The EU-funded EUSCREEN project aimed to make vision and hearing screening available for all children in Europe by comparing the current screening programmes and by developing an online-available, cost-effectiveness model to assist with the introduction of a screening programme, taking the local circumstances in any given country into consideration. In Romania, where few children are screened for vision, and in Albania, where newborn hearing screening is not yet available, such programmes were introduced to identify requisites, facilitators, and barriers for screening. 

In an extensive survey, representatives of 41 European and several non-EU countries were asked to provide detailed data on the demography, the existing screening system, coverage and attendance, screening tests used, follow-up, diagnosis, treatment, benefits, and adverse effects. Through this collaborative effort, the data set regarding vision and hearing screening is the largest ever collected. 

A cost-effectiveness model for vision and hearing screening has been developed to the point that users all over the world can enter their choice of screening programme based on, for example, the number of newborn hearing tests, the salary of the screening nurse and the cost of the screening instrument, or on the number of visual acuity measurements and the age of the screened child, in order to calculate the total costs of the screening programme, the cost per screen and the cost per detected case. 

Outcomes 

The cost-effectiveness model is a success, and it is reliant on accurate and available input data. An important obstacle to efficient screening identified in the survey was the serious lack of monitoring, data collection, quality control and evaluation - even in the most developed screening programmes across Europe. When data is collected, it mostly concerns quality measures like coverage, referral rate and loss to follow up. However, for a comparative cost-effectiveness analysis of screening programmes across borders in Europe, more variables are needed, such as sensitivity and specificity of screening tests.  

In Albania, initial screenings carried out straight after birth went very well. The government included paid newborn hearing screening in the annual budget. In Romania, vision screening by measurement of visual acuity at age 4 or 5 by resident nurses in kindergartens went well in the cities. However, almost half of the population lives in rural areas and screening was more difficult there. A travelling screening nurse was instated, who then successfully screened most children in remote villages.  

Under Horizon 2020, the European Union awarded €4.1 million to the EUSCREEN project, which was coordinated by the Netherlands, with further participants being the United Kingdom, Sweden, Germany, Romania and Albania. The project finished in 2021. Horizon Europe, the EU’s new 7-year framework programme (2021-2027) for research and innovation, represents the most ambitious research and innovation programme ever and is also open to researchers and small and medium sized enterprises based in the Western Balkans.