity(PPP) per capita (US$) 2007: 4,140 (1)
Infant Mortality rate: 51 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.
EHDI Legislation:
No information is available.
EHDI Program Information:
No information is available.
EHDI Publications:
No information is available.
Other EHDI Resources:
No information is available.
References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Brazil

Population (mid-2008): 195.1 million (1)
Annual number of births (2007): 3,706,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 97% (2)
Gross national income (GNI) at purchasing power parity(PPP) per Capita (US$) 2007: 9,370 (1)
Infant Mortality rate: 24 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
Monica Chap Chap
monica.chapchap@gatanu.org

EHDI Legislation:
Several states around the country already have passed legislation to implement the Universal Newborn Hearing Screening in birthing facilities. However, many barriers are reported to be preventing the successful implementation of this legislation, such as inadequate funding for the necessary equipment and lack of sufficient trained personnel to staff newborn hearing screening (NHS) programs. It is likely that the adoption of NHS will be gradual and varied in different areas of the country. It might not be possible in the short term to use a uniform protocol across all states or regions. Some regions might adopt a universal screening policy, while others might need to begin by screening only those babies identified as being at high risk. Much depends on the availability of equipment and competent personnel, as well as the capacity to provide services to infants identified with hearing loss (3).

In São Paulo, Brazil’s largest city, NHS in all birthing hospitals has been required by law since 1998. Nonetheless, lack of government funding has made universal screening difficult to achieve (4).

EHDI Program Information:

Brazil has one of the largest and oldest newborn hearing screening programs in Latin America, with over 237 screening sites across 22 of the 27 Brazilian states (approximately 4% of Brazilian maternity hospitals) (5). The movement toward NHS began within some private hospitals, and in October 1998 a committee on infant hearing was created with representatives from the Brazilian Societies of Otolaryngology, Pediatrics, Speech Pathology/Audiology and other national organizations (Comite Brasileiro sobre Perdas Auditivas Na Infancia). In November 1999, the committee finalized the first consensus on NHS (6). Brazil also has a group, called Grupo de Apoio a Triagem Auditiva Neaonatal, GATANU, that has been directly involved with universal NHS for over 10 years. This group was formed by audiologists, pediatricians, and otolaryngologists who currently are running some of the NHS programs in Brazil. More information about this group can be found at http://www.gatanu.org/.

EHDI Publications:

Bevilacqua MC, Novaes BC, Morata TC. Audiology in Brazil. Int J Audiol. 2008 Feb; 47(2): 45-50. PubMed PMID:18236235

Pádua FG, Marone S, Bento RF, Carvallo RM, Durante AS, Soares JC, Barros JC, Leoni CR. Newborn hearing screening program: A challenge for its implantation. International Archives of Otorhinolaryngology. 2005 Jul; 9(3): 190-194.

Davoine S. Universal newborn hearing screening: A long way to go [Internet]. Audio Infos.2007 [cited 2009, Feb 3]; 6: 19-23.

Chapchap MJ, Segre CM. Universal newborn hearing screening and
transient evoked otoacoustic emission: New concepts in Brazil. Scand Audiol Suppl. 2001; 53:33-6.

Griz S, Mercês G, Menezes D, Lima ML. Newborn hearing screening: an outpatient model. Int J Pediatr Otorhinolaryngol. 2009 Jan; 73(1):1-7.

Borges CA, Moreira MO, Pena GM, Fernandes FR, Borges BdaC, Otani BH. Universal neonatal hearing screening. International Archives of Otorhinolaryngology. 2006 Jan; 10 (1): 28-34.

Françozo Mde F, Fernandes JC, Lima MC, Rossi TR. Improvement of return rates in a Neonatal Hearing Screening Program: the contribution of social work. Soc Work Health Care. 2007; 44(3):179-90.

Russo IC. Overview of audiology in Brazil: State of the art. Audiology. 2000 Jul-Aug; 39(4):202-6.

