Multi-level barriers & priorities accorded by policy makers for Neonatal Hearing Screening (NHS) in Pakistan: A thematic analysis

Objectives: To explore the Barriers and Priorities accorded to neo-natal hearing screening at government health policy level. Methods: This exploratory descriptive study design employed qualitative parameters with purposive sampling and was conducted at Capital Administration Et Development Division (CADD) and Ministry of National Health Services, Regulations Et Coordination (MoNHSREtC) from June 2015 to January 2017 over a period of 18 months. Sample included stakeholders concerned with healthcare planning and policy making in Pakistan. Research included in depth interviews using a self-structured interview guide from three policy makers' fulfilling the selection criteria. Data recorded was transcribed and thematic analyses drawn manually and verified using two separate coders. Results: Outcomes from thematic analysis drawn were Planning, Funding, Governance, Awareness, Medical and technical capacity building, Policy development, Evaluation and Sustainability. Lack of financial resources allocation due to policies and legislation top the list of barriers. The lack of research and reliable data as to the number of persons suffering from hearing loss (HL) from birth and its economic cost to the state and individual remains a policy barrier. Conclusion: The barriers to NHS are lack of financial resource allocation by the federal government, and lack of research and reliable statistics about Hearing Impairment (HI) and its economic cost.