Rashtriya Bal Swasthya Karyakram(RBSK) :: VDAI
 
Image of Child suffering with disease
Image of Child suffering with disease
Image of Child suffering with disease
Image of Child suffering with disease
Image of Child suffering with disease
Image of Child suffering with disease
Image of Child suffering with disease
Image of Child suffering with disease
Image of Child suffering with disease
Image of Child suffering with disease

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RASHTRIYA BAL SWASTHYA KARYAKRAM

Under National Rural Health Mission, significant progress has been made in reducing mortality in children . Early detection and management of conditions that were not addressed comprehensively in the past can help in reducing mortality.

According to survey, out of every 100 babies born in this country annually, 6 to 7 have a birth defect. This would translate to around 17 lakhs birth defects annually in the country and accounts for 9.6% of all the newborn deaths.

Various nutritional deficiencies affecting the preschool children range from 4 per cent to 70 per cent. Developmental delays are common in early childhood affecting at least 10 percent of the children. These delays if not intervened timely may lead to permanent disabilities including cognitive, hearing or vision impairment.

Also, there are group of diseases common in children like : dental caries, rheumatic heart disease, reactive airways diseases etc. Early detection and management diseases including deficiencies bring added value in preventing these conditions to progress to its more severe and debilitating form and thereby reducing hospitalization and improving implementation of Right to Education.

Rashtriya Bal Swasthya Karyakram (RBSK) is an important initiative aiming at early identification and early intervention for children from birth to 18 years to cover 4 ‘D’s -> Defects at birth, Deficiencies, Diseases, Development delays including disability.

RBSK consists of team of doctors having 4 members each for different purpose :
     1. Medical officers -1 male and 1 female having a bachelor degree from an approved institution.
     2. ANM/Staff Nurse.
     3. Pharmacist/paramedical with proficiency in computer for data management.

These teams visit different schools for the inspection of children suffering from disease.

RBSK is a good initiative taken by government to make every child healthy and disease free. There are government hospitals where diseased children are taken and cured under doctor's supervision without spending a single penny, this scheme is very successfull as poor people can also get treatment for their child in these hospitals which is not possible without RBSK(Rashtriya Bal Swasthya Karyakram).

Target group under RBSK Child Health Screening and Intervention Service Categories

  1. Babies born at public health facilities and home - Birth to 6 weeks.
  2. Children in rural areas and urban slum preschool- 6 weeks to 6 years.
  3. Children enrolled from class 1st to 12th in government or government aided schools - 6yrs to 18 yrs.

More about RBSK

We had implemented in Uttar Pradesh, an app based artificial intelligence integrated solution for RBSK program in 2017 at district level that was scaled up for state in 2019 and the solution had been working smoothly since then across U.P. covering all the 822 blocks and 1635+ teams. In past 2 years, we focused on inter department coordination and strengthening department schemes for ensuring optimization in RBSK program including developing a module for Government Medical Colleges to allocate slots for surgery cases and generate a line listing for ensuring timely treatment. In ICDS, focus was on red and yellow category children for SAM/MAM identification. And an AI based solution for birth defects tracking at delivery points have piloted in districts so, that life threatening cases could be attended on priority. So, we wish to propose for implementation of an integrated RBSK solution that focuses on RBSK teams work efficiency optimization and defining processes for other departments so, that maximum children coverage could be achieved.

The modules to be covered are as listed below:
  1. RBSK Team Attendance and Vehicle Availability Monitoring
  2. Leave Management
  3. Salary Sheet Generation
  4. Microplan Updation and Information Communication Module for AWC and Schools for RBSK Team Visit
  5. School/AWC Accountability and Children Attendance Module
  6. Referral Monitoring and Tracking Module
  7. Surgery Cases Scheduling to District Hospital and Medical College/Empanelled centers
  8. NRC Referral and Line Listing Tracker and ICDS Red/Yellow category children tracking
  9. Artificial Intelligence based Birth Defects Tracker
  10. Inventory Management for WIFS program
  11. ML/AI based Unique Identifier for children to track development evolution and ensuring that each child is screened at least once a year.
  12. Module for Migrants Children Screening and Tracking
  13. Module for Patient Health Record Tracker

Module 1. to 7. had been implemented across UP state in the RBSK App. Module 8,9,10 and 12 has been piloted across different districts and divisions for optimization so, that it could be integrated in the state solution. Module 11 and 13 is being proposed uniquely for Uttarakhand as we had been operating the RBSK App (Sood Portal) Nainital, Uttarakhand and believe that geographical diversity makes it imperative to implement both the modules in the state.
The solution will be rolled out over a period of 2 years, in 1st year RBSK teams and Health Department optimization is focused and in 2nd year other department’s stabilization is focused upon. This brings a long lasting behavioural change both in RBSK teams and other departments resulting in a sustained change that benefit both workforce through job satisfaction and children’s through free treatment covered under the program.
In Uttar Pradesh, within first three months of solution launch, the treatment case completion had improved from 40%- 70% and is currently 72.45% despite treatment non availability during some of the period in 2020 due to corona. And by year end, all the districts had reported that RBSK team attendance related complains had stopped being reported and each district had observed savings as vehicle reports had become verifiable. Referral identification improved from 3.5% to 6% and is currently at 6.36% despite corona impact as RBSK MHTs performance became track able. By End of second year inter department coordination stabilization had been achieved in majority of districts and at division level. Due to transparent reporting structure all coordinating departments are sincere towards issue faced by RBSK MHT teams resulting in stabilization of program.