Other EHDI Resources:
Grupo de Apoio a Triagem Auditiva Neaonatal, GATANU: Brazilian Universal Newborn Hearing Screening Association who seeks to publicize the benefits of hearing loss detection during the first months of life, and to encourage the establishment of high quality universal neonatal hearing screening programs in Brazil.
http://www.gatanu.org/

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf
3. Bevilacqua MC, Novaes BC, Morata TC. Audiology in Brazil. Int J Audiol. 2008 Feb; 47(2): 45-50. PubMed PMID:18236235
4. Pádua FG, Marone S, Bento RF, Carvallo RM, Durante AS, Soares JC, Barros JC, Leoni CR. Newborn hearing screening program: A challenge for its implantation. International Archives of Otorhinolaryngology. 2005 Jul; 9(3):190-194.
5. Davoine S. Universal newborn hearing screening: A long way to go [Internet]. Audio Info 2007 [cited 2009 Feb 3]; 6: 19-23.
6. Chapchap MJ, Segre CM. Universal newborn hearing screening and transient evoked otoacoustic emission: New concepts in Brazil. Scand Audiol Suppl. 2001; 53:33-6.

[Return to top of page]

Chile

Population (mid-2008): 16.8 millions (1)
Annual number of births (2007): 250,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 100% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 12,590 (1)
Infant Mortality rate: 8.8 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
Enrica Pittaluga
Neonatologist
Hospital Sotero del Rio
P.O. 7083113
Telephone number: 09-8250594 (562) 5421793
E-mail: enrica@terra.cl

EHDI Legislation:
Since July 2005, Chilean law has required targeted hearing screening using Otocaustic Emissions (OAE) and Auditory Brainstem response (ABR) technology for all premature newborns born prior to 32 weeks’ gestation and weighing less than 1,500 grams who are discharged from any of the 28 facilities in the country with a neonatal intensive care unit (NICU). Although 8% to 10% of all newborns are at risk for hearing loss, this requirement results in approximately 1.0% to 1.3% of all babies born annually being screened for hearing loss. The law also requires diagnostic and intervention services, the provision of bilateral hearing aids, and the reporting of results to a national database maintained by the Ministry of Health (3).

EHDI Program Information:
Universal newborn hearing screening pilot programs have been initiated in a few public and private birthing hospitals, such as the Hospital Sótero del Río and Clínica les Condes in Santiago de Chile (4). If a baby does not pass the hearing screening, the birthing hospital refers the baby for a diagnostic evaluation with a fonoaudiólogo (i.e., a professional with knowledge of both speech language pathology and audiology). If the baby is diagnosed with hearing loss, the national social security system will pay for any needed hearing aids. The national social security system covers 70% to 75% of the total population. Speech and language therapy and cochlear implants also are available to children with hearing loss. A public campaign was conducted in 2005 to promote the program among the general population. Although the program has existed since 2005, there are still several barriers that need to be overcome, such as lack of financial support, equipment, and qualified staff. The country plans to expand the program in the future to include all premature babies and eventually all babies born each year. To reach this final goal, fonoaudiólogos and special educators are being trained to provide the services needed by the target population. Also, several graduate schools are planning to start master’s programs in audiology.

EHDI Publications:

Pittaluga E. Guía clínica: hipoacusia neurosensorial bilateral del prematuro [Internet]. Gobierno de Chile, Ministerio de Salud. 2005 [cited 2009, Feb 3]. Available from: http://www.supersalud.gob.cl/difusion/572/articles-6447_recurso_2.pdf

Godoy. Emisiones Otoacústicas y Métodos de Screening Auditivo en Recién Nacidos [Internet]. Revista Medica Clínica Las Condes. 2003 Jan [cited 2009 May 27]; 14 (1).
Click here for the article.

Other EHDI Resources:
Asociación de sordos de Chile: Nonprofit organization dedicated to advocate for people with hearing loss in Chile
http://www.asoch.cl

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9].
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf
3. Pittaluga, E. Guía clínica: hipoacusia neurosensorial bilateral del prematuro [Internet]. Gobierno de Chile, Ministerio de Salud. 2005 [cited 2009, Feb 3]. Available from:http://www.supersalud.gob.cl/difusion/572/articles-6447_recurso_2.pdf
4. Godoy. Emisiones Otoacústicas y Métodos de Screening Auditivo en Recién Nacidos [Internet]. Revista Medica Clínica Las Condes. 2003 Jan [cited 2009 May 27]; 14 (1). Available from http://www.clinicalascondes.com/area_academica/Revista_Medica_Enero_2003/articulo_004.htm.

