It is known that good hearing is essential for the learning ability of children, and untreated hearing loss is a big challenge throughout the entire world. Hearing screening of school aged children is essential to detect those with hearing challenges, but current tools often require skilled personnel and specialized equipment. This is especially problematic in low-income countries, and the consequence is often that no systematic hearing screening is performed. Many children will therefore go undetected, leading to both reduced learning outcome and even school drop-out. Low-cost hearing screening tools that can be used by non-skilled personnel is therefore one step towards a better situation for many children. This is directly related to the UN sustainable development goals on "quality education" (goal 4), "good health and well-being" (goal 3) and will eventually also reduce poverty (goal 1). There are, however, several challenges that needs to be solved before such hearing screening tool will work as intended. In an ongoing research project, a game-based hearing screening tool is being developed, using relatively cheap off the shelf equipment. The hearing test uses an automatic procedure to determine the hearing threshold of the test subjects, and the game concept is that animal sounds are presented and the test subject should push an animal to give a response. An iterative process has been used to develop the tool, and several challenges have been discovered throughout the development phase. The goal is to come up with a screening tool that can be used locally at schools by non-trained personnel, and the results from the tool will be used in a decision support system that can give guidance to what measures should be initiated. These measures can for instance be direct interventions such as removal of cerumen and treatment of ear infections, information to the teachers about how the child can be helped to get a better speech signal and use of assistive technology (hearing aids and personal amplifiers). The latter is, however, often a challenge in low-income countries because of both expensive equipment and lack of technical support. The presentation will give a technical description of the hearing screening tool and discuss the choices that have been made and the consequences of them. Additionally, the experiences gained throughout the iterative process, and results showing how the screening tool performs will be shown.