Implementation and Evaluation of a Newborn Hearing Screening Database in a Resource-Limited Setting: Advantages and Limitations

Background: Congenital hearing loss affects 1–3 per 1000 newborns and requires early detection to prevent developmental delays. Although Thailand implements universal screening, fragmented data systems limit effectiveness. To address this, Chiangrai Prachanukroh Hospital introduced a dedicated newborn hearing screening (NHS) database in 2023 to improve tracking, coordination, and monitoring in a resource-limited setting. Objectives: To evaluate the advantages and limitations of NHS database integration on screening coverage, referral rates, follow-up completion, and diagnostic timeliness. Methods: A retrospective analytic study was conducted over 24 months, comparing outcomes before (July 2022–June 2023) and after (July 2023–June 2024) database implementation. Key indicators included screening coverage, follow-up attendance, diagnostic ABR completion, and workflow efficiency, with the study period also encompassing the implementation of the database and adaptations to the screening algorithm. Data were analyzed using the chi-square test and fisher’s exact tests, supplemented by qualitative observations of system performance. Results: Among 8290 newborns, screening coverage before one month increased from 83.47% to 96.64% (p < 0.001), while referral rates decreased from 18.44% to 6.47% (p < 0.001). Diagnostic ABR completion improved from 7.41% to 52.63% within three months (p < 0.001) and from 59.26% to 84.21% within six months (p = 0.06). The database improved workflow coordination, but challenges persisted, including incomplete data, limited interoperability, caregiver-related follow-up barriers, and low hearing-aid uptake. Conclusions: Integration of the NHS database, as well as protocol changes, improved screening coverage, referral accuracy, and diagnostic timeliness, but follow-up and early intervention barriers persisted. Continued progress will require stronger interoperability, improved family engagement, and digital infrastructure investment, with tele-audiology and decision-support tools helping expand access and efficiency.