[Return to top of page]

Colombia

 

Population (mid-2008): 44.4 millions (1)
Annual number of births (2007): 876,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 92% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 6,640 (1)
Infant Mortality rate: 19 (1)

Early Hearing Detection & Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
In Colombia, legislation regarding the rights of people who are deaf or hard of hearing, which includes wording related to Newborn Hearing Screening (NHS), was passed in 2005 (3).
However, the NHS component has not yet been implemented. Although a few hospitals possess the equipment needed to provide hearing screening, only a handful of professionals reportedly are aware of the program (4).

EHDI Program Information:

From May 2002 through February 2004 the Centro de Investigación e Información en Deficiencias Auditivas, CINDA (http://www.fundacioncinda.com/), an institution dedicated to providing services to young infants with hearing loss, performed hearing screening tests for premature babies using Auditory Brainstem Response (ABR) technology in four Bogota area birthing hospitals. This was done in an attempt to sensitize health providers to the importance of NHS (5).

EHDI Publications:
Brigard de Pardo ME, Gomez C, González de Barreto H, Pastoriza S, Rangel P, Restrepo C, et al. Detección temprana de pérdidas auditivas un deber pospuesto. Rev Otorrinolaringol [Internet]. 2002 Jun [cited 2009 Feb 3]; 30(2), 9-18. Available from http://www.encolombia.com/medicina/otorrino/otorrino30202supl-detec.htm

Castaño R. Tamizaje universal auditivo neonatal: una utopia para países en
Desarrollo. Rev Otorrinolaringol [Internet]. 2002 Mar [cited 2009 Feb 3]; 30 (1). Available from http://encolombia.com/medicina/otorrino/otorrino30102-artamiz.htm.

Other EHDI Resources:
Centro de Investigación e Información en Deficiencias Auditivas, CINDA: Organization that offers audiological services for families and infants with hearing loss (in Spanish) http://www.fundacioncinda.com/

Instituto Nacional para Sordos, INSOR: Organization dedicated to educate people with hearing loss in Colombia (in Spanish)
http://www.insor.gov.co/

Federación Nacional de Sordos de Colombia, FENASCOL: organization dedicated to advocate for people with hearing loss in Colombia (in Spanish)
http://www.fenascol.org.co/

Sordos Colombianos: Website with information (e.g. news, events, networking) for deaf people in Colombia (in Spanish)
http://www.sordoscolombianos.com/

Asociación Colombiana de Audiología, ASOAUDIO: Colombian Audiology Association (in Spanish)
http://www.asoaudio.org.co/asoaudio/index.php

Fundación para el niño sordo, ICAL: Nonprofit organization dedicated to serve children with hearing loss in Colombia (in Spanish)
www.icalcolombia.org
References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf
3. Ley 982 de 2005. Diario Oficial No. 45.995 (Aug 9, 2005).
4. Brigard de Pardo ME, Gomez C, González de Barreto H, Pastoriza S, Rangel P, Restrepo C, et al. Detección temprana de pérdidas auditivas un deber pospuesto. Rev Otorrinolaringol [Internet]. 2002 Jun [cited 2009 Feb 3]; 30(2): 9-18.

[Return to top of page]

Costa Rica

 

Population (mid-2008): 4.5 million (1)
Annual # of births (2007): 80,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 94% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 8,340 (1)
Infant Mortality rate: 9.7 (1)

Early Hearing Detection & Intervention (EHDI) Contact:
Sebastian Malek
malek@adiscr.com

EHDI Legislation:
There is no legislation.

EHDI Program Information:
In cooperation with the Costa Rican Social Security Administration, the Ministry of Health, the U.S National Center for Hearing Assessment and Management and Fontbonne University, Costa Rica is working toward implementing the EHDI program: Detección e Intervención Temprana de la Sordera, DITS. The primary goal of this program is to establish Universal Newborn Hearing Screening in all hospitals and birthing centers throughout Costa Rica. As of 2010, a pilot hearing screening program is being planned for five major birthing hospitals in the city of San José. In 2007, a nongovernmental organization, Asociación para la Detección e Intervención de la Sordera, ADIS, was created to assist in the planning and development of the program, which includes having an educational center specializing in auditory-verbal or oral communication and training of audiology professionals to be able to provide services to infants with hearing loss (3). This organization currently is identifying funds to create the proposed center and also provide scholarships for students seeking a doctoral degree in audiology or a Master in Deaf Education. In 2008, the proposal for newborn hearing screening was accepted officially by the Costa Rican Social Security Administration, who needs to approve the budget before any work can be planned. Reportedly, it can take several months after budget approval before funds are available to purchase hearing screening equipment.

