Analysis of neonatal hearing screening coverage by State in Brazil

OBJECTIVES: Analyze the evolution of Neonatal Hearing Screening coverage in Brazil, by region and state, over the 12-years following the publication of the Neonatal Hearing Screening Care Guidelines in 2012, aiming to identify trends and the current situation. METHODS: The study was based on national data from public health care system notifications collected between 2012 and 2023. Segmental regression models were applied to identify changes in temporal trends. RESULTS: Neonatal Hearing Screening coverage increased from 25.93% in 2012 to 34.43% in 2018 but dropped to 26.39% in 2023. Paradoxically proportion of screenings conducted with Brainstem Auditory Evoked Potential doubled from 2012 to 2023. The South region had the highest average coverage (62.52%), while the North region showed the lowest performance (11.91%). The highest rate in 2023 were 83.19% in the Federal District. These results are limited by the secondary data source from public health and may be affected by underreporting and exclusion of private sector. CONCLUSION: Neonatal Hearing Screening coverage in Brazil remains critically unsatisfactory and falls short of the 95% target. The significant decline after 2018 calls for detailed investigation and urgent intervention to reverse this trend. LEVEL OF EVIDENCE: 4 - Cross-sectional study.