MIT Solve

Solution Overview

Solution Name

Early Childhood Screening

One-line solution summary.

It is essential to detect hearing problems at the earliest stages of a young child's life or it will most likely delay or impair her/his development.

What is your solution?

There is a paucity of audiologists in rural Nepal. We propose training healthcare workers in performing hearing screenings in Dullu Municipality, which has one of the lowest HDI in Nepal. There is no wide spread hearing screening initiative in the entire province.

It is essential that a child's (0 to 3 years) hearing be screened with an OAE device. This device transmits a signal into the ear canal. While adult screening requires a response (e.g. raising of hand, pressing of button, etc.) to denote that they can hear the signal, this is not possible with young children. Hence, the device is able to 'capture' the reflected sound wave. A screening diagnosis is made on the basis of the quality of reflected sound wave and the young patient is referred for further investigation if any issue is detected.

The project team will use openSRP (https://smartregister.org/) , an interoperable, digital health centric, medical register to ensure health data collection is aligned with global standards. Health data is essential and the project team plans to develop specific workflows that are practical, easily adoptable, and effective.

What specific problem are you trying to solve?

We want to perform early childhood hearing screening to ensure that hearing problems in young children are detected at their earliest stage. Early detection is the key to ensuring that the child is able to lead a more normal life and will be able to acquire speaking and listening skills. While each case might not lead to a complete success, it is imperative that those cases which can be helped through some intervention, must be addressed.

Currently in Nepal, advance ear surgeries are performed and many institutions offer a number of free or deeply discounted surgeries for rural children. Our research team has contacted a couple of NGOs and other such entities which are willing to financially assist the surgery costs for children with hearing loss.

In Nepal the incidence of hearing loss in neonates is 1.8% and many children go undiagnosed for a number years until it is too late to perform any intervention thus it is necessary to detect early and refer to larger tertiary hospitals for interventions.

Hearing loss in neonates is related to socioeconomic factors in Nepal and hence the project team proposes to initiate the hearing screening program in Public Schools of Dullu Municipality.

Reference:

https://nmj.com.np/nmj/index.p...

https://www.researchgate.net/p...

Hence, the team wants to train local medical personnel to perform hearing screening, provide capacity building workshops in public health related to hearing loss and prevention.

Who does your solution serve? In what ways will the solution impact their lives?

The project team has been gathered hearing screening information from multiple sources, and all data points to a lack of any regular hearing screening program in entire Karnali Province. The team has come to realise that hearing screening and/or diagnosis has been a long neglected public health vertical in Nepal.

This initiative will provide training, raise awareness, and help in hearing screening of neonates and young children. Research points to socioeconomic factors that have a major role in deafness in young children and a public health and awareness campaigns must be integral with any hearing screening program.

The project team believes that this solution will provide a start in prevention, detection, and mitigation of early childhood hearing issues. The Dullu Muncipality leadership and administration is enthusiastic to support and provide all coordination with local doctors, nurses, and school teachers to make this project a success.

What steps have you taken to understand the needs of the population you want to serve?

I have volunteered with a non-profit organization, Center for Information for Communication Technology for Development (ict4dnepal.org) which has also been my mentor.

I have met the local doctors from Dullu Hospital and wish to further work with them on an early childhood screening program. I believe there is much to learn from past project experiences and also much to achieve in newer areas of rural healthcare delivery.

I have worked with ICT4D Nepal in developing and fine tuning this project and have learnt the project proposal development process from the team members and their outreach program initiatives.

Which aspects of the Challenge does your solution most closely address?

Improving healthcare access and health outcomes; and reducing and ultimately eliminating health disparities (Health)

Our solution's stage of development:

Growth: An organization with an established product, service, or business model rolled out in at least one community, which is poised for further growth

Explain why you selected this stage of development for your solution—in other words, what have you accomplished to date?

The project team has previously worked in Dullu Municipality, Karnali Province, Nepal since 2017. We have received one ISOC grant, and two APT grants.

We had developed a community based safe motherhood model in which health workers perform antenatal care (ANC) ultrasound scanning of pregnant women closer to their home. This was especially useful during the Covid-19 pandemic since many pregnant women avoided institutional visits due to fear of contracting Covid-19.

While, it has been a challenge to convince many women to still visit a local community center, the project team has been fortunate in working with extremely dedicated and enthusiastic team of local doctors and medical personnel at Dullu Hospital, which is run by Dullu Muncipality.

The project team wishes to extend this model to early childhood hearing and vision screening as well. This project is specifically related to hearing since there is a serious paucity of hearing screening and diagnosis teams and also a general lack of awareness of hearing issues faced by many people across Nepal.

We might even extend this project to include eye screening but that might require additional project resources so have decided to put that on hold.

Where our solution team is headquartered or located:

Lalitpur, Nepal

Team Lead:

Shivani Dhakal