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Background: The Rashtriya Bal Swasthya Karyakram (RBSK) was launched in 2013 to screen and manage birth defects, deficiencies, diseases, and developmental delays including disabilities in Indian children, with the help of designated mobile health teams and grassroot workers across the country. Objectives: Performance of the RBSK program in three selected blocks of a health district of a large Indian state (West Bengal) was assessed. Methods: The performance assessment was based on input, process, and output performances, using checklists based on RBSK operational guidelines. Results: While some essential evaluation tools were available in required numbers at the block level, many were unavailable. There were deficiencies in the number of health staff appointed. Although most screening camps were conducted as per microplan, some were not. Anthropometric measurements were not done in some camps; Information, Education, and Communication (IEC) materials were not used adequately. Issues with fund management were also noted. The intervention rate at higher centers (District Early Intervention Centre) was low with regard to the children referred for management. Involvement of grassroot workers such as ASHA was also found to be lacking. Conclusion: Frequent orientation training of medical officers and staff is needed along with the efforts to strengthen the referral system and the patient tracking system. Sensitizing the children and their guardians regarding the importance of the relevant health issues is also needed with the help of the proper implementation of IEC services.
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Introduction : Rashtriya Bal Swasthya Karyakram (RBSK) is a systemic approach of 4‘D’s (Defect, Diseases, Deficiency, Developmental delay) for early identification and linkage with care, support and treatment. (1) Document utilization of RBSK services within a year of referral, (2) Assess reasonsObjectives : for non-utilization of services and (3) Assess out of pocket expenditure (OOPE) among users and non-users of the program. Retrospective Cohort Study was conducted at an Urban Health Centre (UHC) takingMethod: two cohorts of children referred for 4‘D’s during April 2018-March 2020 under RBSK. A total of 102 cases were sampled. Probability Proportionate to size (PPS) method was used to ensure proportionate representation of each of 4‘D’s in the sample. Required number of participants in each category were selected randomly. Out of 102 sampled cases, 97 were covered. Utilization of services was 50.5%; majorResults: reasons for non-utilization were preference for private providers and reluctance to stay at Comprehensive Malnutrition Treatment Centre (CMTC). Mean OOPE in users was Rs. 21545, significantly less (p <.05) than Rs. 70198 in non-users. After referral by RBSK team, only half utilized the services. Among users,Conclusion: OOPE was less for total cost incurred and also for direct cost incurred like consultation charges, medicines, consumables etc. Counselling those parents whose children are detected with any of 4Ds, to visit Child Malnutrition Treatment Center (CMTC)/ District Early Intervention Center (DEIC) remains a challenge.
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Background: Congenital heart disease (CHD) is the most common birth defect and in India, the prevalence is 2.5 to 5/1000 live births. Malnutrition and anemia are common co-morbidities, that determine the outcome in CHD. This study was undertaken to assess the extent of malnutrition and anemia among 1-12-year-old children with CHD.Methods: A total 80 children with CHD, admitted for intervention under the Rashtriya Bal Swasthya Karyakram (RBSK) scheme were enrolled. Nutritional status was assessed using standardized anthropometric measurements. Anemia was estimated using hemoglobin, red cell indices, red cell distribution width and peripheral smear. IEC approval, informed consent and assent from participants were obtained prior to the study. Statistical analysis was performed using SPSS version 19.Results: 2/3rd children were >5-years-old. Acyanotic CHD was more common (81.3%) and 35% had ventricular septal defect. Among cyanotic CHD (18.7%), 13.7% had tetralogy of fallot. In CCHD, there was only one child with normal weight and height. In ACHD, 71% were underweight, 49%, had stunting and 82% had wasting. Anemia was diagnosed in nearly 1/3rd, and iron deficiency was the most common. Even though polycythemia was noted in those with CCHD, increased RDW and reduced red cell indices unmasked iron deficiency.Conclusions: Majority were >5-years-old, due to late referral for intervention. The burden of malnutrition and iron deficiency anemia, that modify the outcome, was very high, Hence, early identification, prompt referral and correction of co-morbidities are of utmost importance, as majority are likely to get surgical/non-surgical interventions under government sponsored schemes like RBSK in India.