EHDI Publications:

Muñoz K, Malek S, Cooper L, Shisler S. Costa Rica and the United States Collaborate on EHDI Initiative. Volta Voices [Internet]. 2007 Nov [cited 2009 March 3]; 14(6): 22-25. Available from http://www.infanthearing.org/resources_home/latin_america/docs/Costa_Rica.pdf.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf
3. Muñoz K, Malek S, Cooper L, Shisler S. Costa Rica and the United States Collaborate on EDHI Initiative. Volta Voices [Internet]. 2007 Nov [cited 2009 March 3]; 14(6): 22-25.

[Return to top of page]

Cuba

Population (mid-2008): 11.2 million (1)
Annual # of births (2007): 118,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): N/A
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: N/A
Infant Mortality rate: 5.3 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.
EHDI Legislation:
No information is available.

EHDI Program Information:
In Cuba, targeted newborn hearing screening was implemented in 1983. Children 0 through 3 years of age who are classified as being at risk for hearing loss are clinically preselected and then referred to a regional center where they are screened for hearing loss using Brainstem Auditory Evoked Response (BAER) technology. The centers receive an average of 1,000 to 1,500 infants per year. These centers also provide services to children referred from other sources (3).

EHDI Publications:
Pérez-Abalo MC. Diagnóstico e intervención temprana de los trastornos de la audición: una experiencia cubana de 20 años. Revista de Neurología. 2005; 41 (9): 556-553. Disponible en http://www.sld.cu/galerias/pdf/sitios/pediatria/pesqaudcuba-revneurol2005-41(9)556-63.pdf

Perez-Abalo MC, Gaya Vasquez JA, López GS, González MP, Ponce de León Mola M, et.al. A 25-year review of Cuba’s screening program for early detection of hearing loss. MEDICC Review. 2009; 11(1): 21-28.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf .
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf
3. Perez-Abalo MC, Gaya Vasquez JA, López GS, González MP, Ponce de León Mola M, et.al. A 25-year review of Cuba’s screening program for early detection of hearing loss. MEDICC Review. 2009 [cited 2010, May 5]; 11(1): 21-28. Available at http://www.medicc.org/mediccreview/articles/mr_74.pdf

[Return to top of page]

Dominican Republic

 

Population (mid-2008): 9.9 million (1)
Annual # of births (2007): 231,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 95% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 5,050 (1)
Infant Mortality rate: 32 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
No information is available.

EHDI Program Information:
No information is available.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Ecuador

 

Population (mid-2008): 13.8 million (1)
Annual # of births (2007): 283,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 74% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 7,040 (1)
Infant Mortality rate: 25 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
No information is available.

EHDI Program Information:
No information is available.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

El Salvador

Population (mid-2008): 7.2 million (1)
Annual # of births (2007): 158,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 69% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 4,840 (1)
Infant Mortality rate: 24 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
No information is available.

EHDI Program Information:
No information is available.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Guatemala

Population (mid-2008): 13.7 million (1)
Annual number of births (2007): 449,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 42% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 4,120 (1)
Infant Mortality rate: 34 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
Patricia Castellanos de Muñoz
audiocaresa@yahoo.com
CEDAF / Comité Pro ciegos y sordos de Guatemala

EHDI Legislation:
Guatemala currently does not have legislation requiring Newborn Hearing Screening (NHS).

EHDI Program Information:
In 2004, high-risk NHS was implemented in one hospital in the capital city, and in 2008 a second site was established. These NHS programs were started with donated Otoacustic Emissions (OAE) equipment and with plans to expand screening programs as additional (donated) equipment became available and hospitals agreed to participate.
The screening is offered at no charge to all children who show up for vaccination and development and growth assessments.
Children not passing the screening are referred to the Hospital Rodolfo Robles, where they receive Auditory Brainstem Response (ABR) and Auditory Steady State Response (ASSR) tests. The age of identification for hearing loss averages 3 years across the country. Hearing aids are available to children younger than 5 years of age who have access to social security services, and to children whose families can afford to purchase them. No insurance in Guatemala covers hearing aids. Cochlear implants are not common.

EHDI Publications:
No information is available.

Other EHDI Resources:
Centro de Audición y Adiestramiento Fonético, CEDAF: private entity dedicated to provide audiology services to people with hearing loss in Guatemala
http://www.cedaf.com.gt/index.html

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Honduras

Population (mid-2008): 7.3 million (1)
Annual number of births (2007): 200,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 67% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 3,160 (1)
Infant Mortality rate: 23 (1)
Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
No information is available.

