Abstract

Bijaya Kumar Panigrahy*, Kaushik Mishra, Arakhita Swain and Saiprasanna Behera

ABSTRACT

Background: With a child population of over 400 million, India has the largest number of children between the ages of 0-18 years globally. India contributes 20% to global child deaths. Govt. of India introduced several health programmes over years to address country’s poor health and survival status Rashitrya Bal Swasthya Karyakram (RBSK) is a newly launched programme under NHM aiming at child health screening, early identification and early intervention for children from birth to 18 years of age to cover 4DS vis. Defects of birth, deficiencies, Diseases, developmental delays including Disabilities, free of cost. Objective: To evaluate the functioning and infrastructure of mobile health teams and DEIC (District Early Intervention Centre) at Koraput District in Odisha under Rashitrya Bal Swasthya Karyakram (RBSK). Materials and Methods: It is a retrospective cross-sectional study for a period of 4 years i.e. form 2014-15 to 2017-18. Different data regarding the activities of MHTs and DEIC were collected from RBSK Manager and Data Entry Operator of DEIC. After compilation of 4 years data, functioning and infrastructure of DEIC was evaluated. Result: DEIC and MHTs under RBSK, Koraput is deficient in both human resources and infrastructure. 87% of 0-18 year children were screened by MHTS out of which 8% of children with 4Ds were referred to DEIC. Out of all referred cases 52% of Birth defects, 43% of developmental Delays including disabilities, were treated and supported by DEIC. 66% of children with various diseases and 70% of children suffering from deficiencies were treated at CHCs by MHTs and also at DEIC. Newborn screening at DPs was 82%. 61% of newborns discharged from SNCU were screened at DEIC. Total achievement of RBSK Programme includes 254 cases of clubfoot correction, 157 cases of clef flip and clef palate repair, 76 cases of congenital cataract surgery, 36 cases of CHD management, distribution of hearing aids to 387 children, distribution of spectacles to 1538 school children with refractory error and referral of 530 SAM children to different NRCs. Conclusion: RBSK Programme provided an effective platform for early screening of 0-18 year children for 4Ds. Deficiency of staffs need to be filled up to make still more effective. Infrastructure should also be strengthened. Referral system should be strengthened for early intervention for congenital heart diseases and NTDs. Capacity building and awareness of health care providers at DPs should be undertaken for screening of birth defects. SNCU staffs need orientation for referring all newborn babies discharged from SNCU to attend DEIC for screening and follow up. Each baby discharged from SNCU should be tracked for regular follow up.