What is Rashtriya Bal Suraksha Karyakram (RBSK)?

Rashtriya Bal Swasthya Karyakram (RBSK): A Comprehensive Child Health Screening and Early Intervention Program

Rashtriya Bal Swasthya Karyakram (RBSK) is a national healthcare program launched in 2013 by India's Ministry of Health and Family Welfare that provides community-level screening, early identification, and management of health conditions in children from birth to 18 years of age, focusing on improving quality of life through early intervention at zero expense to families.

Core Components of RBSK

Target Population and Focus Areas

• Covers children from birth to 18 years of age
• Addresses health conditions categorized under "4Ds":
  • Defects at birth (primarily congenital defects, especially heart defects) 1, 2
  • Diseases (chronic conditions) 1, 3
  • Deficiencies (nutritional and other deficiencies including severe anemia and malnutrition) 2, 3
  • Developmental delays and disabilities 1, 3

Screening Approach

• Newborns: Screened at delivery points or at home under the Home-Based Newborn Care package 1
• Pre-school children: Evaluated at anganwadi centers by mobile health teams using standardized tools 1
• School-aged children: Screened at schools by mobile health teams 1, 3
• Screening teams: Dedicated 4-member Mobile Health teams conduct community screening 3

Service Delivery Structure

• District Early Intervention Centers (DEICs):
  • Staffed with 14-member multidisciplinary teams 3
  • Use evidence-based, trans-disciplinary, collaborative approach 1
  • Provide comprehensive management at zero expense to families 1, 4
• Referral System: Children identified with health conditions are referred to higher centers for specialized care 2, 5
• Mobile Health Teams: Over 11,000 teams have been established for community-level screening 1

Program Achievements

• Infrastructure Development:

  • 234 District Early Intervention Centers established 1
  • 2 Nodal Collaborating Centers developed (the Kolkata center has trained 852 personnel) 1
  • 11,000 mobile health teams formed 1

• Screening Coverage (2014-2020):

  • Cumulatively screened over 45.64 crore (456.4 million) children under 6 years 1
  • Identified 13.95 lakh (1.395 million) delays/disabilities 1
  • Managed 3.04 lakh (304,000) children appropriately 1

• Client Satisfaction:

  • 82.6% of service users rated RBSK services as "very good" or "good" 2
  • 81.7% of children had good Quality of Life outcomes after intervention 2

Supplementary Initiatives

• Journey of First 1000 days: Booklet promoting healthy family practices during pregnancy and first two years 1
• Ayushman Bhava: Android app supporting child development 1
• ECD call centers: Provide individualized counseling for queries 1
• LaQshya program: Promotes mother-friendly labor 1
• Mother and Child Protection Card: Assists in developmental monitoring 1

Implementation Challenges

• Resource Deficiencies:

  • Shortage of proper infrastructure and equipment 5, 4
  • Deficiencies in the number of health staff appointed 5
  • Issues with fund management 5

• Service Delivery Gaps:

  • Low intervention rate at higher centers relative to referrals 5
  • Inadequate use of Information, Education, and Communication (IEC) materials 5
  • Limited involvement of grassroot workers like ASHAs 5

• Operational Challenges:

  • Inadequate capacity building and training 4
  • Administrative bottlenecks 4
  • Limited supportive supervision 4
  • Awareness deficit among communities 4

Future Directions

• Further expansion of services and centers 1
• Development of state-of-the-art specialized centers 1
• Collaborative research initiatives 1
• Self-sustaining capacity building of multi-disciplinary personnel 1
• Need for frequent orientation training of medical officers and staff 5
• Strengthening the referral system and patient tracking system 5
• Enhanced sensitization of children and guardians regarding health issues 5
• Ensuring continuous flow of logistics and appropriate awareness building 4

RBSK represents a significant step toward universal healthcare for children in India, with its comprehensive approach to early identification and intervention for a wide range of health conditions that can impact child development and quality of life.