National Health Mission Govt. of uttarakhand

RBSK Programme

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Rashtriya Bal Swasthya Karyakram (RBSK)

The ‘Child Health Screening and Early Intervention Services’ programme under NHM aims at early detection and management of the 4Ds prevalent in children. These are Defects at Birth, Diseases in children, Deficiency conditions and Developmental Delays including Disabilities. Comprehensive Child Health screening and management as a public health approach assures a package of health services for all children from birth to 18 years of age under the Rashtriya Bal Swasthya Karyakram (RBSK) initiative. Timely intervention has reported reduction in out-of –pocket expenditure of the poor and the marginalized population in the State. Additionally, the child health screening and early intervention services also provide epidemiological data on the 4Ds (i.e. Defects at birth, Diseases, Deficiencies and Developmental Delays including Disabilities). Such a data is expected to hold relevance for futures planning of area specific services. There are also groups of diseases which are very common in children e.g. dental caries, otitis media, rheumatic heart disease and reactive airways which can be cured if detected early. It is understood that early intervention and management can prevent these conditions to progress into more severe and debilitating forms, thereby reducing hospitalization and resulting in improved school attendance.

RBSK is being implemented in Uttarakhand State since 2012-13 in convergence with education, ICDS, Social Welfare and other departments. Since 2012-13, this programme is being implemented through a dedicated Mobile health team (MHT) which includes two AYUSH MO’s (01 male & 01 female), one Pharmacist, and one ANM/Staff Nurse at block level. One/two RBSK Managers are also positioned at District level to facilitate the block MHTs and the task of monthly report compilation. 

Currently, State of Uttarakhand has 148 MHTs covering a population of approximately 21 lakhs under the age group of 0–18 years per year in all the 13 districts as part of RBSK field plans. MHTs are regularly visiting 17966 schools and 20074 AWCs located in difficult terrains of the state as part of their monthly/annual plans. Institutions empanelled for conducting surgeries for birth defects are Doon Medical College & Hospital, AIIMS Rishikesh, HIHT Jollygrant, SRMS Bareilly. Three NGOs namely CURE International, Mission Smile and Smile Train are also engaged to conduct these surgeries. Children referred to secondary and tertiary care hospitals for surgeries need to travel quite a long distance from the upper Himalayas districts to Dehradun which also leads to high out-of-pocket expenditure on families. To address this prevailing issue, State had proposed free transportation services in FY 21-22 which got approved by GOI. Now all children are getting benefits of free transportation.

MHTs have also contributed in village level screening for 0-18 years children and other COVID-19 duties with all Covid protocol in FY 2020 -21 and 2021-22. A total of 11,59,417 children got screened between FY 2020 to 2022 and 384 children undergone surgeries/implants for birth defects. In FY 2022-23 till May 2022 a total of 2,73,757 children got screened and 108 children undergone surgeries/implants for birth defects 

Under the RBSK Program 4Ds are covered :

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