Coverage gaps in child health screening under Rashtriya Bal Swasthya Karyakram: a Tanahashi framework analysis using national and state-level data from India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20261431Keywords:
RBSK, Tanahashi model, Child health services, Program evaluation, Coverage gap, IndiaAbstract
Background: Childhood conditions, including congenital anomalies and developmental delays, are significant contributors to morbidity in India. To address these challenges, the Rashtriya Bal Swasthya Karyakram (RBSK) was initiated under the national health mission for the early detection and management of health issues through widespread screenings of children aged 0 to 18 years. However, limited evidence exists regarding the program's overall effectiveness. This study aims to assess coverage gaps in the implementation of RBSK using the Tanahashi model and to evaluate key program indicators at both national and state levels.
Methods: We conducted a secondary data analysis based on reports from the ministry of health and family welfare, the national health mission, and parliamentary records. Program indicators were mapped according to the Tanahashi coverage stages: availability, accessibility, contact coverage, detection, and care, with a particular focus on Andhra Pradesh.
Results: Between 2014 and 2024, approximately 160.84 crore screenings were performed under RBSK, achieving coverage of nearly 60% of the target population. The detection rate stood at 7.4%, revealing that 11.90 crore children were identified with health issues; however, only 5.64 crore (47.4%) received further care, indicating a significant treatment gap. Furthermore, there were 430 district early intervention centres (DEICs) across approximately 53.75% of districts. In Andhra Pradesh, while screening trends were observed, data regarding referrals and treatments were insufficient.
Conclusions: Although RBSK has realized considerable screening coverage, substantial gaps persist in service availability and effective care delivery. It is essential to strengthen referral pathways and enhance diagnostic and treatment capacities to ensure that children identified through screenings receive timely and appropriate care.
References
March of Dimes global report on birth defects: The hidden toll of dying and disabled children-Alignmnh. Available at: https://www.alignmnh.org/resource/march-of-dimes-global-report-on-birth-defects-the-hidden-toll-of-dying-and-disabled-children/. Accessed on 17 March 2026.
Shonkoff JP, Phillips DA. From neurons to neighborhoods: the science of early childhood development. Washington, DC: National Academy Press. 2000.
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427-51. DOI: https://doi.org/10.1016/S0140-6736(13)60937-X
World Health Organization. Birth defects: report. Available at: https://iris.who.int/handle/10665/75355. Accessed on 17 March 2026.
National Health Mission. Operational guidelines. Available at: https://nhm.gov.in/index1.php?Lang=1&level=5&sublinkid=1193&lid=372. Accessed on 17 March 2026.
National Health Mission. Rashtriya Bal Swasthya Karyakram. Available from: https://nhm.gov.in/index4.php?Lang=1&level=0&linkid=499&lid=773. Accessed on 17 March 2026.
S AS, R AKS, Sundar JS. Insights of Rashtriya Bal Swasthya Karyakram: a strength, weaknesses, opportunities, and threats analysis. Int J Community Med Public Health. 2022;9:4279. DOI: https://doi.org/10.18203/2394-6040.ijcmph20222926
Kar A, Radhakrishnan B, Girase T, Ujagare D, Patil A. Community-Based Screening and Early Intervention for Birth Defects and Developmental Disabilities: Lessons from the RBSK Programme in India. Disabil CBR Inclusive Develop. 2020;31(1):30. DOI: https://doi.org/10.5463/dcid.v31i1.890
Tanahashi T. Health service coverage and its evaluation. Bull World Heal Organ. 1978;56(2):295.
Ministry of Health and Family Welfare, Government of India. Rashtriya Bal Swasthya Karyakram. Lok Sabha starred question no. 174. 2024.
Ministry of Health and Family Welfare, Government of India. Update on the Rashtriya Bal Swasthya Karyakram (RBSK). Available at: https://www.mohfw.gov.in/?Q=en/pressrelease-207. Accessed on 17 March 2026.
National Health Mission. Annual reports. Available at: https://nhm.gov.in/index1.php?Lang=1&level=3&sublinkid=957&lid=405. Accessed on 17 March 2026.
UNICEF. UN inter-agency group for child mortality estimation (UN IGME). Available at: https://data.unicef.org/resources/un-inter-agency-group-for-child-mortality-estimation-unigme/. Accessed on 17 March 2026.
National Portal of India. Ayushman Bharat: Pradhan Mantri Jan Arogya Yojana. Available at: https://www.india.gov.in/spotlight/details/ayushman-bharat-pradhan-mantri-jan-arogya-yojana. Accessed on 17 March 2026.
World Health Organization. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva: World Health Organization; 2010.
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