Congenital hypothyroidism (CH) is the most prevalent congenital endocrine condition in children.^1,2) Thyroid hormones are essential in growth and neurological development, especially during the first years of life. Thus hypothyroid screening during childbirth can prevent mental retardation and disability.³⁾

The global prevalence of CH is 1 per 3000 to 4000 births.^1,2) In Indonesia, the incidence of CH is estimated to be higher than the existing data.⁴⁾ The prevalence in Indonesia is 1 per 2513 birth, based on CH screening in 14 provinces. CH rarely manifests during childbirth and becomes misdiagnosed if not screened.⁵⁾ However, neonatal CH screening in Indonesia has not been implemented nationally, only in selected regions and hospitals.⁴⁾ Hence, CH often goes undetected and is found too late.⁶⁾

The newborn screening program for CH has been mandatory by the Minister of Health of the Republic of Indonesia since 2014. However, the implementation is still challenging due to the screening not being covered by universal health insurance.⁷⁾

The first level of health facility (Public Health Center or Puskesmas) plays a vital role in the Congenital Hypothyroid Screening program. Puskesmas not only does the specimen collection and examination, but also provides communication, information, education, follow-up on screening results, diagnosis, management, case monitoring, organization, and program monitoring-evaluation.⁸⁾ This study aims to increase the awareness and knowledge of CH and Congenital Hypothyroid Screening programs among primary healthcare professionals.

In this study, a pre-posttest design was used in order to assess the healthcare in their awareness of congenital hypothyroid screening for newborns. Congenital hypothyroid screening for newborn instruction was delivered through online meetings with experts as part of the strategy. Indonesian Bahasa was used to teach health education through seminars and group discussions. Participants took a pre-test evaluating their general knowledge of congenital hypothyroid screening for newborns before the interven-tion. A post-test was taken once the intervention was over. Volunteers from Indonesian healthcare facilities in East Java (Driyorejo Public Health Center, Gresik) were made the study’s sample. The following criteria were used to determine inclusion: age above 18, communication skills, and willingness to participate in a survey. Consent from participants was gained in advance using consecutive sampling. This project received ethical clearance from the connected university under number 138/EC/KEPK/FKUA/2022. In this study, samples’ age, gender, employment status, and educational background were recorded via an online self-reported questionnaire that participants completed. Using a self-created questionnaire based on our previous study, participants’ knowledge of the fundamentals of congenital hypothyroid screening in the newborn was assessed.

This study had 53 participants and of them there were doctors totaling 9/53 (16.98%). Among 53 participants, most of them were Diploma degree and also 1 doctoral degree. The least participant is from the pharmacist (Table 1).

There was an improvement in the posttest score compared to the pretest where previously there were 23/53 (43.40%) participants who scored poorly in the pretest and increased in the posttest to 26 (49.06%) participants who scored well (Tables 2, 3). The data acquired is p <0.05, which indicates that there has been an increase in the average data from the pretest to the post-test. Using the Paired Sample test, we demonstrate that the participant scores have significantly increased.

The detail of the questionnaire is described in Table 4.

This study showed that education should be viewed as an important factor in empowerment for all healthcare. This approach should enable all healthcare to use knowledge and practical skills in a newborn screening program of CH for better care. The clinical manifestation of CH, which is undetected at or around birth, occurs too late for treatment to reverse the resulting mental and growth retardation. CH may not be detected at all in many neonates, which places an unwarranted financial, social, and medical burden on the family. Infants who receive early diagnosis and treatment typically grow up without mental disabilities and can contribute positively to society. With effective screening, the newborn with CH can be diagnosed early and treated early about their disease.⁹⁾

From the result, we can also see that the subject mostly were female at the age around 38, and mostly of their job were nurses where it was also reported in a previous journal in Brazil that it was known that many of their subjects were female caregivers who were more concerned with pediatric patients because many of them also had children.¹⁰⁾

Our study showed significant gains in knowledge and attitude following counseling in a healthcare unit. In previous study, there was a comparable improvement in attitude was shown with CH screening for newborn tests. The results also led to a comparable modification in practice.¹¹⁾

This result also shows that there was a difference in the pretest and post-test scores in subjects after being given education about the importance of newborn screening for CH, it was intended that pediatric patients suffering from CH can be treated early. This was also stated in another journal where there was a significant difference in the quality of life of a child with CH in which one of them was given early treatment after newborn screening was done compared to children who already have symptoms of hypothyroidism and had just been treated.¹²⁾

In conclusion, the findings of several studies highlight the difficulties healthcare faces in screening for CH in newborns. Although this course of screening is simple, it may not provide adequate education. According to the data presented, that well-educated healthcare with essential information about CH in newborns and its screening processes present higher chances of early screening of CH in newborns.