Unlike developed countries newborn hearing screening is not mandatory. By the time hearing impairment is detected, it becomes too late to take any corrective steps. Pointing out the required measures needed to be taken by the government, Nitin Sisodia, Founder & CEO, Sohum Innovation Lab, speaks about his company’s efforts in this direction in an interview with Usha Sharma
Globally, how many babies are born with hearing impairment and how severe is it in India?
800,000 hearing impaired babies are born every year all over the world, of which 100,000 are in India and 90 per cent are in developing countries. Besides India, 40 low income and 53 low middle-income countries do not have an affordable solution for early screening of hearing impairment. Universal newborn hearing screening has thus been endorsed in many developed countries, but still not widely adopted in India due to high infrastructural and operational costs and requirement of skilled workers. Sohum BERA technology tackles these issues with reduced costs, increased accuracy, simplicity of use and accessibility to remote areas with its telemedicine portal. Sohum provides early screening, that leads to timely treatment and rehabilitation, as well as savings in healthcare expenses to the system.
What are the causes, are there any associated genetic factors ?
The possible factors which lead to hearing loss in newborns are both genetic and non- genetic. The non- genetic factors are rubella infection in mothers, low APGAR score, low birth weight, ventilation, jaundice (hyperbillrubinemia), bacterial meningitis, family history & administration of toxic drugs. Marriages in the same family and presence of hearing loss in the family also affect hearing of a child.
In developed countries universal newborn hearing screening is a norm, tell us about the Indian context?
In India and similar developing countries, newborn hearing screening is not mandatory and not available. Only in few tertiary hospitals, the protocol of screening high risk newborns is followed. Most of the urban poor and rural population doesn’t have access to newborn hearing screening. It is mainly because of expensive equipment and disposables, unavailability of experts to conduct the test and ineffective care cycle. Sohum has created an affordable technology which can be used by healthcare workers with no requirement of expert and it is enabled with telemedicine modality to ensure aftercare.
How essential is early diagnosis to ensure and effective care cycle?
Early diagnosis can save the speech and mental development of the child. A child who is diagnosed early and provided hearing aid or cochlear implant with rehabilitation in the first six months of age will be able to speak and learn just like a normal child. Early screening and diagnostics will enable the children with hearing loss to be a part of mainstream education and livelihood opportunities.
Can hearing impairment be reversed, if it diagnosed at a right time?
Hearing impairment can be conductive, sensioneural or mixed hearing loss. Different types of hearing loss require different interventions. Fitting a hearing aid, cochleae implant with rehabilitation or a surgical intervention can improve the condition. Hearing impairment can be corrected with an intervention and its impact on the growth of the child can be minimised.
What efforts and measures government is taking to avoid these problems?
Government has several national level programmes and schemes to prevent and provide intervention for the affected population. There is a National Programme for Prevention and Control of Deafness (NPPCD) & Cochlear implant program (ADIP Scheme) from Ministry of Social Justice and Empowerment. These programmes are creating awareness, enabling health setups with infrastructure, and providing free hearing aids and cochlear implants to patients in need. The programmes will be more effective if Newborn Hearing Screening gets implemented at scale and babies can reach these programme initiatives at an early stage. We envision to provide newborn hearing screening to every child born no matter where he or she is born.
Tell us about Sohum hearing screening device? And how has it been designed?
In most advanced healthcare systems, universal newborn hearing screening is mandatory at the time of birth. In a resource constrained setting, such as India, hearing impairment goes undiagnosed till the child is about four years. By then, it is too late for the care cycle to be effective. This leads to speech loss, impaired communication skills, mental illness and unemployment. Sohum provides early screening, that leads to timely treatment and rehabilitation, as well as savings in healthcare expenses to the system.
Sohum is a gold standard Brainstem Evoked Response Audiometry (BERA) technology to conduct Newborn Hearing Screening with high sensitivity and specificity. The compact, battery operated device can perform in noisy clinical settings (no requirement of noise proof room), require minimal disposables (low per test cost), can be used by semi- skilled healthcare worker and gives automated results (no requirement of specialist), and is telemedicine enabled (ensures every baby tested positive, receives aftercare). Sohum provides early hearing screening, that leads to timely treatment and rehabilitation to save the child from speech loss and disability.
What support did you get it from SIB, DBT? Was it under the ‘Make in India campaign’?
I did my fellowship from Stanford India Biodesign programme in 2010, an initiative of Department of Biotechnology (DBT) and collaboration of AIIMS, IIT D and Stanford, the programme focuses on the process of finding unmet clinical needs in healthcare system and solving them. And since then I could find several unmet clinical needs in the Indian healthcare system and could solve few of them, reducing the burden of disease and generating livelihood. Our initiative ‘Sohum’ for Newborn Hearing Screening is a need found during the programme. The project focused on designing a novel technology which works in resource poor setting (developing country scenario) and a sustainable implementation model which incentivise all stakeholders.
DBT has shown immense far sightedness initiating this programme, nurturing Indian talent to solve Indian and global healthcare needs. Make in India, local innovation, creating healthcare startups and companies was at the core of the SIB programme. The intention of DBT to solve developing countries healthcare needs with Indian talent and intellect is really commendable. Dr APJ Kalam said once “Do we realise that self-respect comes with self-reliance”. The thought is very relevant in today’s Indian context and that is what SIB- DBT is trying to achieve.
What is your marketing plan for India?
We are targeting all newborns in resource-poor settings, starting with India. In India, 26 million babies born every year, need to be screened for hearing impairment. We aim to focus on institutional births, which addresses 47 per cent of these births (12.2 million) through maternity homes, paediatric clinics, privately owned local and chain hospitals. With the support of government run programmes and local entrepreneurs we target non-institutional births (mostly rural). Currently, more than 50 Sohum devices are in use in Bangalore (Narayana Netralaya, Vani Vilas Maternal and Child care hospital), Bhopal (Five hospitals), Pune, Delhi (MAMC) & in the States of Tripura, Rajasthan & Himachal Pradesh. We have exported Sohum devices to Uganda and Tanzania in this year and looking to expand the Sohum programme in South- East Asia.