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Background: The Rashtriya Bal Swasthya Karyakram (RBSK) program is technically known as Child Health Screening and Early Intervention Services. The main purpose of the program is to detect and manage 4Ds which are prevalent in children. Objective: The objective of the study was to assess the knowledge of ASHA workers as well as anganwadi workers about the RBSK in rural area of District Kathua using semi-structured questionnaire. Materials and Methods: The present study was a cross-sectional descriptive study conducted in the zone Budhi which is a field practice area of the Department of Community Medicine, GMC Kathua. The zone consists of 24 villages with 18 ASHA workers and 35 anganwadi workers and one mobile RBSK team available at Community Health Center, Parole. After obtaining ethical clearance, all the ASHA workers and anganwadi workers were included in the study as they were willing to participate. Results: The present study revealed that majority of the workers were between the age group of 20–40 years. About 71.42% of the anganwadi workers were 12th pass and majority of the ASHA workers were 8th and 10th pass. Majority of the anganwadi workers received training related to RBSK program and knew about the benefits of the RBSK program. About 82.85% of the workers knew about the equipment used by RBSK team members for screening. Conclusion: Anganwadi workers and ASHAs need to be made aware of their perceptions and role in the program so that their efficiency is increased and the percentage of child morbidity and mortality can further be lowered.
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Background: As per World Health Organization (WHO) congenital anomalies are also known as birth defects, congenital disorders or congenital malformations. Most common and severe congenital anomalies are congenital heart diseases, neural tube defect and Down’s syndrome. No data on the magnitude of congenital anomalies is available in India. Thus, the study aims to determine the magnitude and pattern of babies with birth defect reporting at District Early Intervention Center, Bhopal in children aged 0 to 6 years.Methods: This was an observational study conducted at DEIC, Bhopal under Rashtriya Bal Swasthya Karyakram services, over a period of one year. Children between 0 to 6 years visiting the center and belonging to Bhopal district were included in the study. Data entry was by Microsoft Excel and analysis was by Epi info.Results: 2891 children were registered for the study out of affected children 18.7% of them were diagnosed with Developmental delays while birth defect was observed in 4.3% cases. Of the birth defect cases majority i.e. 37.7% had congenital heart disease and 16.7% had congenital hearing loss. No case of retinopathy of prematurity was registered.Conclusions: The study also helps to know the magnitude and pattern of congenital anomalies. Any effective health intervention will reduce both direct costs and out-of-pocket expenditure.
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Background: The objective of this study is to know the gender variation in number of admissions, severity of malnutrition at the time of admission, gaining of weight and adherence to follow up in children admitted to nutrition rehabilitation center and during follow up.Methods: This is a retrospective study involving the review of existing programme records. Children who were admitted to nutrition rehabilitation centre, district hospital, Chamarajanagar, Karnataka, India, between January 2017 to December 2017 with severe acute malnutrition were involved in the study. The programme included 2 weeks of in-patient care, and four follow-up visits to the NRC subsequently as follows; 1st visit at 7 days, 2nd at 14 days, 3rd at 1 month and 4th at 2 months after discharge.Results: Among 57 children who admitted to NRC females were 30 (52.6%) and males 27 47.4%). 25 among 57 children (43.9%) could sustain weight gain of >5grams/kg/day as per one of the discharge criteria. 13 (52%) were females and 12 (48%) were males. 32(56%) among 57 admitted children to NRC, could achieve <-1SD during entire programmed. 15(46.8%) were females and 17 (53.1%) were males.Conclusions: There was no gender variation in either number of admission or severity of malnutrition at the time of admission or weight gain during NRC programme.