The population coverage of a hospital based screening program would not exceed 70 % in the Netherlands, due to an high home birth rate (30-35%). Therefore a combination of hospital based screening for NICU baby's and community based screening for healthy baby's was designed and evaluated in a number trial studies, since 1995. Finally this resulted in a two stage AABR screen for the NICU baby's and a three-stage combined automated OAE and AABR screening for the healthy neonates (twice A-OAE and eventually AABR). For the community based screening the preferred site of testing is at the baby's home. The pass rate are the highest at that site. But for logistic reasons in some districts the site of testing has to be the Well Baby Clinic in the baby's neighbourhood. However the final AABR-screening , if needed) is done at home in all districts. The implementation of the NICU-screening program was completed in 2001. The implementation of the community based screening has started in July 2002 and will be completed at July 2006. The reasonable aims are to get at a population coverage exceeding 97% and a refer rate of less than 0.4 % in the healthy baby group and less than 3% in the NICU-baby group. Results up to now are favourable. The results for 2002 are given in the table below:

         As is clear from this table, the major problem in getting at a high coverage is the lost percentage for the 1st stage of the screening. The lost percentages for the 2nd and 3rd stage are significantly lower the in the 1st stage.

Date of report: October 23, 2003
e-mail : Bert van Zantem