EHDI Program Information:
No information is available.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Mexico

Population (mid-2008): 107.7 million (1)
Annual number of births (2007): 2,088,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 86% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 12,580 (1)
Infant Mortality rate: 19 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
Dr. Pedro Berruecos, Presidente de la Sociedad Panamericana de Audiología (PASA)
General Hospital in Mexico (HGM)
Address: Dr. Balmis 184, Col. Doctores, 06726, México D.F.
Phone #: +(52-55) 5004-3806
Phone #: +52-55 5999-6133 ext. 1016

EHDI Legislation:
In February 2005, a national law requiring universal newborn hearing screening and audiological evaluation was passed.

EHDI Program Information:
The Hospital General de México, HGM (General Hospital of Mexico) in México City implemented a targeted Newborn Hearing Screening (NHS) program in August 2003 and in July 2007 the program was expanded to include all newborns. Some NHS programs have been implemented in a few public and private hospitals around the country as well (3).
When a baby does not pass the initial screening, a rescreening is provided before the baby leaves the hospital. As part of this effort, HGM has a manual describing the responsibilities of those involved with the NHS program to make sure babies are not discharged before being screened. This program is coordinated through the audiology service department at HGM.

When a child is identified with a hearing loss, the services available include hearing aids, speech-language therapy, genetic services, cochlear implants, and family education. The services are paid for by the government, nonprofit organizations, and the family. With the implementation of the new government-sponsored popular insurance plan in Mexico (Universal Insurance for a New Generation) it is expected that access to screening, diagnostic, and specialized therapy services will be improved. Through the Ministry of Health and under the coordination of the Audiology Department of HGM, 520 professionals at 265 hospitals in 29 of the 32 states in the country have been trained to start screening babies in 2009. Moreover, funds have been allocated to provide hearing screening equipment to 300 entities such as hospitals and birthing facilities. Also, a national database will be implemented eventually to assist with follow-up activities.

EHDI Publications:
Yee-Arellano HM. Universal newborn hearing screening in Mexico: Results of the first 2 years. Int J Pediatr Otorhinolaryngol. 2006 Nov; 70(11): 1863-1870.

Other EHDI Resources:
Programa de Acción Específico 2007-2012, Tamiz auditivo neonatal e intervención temprana: Complete plan to implement the EHDI program in Mexico published by the Secretary of Health

Fundación Venga y Oiga: Nonprofit organization dedicated to provide audiology services to low-income populations with hearing loss
http://www.fvyo.org.mx/

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from: http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf
3. Yee-Arellano HM. Universal newborn hearing screening in Mexico: Results of the first 2 years. Int J Pediatr Otorhinolaryngol. 2006 Nov; 70(11): 1863-1870. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16914209

[Return to top of page]

Nicaragua

Population (mid-2008): 5.7 million (1)
Annual number of births (2007): 140,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 66% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 2,080 (1)
Infant Mortality rate: 29 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
No information is available.

EHDI Program Information:
No information is available.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Panamá

Population (mid-2008): 3.4 million (1)
Annual # of births (2007): 70,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 92% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 8,340 (1)
Infant Mortality rate: 15 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
Amarilis Melendez
IAPO Asociación Interamericana de Otorrinlaringología Pediatrica
507 6611 1927
amarimd2002@yahoo.com
Cynthia Guy
cynthiaguymd@gmail.com

EHDI Legislation:
Currently, there is no Newborn Hearing Screening (NHS) law in place, but a local group called Instituto de Implantes Cocleares is advocating for the implementation of universal NHS.

EHDI Program Information:
Since 2000, Panama has offered targeted NHS in some birthing hospitals around the country. Some equipment and well-qualified personnel are available to screen a small percentage of the newborn population.

When a baby does not pass the hearing screening, the pediatrician or primary care provider is in charge of informing the family about the importance of further testing by an audiologist. Available interventions for children with hearing loss include speech language services, hearing aids, and genetic services. The services are paid for by the government, nonprofit organizations, and the family.

The Instituto de Implantes Cocleares was created in 2006 with the goal of educating professionals and the general public about the availability of this device and providing cochlear implants to people in need of them. They also have partnered with several national and international organizations such as Sociedad Panameña de Otorrinolaringología, Sociedad Panameña de Pediatría, Pan American Health Organization, National Center for Hearing Assessment and Management and The Centers for Disease Control and Prevention to promote newborn hearing screening.

