Establishing a newborn hearing screening programme in a low-income country with poor communication infrastructure has unique challenges. Data from 195 infants in three different patient populations in Malawi who underwent hearing screening using transient evoked otoacoustic emissions (TEOAE) testing were analysed to investigate the feasibility of a long-term screening programme. There were 65 infants in each group: infants from Group A were born in a private maternity unit, Group B attended a free community vaccination clinic, and Group C were receiving special care at a government hospital. 75% of infants requiring follow-up from the special-care baby unit were uncontactable following hospital discharge, and screening was discontinued there. Lost to follow-up rates after the first screen were lower from the private maternity unit (14%) and the community vaccination clinic (36%), and these screening programmes continue. A successful hearing screening programme requires extensive support services to manage infants requiring further testing and habilitation, this is not currently possible on a large scale in Malawi due to the small number of Audiology departments and trained staff.
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