Rashtriya Bal Swasthya Karyakram (RBSK) : Details & Objectives

Rashtriya Bal Swasthya Karyakram

Rashtriya Bal Swasthya Karyakram is an initiative taken into action to provide comprehensive healthcare and improve the quality of life of children. This is achieved through early detection of birth defects, diseases, deficiencies and development delays including disability. Rashtriya Bal Swasthya Karyakram aims at screening over 27 Crore children from 0 to 18 years of age for 4’D’s. Children diagnosed with any of the illnesses will receive treatment including surgeries at tertiary level at free-of-cost under NRHM.

About Rashtriya Bal Swasthya Karyakram

Rashtriya Bal Swasthya Karyakram

Health initiative named as ‘Rashtriya Bal Swasthya Karyakram’ was launched by UPA Government in February 2013. It is technically called as ‘Child Health Screening and Early Intervention Services’. This programme has been launched under National Rural Health Mission initiated by the Ministry of Health and Family Welfare. The scheme aims at early detection and management of the 4’D’s prevalent in children. These include:

  • Defects at Birth
  • Diseases in Children
  • Deficiency conditions
  • Developmental Delays including Disabilities

Key Features of Rashtriya Bal Swasthya Karyakram

  • It covers all the districts of the country in a phased manner, with a target to cover over 27 crore children.
  • Under this scheme, the children are screened for 30 common health conditions, so as to ensure possibility of early medical intervention if it is required.
  • The children will be screened for the birth defects like Down syndrome, congenital cataract, deafness and heart defect, deficiency conditions like anaemia, malnutrition and goitre, developmental delays and disabilities like hearing impairment and vision impairment
  • Screening of the children will be done by the Mobile health teams and two AYUSH doctors (one male and one female), nurse and a pharmacist would be available for the service in every block.
  • All children ranging between 0-6 years of age will be enrolled in anganwadis would be screened at least twice a year; all children in government schools and in schools aided by the government would also be regularly screened for the above mentioned conditions.
  • Newborn children will also be screened for possible birth defects in health centers where deliveries take place.
  • Children with deficiencies, disabilities or diseases would be referred to higher centres for further investigation and treatment if required.

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Age Group Covered Under The Scheme

The services aim to cover children of 0 -6  years of  age  in  rural  areas  and  urban  slums  in addition  to  children  enrolled  in  classes  I to XII in  Government  and  Government  aided  Schools. The children have been grouped in to three categories owing to the fact that different sets of tools would be used for different sets of children and also different set of conditions could be prioritized. It is to ensure that these services will reach to about 27 Crores children in a phased manner. The broad category of age group and estimated beneficiary is shown in the given below:

Target group under Child Health Screening and Intervention Service Categories
Categories Age Group Estimated Coverage
Babies born at public health
facilities and home
Birth to 6 weeks 2 crores
Preschool children in rural areas  and urban slum 6weeks to 6 years 8 crores
School  children  enrolled  in  class  1st and  12th in government and
government aided schools
6yrs to 18 yrs 17 crores

The screening for the health Condition is carefully done under the scheme through a well-qualified team of doctors and nurses. The formation of team is also a well strategized plan for the success of the scheme. Therefore, the mobile health team will consist of four members- two Doctors (AYUSH) one male and one female, at least with a bachelor degree from an approved institution, one ANM/Staff Nurse and one Pharmacist with proficiency in computer for data management.

Composition of Mobile Health Team

Suggested Composition of Mobile Health Team.
S.No. Member Number
1 Medical officers (AYUSH) -1male and 1 female at least with a bachelor degree from an approved institution 2
2 ANM/Staff Nurse 1
3 Pharmacist with proficiency in computer for data management 1

Health Conditions To Be Screened

  • Child Health Screening and Early Intervention Services under RBSK has decided to cover 30 selected health conditions for screening, early detection and free management.
  • States and Union Territories may also include diseases namely hypothyroidism, Sickle cell anemia and Beta Thalassemia based on epidemiological situation and availability of testing and specialized support facilities.
  • The health conditions screened are categorized into different categories for the ease of propagation of the scheme. These conditions in categorized manner are given as follows:

Defects At Birth

  • Neural tube defect
  • Down ’s syndrome
  • Congenital heart diseases
  • Cleft Lip & Palate / Cleft palate alone
  • Talipes (club foot)
  • Developmental dysplasia of the hip
  • Congenital cataract
  • Congenital deafness
  • Retinopathy of Prematurity

Deficiencies

  • Anaemia especially severe anaemia
  • Vitamin A deficiency (Bitot spot)
  • Vitamin D Deficiency, (Rickets)
  • Severe Acute Malnutrition
  • Goiter

Childhood Diseases

  • Skin conditions (Scabies, fungal infection and Eczema)
  • Otitis Media
  • Rheumatic heart disease
  • Reactive airway disease
  • .Dental conditions
  • Convulsive disorders

Developmental delays and Disabilities

  • Vision Impairment
  • Hearing Impairment
  • Neuro-motor Impairment
  • Motor delay
  • Cognitive delay
  • Language delay
  • Behavior disorder (Autism)
  • Learning disorder
  • Attention deficit hyperactivity disorder

Mechanisms For Screening At Community & Facility Level

Child screening under RBSK is at two levels community level and facility level.  While facility  based  new  born  screening  at  public  health  facilities  like  PHCs / CHCs/ DH, will be by existing health manpower like Medical Officers, Staff Nurses & ANMs, the community level screening  will be conducted  by  the  Mobile health teams  at  Anganwadi  Centres  and  Government and Government aided Schools.

  • Screening at Anganwadi Centre

All pre-school children below 6 years of age would be screened by Mobile Block Health teams for deficiencies, diseases, developmental delays including disability at the Anganwadi Centre at least twice a year.

  • Screening at Schools – Government and Government aided

School children age 6 to 18 years would be screened by Mobile Health teams for deficiencies, diseases, developmental delays including disability, adolescent health at the local schools at least once a year.

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