A brief about each of the module above is as detailed below:

  1. RBSK Team Attendance and Vehicle Tracking:
    The RBSK team is required to mark their attendance through an app module that includes face pic, geo location, School/AWC name in background, and time stamp, for geo location: triangulation, satellite location and last recorded location is used to calculate current approximate location. An Artificial Intelligence based solution is used to ensure that same employee marks the attendance and any deviations are identified. Thereby ensuring discipline and achieving that team reaches the School/AWC on a daily basis as per the schedule in Microplan. In case vehicle doesn’t arrive on time/absent than RBSK MHTs have an option to report it which results in deduction for service provider. This translates into high vehicle availability.
  2. Leave Management:
    RBSK Team members when on leave have to get approval through the app so, that salary generation process becomes automated thereby ensuring transparency and in turn increasing team efficiency.
  3. Salary Sheet Generation:
    The salary sheet for each employee calculating verified attendance from the app, including leaves and government holidays is generated. Block nodal has the authority to approve it thereby ensuring that authority remains distributed and transparency is also maintained.
  4. Microplan Updation and Information Communication Module:
    for AWC and Schools for RBSK Team Visit: RBSK Teams have to update the proposed daily visit schedule of the AWC and Schools in the block thereby ensuring that schools/AWC know in advance the date, when team will be visiting. Teams have to make call through app to ensure that school/AWC are informed about planned visit. Additionally automated voice and text messages are sent to school/AWC so, that proper information intimation is assured.
  5. School/AWC Accountability and Children Attendance Module:
    It is monitored that on team visit day at least 90%+ students be present so, that the team is able to screen majority of them. As multiple times deviation are observed so, a hierarchy wise structure of monitoring and action taking through Block officer and compliance monitoring by District Officer ensures discipline in Teachers and AWW about team visit.
  6. Referral Monitoring and Tracking Module:
    All the children that are referred by MHT during screening are tracked and their treatment cycle monitored Teachers/AWW are also motivated to encourage children and parents to complete their treatment and in case of delay from CHC/District Hospital/Medical College, accountability of concerned is fixed thereby ensuring that treatment is provided to all.
  7. Surgery Cases Scheduling to District Hospital and Medical College/Empanelled centers:
    Due to logistics issues multiple times surgeries/treatments are delayed resulting in complex situations as parent’s unwillingness to avail treatment or patient suffering complications. Therefore to prioritize and ensure that cases are tracked and monitored a module for District Hospital, Medical Center and Specialized/Empanelled center is implemented to bring all under scrutiny.
  8. NRC Referral and Line Listing Tracker and ICDS Red/Yellow category children tracking:
    NRC referral and active support from ICDS is a continuous issue therefore to ensure it, children in red and yellow category feeded on portal and their health check-up done to identify potential SAM/MAM/Deficiency cases thereby ensuring line listing and continuous referrals in NRC and treatment to others thereby covering extensively children’s in deficiency related health conditions.
  9. Artificial Intelligence based Birth Defects Tracker:
    Birth Defects are a key component of RBSK program but still they are not rigorously covered so, we have implemented a comprehensive IEC solution and an app to monitor birth defects through use of AI.
  10. Inventory Management for WIFS program:
    WIFS program tracking of inventory and dosage is tracked through the solution so, that it ensures that all schools have requisite supply and intake of the dosage.
  11. ML/AI based Unique Identifier for children:
    to track development evolution and ensuring that each child is screened at least once a year. An unique identifier for each children so, that each child could be uniquely identified for the purpose RBSK program screening. As due to duplicity of screening due to migrant nature of families it is an issue observed across states. Therefore to ensure clean data and organized screening, we propose to implement an unique child id tracker.
  12. Module for Migrants Children Screening and Tracking:
    Module for migrants child tracking so, that any duplicity can be tracked and it be ensured that migrant workers children be tracked and ensured that they are provided with requisite medical support.
  13. Module for Patient Health Record Tracker:
    Health Records digitization to avoid duplicity of medical tests and also ensure that patient case history is maintained and is accessible to Health service provider for advising the patients effectively.

