1

0

ENT, Head & Neck Research CenterIran University of Medical Sciences (IUMS)WHO Collaborating Centre for Research and Education on Hearing Loss

www.ent-hns.org

2

OutlineResearch and Education on Hearing Loss

1. Strategic Goals (till 2016)2. Strategic Plans

PromotiveFacilitativeObligatory

3. AchievementsResearchesIntersectional collaboration in PHC

4. Challenges5. Perspective

3

Strategic Goals (till 2016)

1. To improve health knowledge in ear and hearing care twice the rate of the base

year

2. To increase coverage rate of newborn hearing screening to rate of 100% in the

country.

3. To increase coverage rate of preschool children hearing screening (3-6 years

old) twice the rate of the base year in the country.

4. To improve hearing impairment preventive behavior at work, entertainment and

lifestyle as much as 50% of base year.

5. To established the package of ear and hearing care services in PHC system.

6. To improve supporting services for hearing impaired people twice the rate of the

base year.

7. To seek support for improving the quality of vaccinations and immunization

services for children and women, reproductive health, geriatric health, referral

of high risk people and prevention of harmful drugs.

Purposes of an EHDI Data System

Screening

Research

Diagnosis InterventionMedical, Audiological and

Educational

Program Improvement and Quality Assurance

4

5

Strategic Plans

Promotive

To promote educational package in ear and hearing care for:

Public population

Health workers

Specialist curriculum (general and family practitioners,

experts and specialists)

Facilitative

To provide package of ear and hearing care services in Report Card on

the EHDI Programs in Iranian PHC system

To evaluate EHDI program in the country and to accomplish promoted

referral program including treatment and rehabilitation. systems

6

Strategic Plans

Facilitative (continue)

To evaluation hearing screening program in preschool and

school children in the country and implement of  enhanced

program.

To evaluate efficiency and effectiveness of rules for reducing

noise in work, entertainment and military places

To evaluate efficiency and access to the genetic consultation

To evaluate opportunities for improving services related to

maintaining and promoting ear care

To provide mobile hearing screening centers in villages and

rural areas

7

Obligatory

To integrate ear care services in primary health care and

providing these services in mobile centers for rural and

marginal areas

To evaluate and approve of hearing screening programs in

policy council

Accreditation of screening and rehabilitation centers

Developing a supporting package for hearing loss and

deafness, and approval in relevant authorities including

Supreme Council of Insurance

To include monitoring of hearing care indicators in country

health and to rank cities

Strategic Plans

8

Achievements (Intersectional collaboration in PHC)

Community-based newborn hearing screening program

for early detection of permanent hearing loss in Iran: An

eight-year cross-sectional study from 2005 to 2012

(National Research on 3,350,995 infants)

Presented Guidelines for Newborn Hearing Screening

and Evaluation Services (EHDI program in Iran)

More than 60 Educational Workshops (National and

Regional)

9

Professional Education Programs: Regular educational programs:

Audiology studentsMedical students Otolaryngology Residency programOtology-Neurotology Fellowship programPh.D. students

Occasional educational programs :WorkshopsSeminarsCongresses

Achievements (Intersectional collaboration in PHC)

10

Advanced & Hi-Tec programs Cochlear implant

Auditory brainstem implant

Implantable hearing aids

Other advanced otologic-neurotologic and skull base

surgeriesNavigation assistedAnterior, middle and posterior cranial fossa

approaches

Publications Books

Articles (National & International)

Achievements (Intersectional collaboration)

11

Achievements (Researches)

Hearing impairment survey in Tehran in collaboration with WHO.

National study of neonatal hearing screening in Tehran (National

Research)

Hearing screening of high risk neonates at the NICU's of Tehran.

Hearing and tinnitus screening in industrial workers (Khoozestan

Steel Co.)

Genetic study of hearing loss (patients who are screened in the

previous projects).

Cross sectional and clinical trial studies:Meniere diseaseCochlear implantsTinnitusDrug delivery in cochleaNoise induce hearing loss

Studies for application of stem cells in hearing loss.

Challenges Lack of awareness about hearing impairment in authorities

Lack of coordination in Education, Social Welfare and the Ministry of

Health to monitor hearing impaired students not covered by special

education

Different data and statistics about deaf and hearing impairment

Because of high cost of treatments, some parents deprive their children

of receiving rehabilitation services

Lack of educational programs on TV and radio and public media

Weakness of health centers in educating health affairs in schools

(teachers, parents,…)

Failure to comply ear protection in the workplaces

Both, average age of parents suspicion to their children hearing loss

(one and half years) and average age of hearing loss diagnosis (three

and half years) are high.

13

Perspective

Promoting ear and hearing care in Iranians people to the end of

2016

Promoting ear and hearing health program in educating health

workers and curriculum of general practitioners, family physicians

and specialists.

To institutionalize all the organizations for preventing hearing loss

and deafness

Providing ear and hearing care services in the primary care system

Reducing the incidence of hearing deficits in the country

14

Thank you for your attention

15

year

Number of infants screened

(first stage)

Referrals to the second stage

Number of infants screened (second stage)

Referrals to the diagnostic services

Final

audiologic results

Referrals to the medical

services

Number of infants who were treated

2005 21056 2995 1300 306 156 99 71

2006 75116 9468 6087 900 710 300 164

2007 136725 16768 9476 1622 975 594 343

2008 259436 36981 21563 2185 1303 657 506

2009 521741 68571 42872 5245 3444 1498 1251

2010 686538 86373 59165 5442 4110 2027 1730

2011 789837 126858 87224 8624 6385 2292 2088

2012 860506 139885 116782 8972 7335 2274 2101