In February 2013, Rashtriya Bal Swasthya Karyakram (RBSK), a Child Health Screening and Early Intervention Services Programme to provide comprehensive care to all the children (from birth to 18 years of age) in the community. The objective of this ambitious programme is to improve the overall quality of life of children through early detection and management of birth Defects, Diseases, Deficiencies, Developmental Delays including Disability (4Ds) and provision of universal health care to children from birth to 18 years of age.All the children identified with any of the 4Ds will be given medical as well a s surgical treatment free of cost.
The program has huge potential to alleviate future suffering of these children in the state, in general and those from rural areas, in particular, as equitable child health care. Moreover it will also reduce the out of pocket expenditure of the poor families spent on the treatment of health conditions in childhood.
Haryana becomes the second state after Maharashtra to roll out this program in India.
The program includes two major components:-
The program outline the following mechanism to reach the target group of children for health screening-
For new born:
Facility based newborn screening at public health facilities, by existing health functionaries.
Community based newborn screening at home through ASHAs for newborn till 6 weeks of age during home visits.
For children (6 weeks to 6 years and 6 to 18 years):
Dedicated Mobile health team (consisting of AYUSH doctors (One Male and One Female), one pharmacist and one ANM) will screen the children in Anganwadi Centers, Government and Government aided school with help of screening tools.
2. REFERRAL AND MANAGEMENT
At District Early Intervention Centre (DEIC) at District level and other Govt. health facilities health depending upon the condition of the child.
Establishment of District Early Intervention centre
A District early intervention centre (DEIC) for management and treatment of the cases is being established at all the District hospitals. A team consisting of health professionals will be engaged to provide services.
The purpose of Early Intervention Center is to provide referral support to children detected with health conditions during health screening by the teams as well as the health staff posted at the delivery points.
The doctors of DEIC (Pediatrician and Medical officer) will visit all newborns delivered at the District Hospital, including those admitted in SNCU, postnatal and children wards for screening all newborns irrespective of their sickness for hearing, vision, congenital heart disease and birth defects before discharge .
Every child born sick or preterm or with low birth weight or any birth defect is followed up at the District Early Intervention Center .All the referrals for developmental delay are followed and records will be maintained.
For the children requiring tertiary level care linkages will be established from the renowned govt. health institutes.
Management of the identified cases
All the children identified with Defects at birth, Diseases, Deficiencies, Developmental Delays including Disability (4Ds) will be given treatment at the govt. health facilities in Haryana free of cost and those requiring tertiary level care will be referred for further treatment at the approved tertiary level centers (PGIMER,Chandigarh,GMCH-32 Chandigarh, PGIMS ,Rohtak and AIIMS, New Delhi).
Management of Children with Disability
Disability Camps are held in various districts of Haryana at level of Education blocks for all the children with special needs studying in Govt. schools in convergence with SSA (Sarv Shiksha Abhiyan) and RMSA (Rashtriya Madhyamik Shiksha Abhiyan), Haryana .In these camps children with special needs are examined, issued disability certificates, assessment is done for provision of aids and appliances which are issued by SSA and RMSA. Children requiring corrective surgeries are further referred for treatment.