0 ENT, Head & Neck Research Center Iran University of Medical Sciences (IUMS) WHO Collaborating Centre for Research and Education on Hearing Loss 1

Outline Research and Education on Hearing Loss 1. Strategic Goals (till 2016) 2. Strategic Plans Promotive Facilitative Obligatory 3. Achievements Researches Intersectional collaboration in PHC 4. Challenges 5. Perspective 2

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. 3

Purposes of an EHDI Data System Screening Research Diagnosis Intervention Medical, Audiological and Educational Program Improvement and Quality Assurance 4

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 5

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 6

 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 7 Strategic Plans

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) 8

Professional Education Programs:  Regular educational programs:  Audiology students  Medical students  Otolaryngology Residency program  Otology-Neurotology Fellowship program  Ph.D. students  Occasional educational programs :  Workshops  Seminars  Congresses 9 Achievements (Intersectional collaboration in PHC)

Advanced & Hi-Tec programs  Cochlear implant  Auditory brainstem implant  Implantable hearing aids  Other advanced otologic-neurotologic and skull base surgeries  Navigation assisted  Anterior, middle and posterior cranial fossa approaches Publications  Books  Articles (National & International) 10 Achievements (Intersectional collaboration)

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 disease  Cochlear implants  Tinnitus  Drug delivery in cochlea  Noise induce hearing loss  Studies for application of stem cells in hearing loss. 11

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.

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 13

Thank you for your attention 14

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