EHDI Publications:
No information is available.

Other Resources:
Fundación oír es vivir: Nonprofit organization dedicated to help people with hearing loss
www.fundacionoiresvivir.org

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Paraguay

Population (mid-2008): 6.2 million (1)
Annual number of births (2007): 153,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 74% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 4,380 (1)
Infant Mortality rate: 36 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
No information is available.

EHDI Program Information:
No information is available.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Peru

Population (mid-2008): 27.9 million (1)
Annual number of births (2007): 584,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 70% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 7,240 (1)
Infant Mortality rate: 24 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
Susana Stiglich Watson
sustiwa@gmail.com

EHDI Legislation:
No information is available.

EHDI Program Information:
No information is available.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Puerto Rico

Population (mid-2008): 4.0 million (1)
Annual number of births (2006): 48,744 (3)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): No data is available
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: No data is available
Infant mortality rate: 9.2 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
Carol D. Cruz Pagán, Au.D
EHDI Program Coordinator
carolcruz@salud.gov.pr

EHDI Legislation:
The program was initiated in January 2000 and become required by law in December 2003. The legislation requires hearing screening, referral for medical evaluation, audiological evaluation, and reporting of results to the EHDI program within the Department of Health.

EHDI Program Information:
Puerto Rico is a U.S. territory and receives directives regarding health care initiatives from the U.S. government. Currently, there is an EHDI program (Programa de Cernimiento Auditivo Neonatal Universal or PCANU), which is in operation at all birthing hospitals.

When a baby does not pass the hearing screening, staff from the Department of Health are responsible for making sure the baby receives follow-up testing by an audiologist. If a hearing loss is identified, the services available to infants and their families include hearing aids, speech-language therapy, genetic services, cochlear implants, and family education. These services are paid for by the government, by families, and through various medical plans.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf
3. Department of Health, Auxiliary Secretariat for Planning and Development, Division of Statistical Analysis. Annual statistics preliminary report: 2006. San Juan (Puerto Rico): The Department; 2006.

[Return to top of page]

Uruguay

Population (mid-2008): 3.3 million (1)
Annual number of births (2007): 51,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel): N/A
Gross national income (GNI) at purchasing power parity (PPP) per capita (US$) 2007: 11,040 (1)
Infant mortality rate: 10.5 (1)

Early Hearing Detection and Intervention Contact:
Enrique Dal Monte, ENT, MD
Jefe del Dpto De ORL de COMEPA
Corporación médica de Paysandú
Adress: Colon y Montecaseros, Paysandú 60000
Paysandú, Uruguay

Telephone number: 598 72 24226
E-mail: edm099@gmail.com

EHDI Legislation:
Currently, there is no legislation.

EHDI Program Information:
Beginning in 2000, Uruguay started implementing both targeted and universal newborn hearing screening in a limited number of hospitals. Currently, several hospitals in the capital and one hospital in the city of Paysandú offer the program. The baby’s primary care provider is usually the one in charge of providing further audiological testing. Hearing aids, speech language therapy, and cochlear implants are available for children diagnosed with hearing loss. The government or the infant’s family, or both, pay for these services.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

1. Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
2. UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf

[Return to top of page]

Venezuela

Population (mid-2008): 27.9 million (1)
Annual number of births (2008): 599,000 (2)
Institutional births (births that occur in health facilities attended by skilled health personnel) (2000/7): 95% (2)
Gross national income (GNI) at purchasing power parity (PPP) per Capita (US$) 2007: 11,920 (1)
Infant Mortality rate: 16.5 (1)

Early Hearing Detection and Intervention (EHDI) Contact:
No information is available.

EHDI Legislation:
No information is available.

EHDI Program Information:
No information is available.

EHDI Publications:
No information is available.

Other EHDI Resources:
No information is available.

References:

• Haub C, Mederios M. 2008 World Population data sheet [Internet]. Population Reference Bureau; 2008 [cited 2009, July 9]. Available from: http://www.prb.org/pdf08/08WPDS_Eng.pdf.
• UNICEF. The State of the World’s Children Special Edition [Internet]. Childinfo; 2009 [cited 2009, July 15]. Available from http://www.childinfo.org/files/SOWC_Spec_Ed_CRC_Statistical_Tables_EN_111809.pdf