Impact of the national hearing screening programme in China.

China has a large population with different levels of medical care among the eastern, central and western areas. The national universal newborn hearing screening (UNHS) programme was initiated in 1999 and then progressively implemented nationwide. A "National UNHS Experts Group" was set up, formulating the national UNHS administration rules and technological specifications. 3 March had been named as national "ear-care day" since 2000 and such social activities help make deafness prevention work more widely accepted. UNHS in China presently has 3 phases due to disparities in economic development. 1) Implementation in stages: in economically under-developed areas. 2) Implementation completed: in the coastal cities. 3) Beyond basic UNHS: i) Development of a completed UNHS system including follow-up and quality control based on the neonatal disease screening system, ii) Exploration of a new public health care programme: simultaneous screening of newborn hearing and ocular disease, iii) Carrying out of a multi-centre study on high-risk factors and GJB2 gene mutations in newborn with non-syndromic hearing impairment. The incidence of newborn bilateral hearing loss was 2.22 per 1000, and 2.74 per 1000 for unilateral hearing loss. Though UNHS have been carried out widely in the eastern parts of China, there are difficulties for its implementation in the western regions. Economic development and technical expertise are the main restricting factors.