S. No. Activity Status in numbers from 1-May-2019 to 01-Mar-2021
1. Total children enrolled 25245141
2. Total cases screened 12573039
3. Total Referral made 799440
4. Total cases screened by RBSK team but not turned up for treatment 217959
5. Total under process 2319
6. Total treatment completed 579162
7. % Referral vs Screening 6.36
8. % Treatment completed vs Referral 72.45


RBSK Disease-wise Status (1-May-2019 to 22-Fab-2021)

  1. Defects of Birth

  2. S.No. Disease Total Referral Referred by RBSK Team but not turned up for treatment Total under process Completed % completed vs Referral
    1 Congenital Heart Diseases 3108 2291 95 722 23.23
    2 Talipes (Club Foot) 3016 1933 81 1002 33.22
    3 Congenital Deafness 2239 1731 61 447 19.96
    4 Cleft Lip & Palate 2175 1293 62 820 37.70
    5 Congenital Cataract 1472 1050 16 406 27.58
    6 Down’s Syndrome 803 584 10 209 26.03
    7 Neural Tube Defect 763 537 25 201 26.34
    8 Developmental Dysplasia Of The Hip 591 415 13 163 27.58
    9 Retinopathy Of Prematurity 145 101 2 42 28.97
    Total 14312 9935 365 4012 28.03
  3. Developmental delays

  4. S.No. Disease Total Referral Referred by RBSK Team but not turned up for treatment Total under process Completed % completed vs Referral
    1 Vision Impairment 130592 37209 530 92853 71.10
    2 Neuro Motor Impairment 4319 3090 50 1179 27.30
    3 Language Delay 3865 2587 28 1250 32.34
    4 Hearing Impairment 2393 1557 24 812 33.93
    5 Motor Delay 1468 953 23 492 33.51
    6 Learning Disorder 1181 822 8 351 29.72
    7 Behaviour Disorder (Autism) 917 678 13 226 24.65
    8 Cognitive Delay 431 314 3 114 26.45
    Total 145331 47306 681 97344 66.98
  5. Disease of Childhood

  6. S.No. Disease Total Referral Referred by RBSK Team but not turned up for treatment Total under process Completed % completed vs Referral
    1 Skin Conditions 201067 40552 547 159968 79.56
    2 Dental Conditions 125495 33930 379 91186 72.66
    3 Otitis Media 97105 25726 217 71162 73.28
    4 Reactive Airway Disease 22129 4165 110 17854 80.68
    5 Convulsive Disorders 3206 1878 26 1302 40.61
    6 Rheumatic Heart Disease 580 317 7 256 44.14
    Total 449582 106568> 1286 341728 76.01
  7. Deficiencies

  8. S.No. Disease Total Referral Referred by RBSK Team but not turned up for treatment Total under process Completed % completed vs Referral
    1 Vitamin A Deficiency (Bitot Spot) 68907 14865 205 53837 78.13
    2 Sam 29692 13444 360 15888 53.51
    3 Severe Anaemia 29121 8048 150 20923 71.85
    4 Vitamin D Deficiency, (Rickets) 5711 1411 25 4275 74.86
    5 Goitre 320 166 4 150 46.88
    Total 133751 37934 744 95073 71.08
  9. Adolescent Health

  10. S.No. Disease Total Referral Referred by RBSK Team but not turned up for treatment Total under process Completed % completed vs Referral
    1 Pain During Menstruation 6589 1380 50 5159 78.30
    2 Discharge/ Foul Smelling Discharge From The Genitor-urinary Area 4955 1050 39 3866 78.02
    3 Irregular Periods 4043 986 39 3018 74.65
    4 Delay In Menstruation Cycles 1938 475 14 1449 74.77
    5 Pain Or Burning Sensation While Urinating 1157 249 2 906 78.31
    6 Substance Abuse 699 186 0 513 73.39
    7 Growing Up Concerns 592 261 2 329 55.57
    8 Feel Depressed 365 66 0 299 81.92
    Total 20338 4653 146 15539 76.40
  11. Others

  12. S.No. Disease Total Referral Referred by RBSK Team but not turned up for treatment Total under process Completed % completed vs Referral
    1 Others 31410 9014 105 22291 70.97
    2 Severe Thinning 2665 1025 17 1623 60.90
    3 Obesity 347 146 1 200
    4 Macrocephaly 29 24 2 3 10.34
    5 Microcephaly 15 12 1 2 13.33
    Total 344466 10221 126 24119 69.98

Grand Total

S.No. Disease Total Referral Referred by RBSK Team but not turned up for treatment Total under process Completed % completed vs Referral
Grand Total 797780 216617 3348 577815 72.13
app screenshots
01.

Our Efforts..

Our UP RBSK APP is implemented and working in U.P. state. It makes easy tracking of child suffering from disease and helps him/her to fight with it by providing the required treatment from doctors.

All pre-school children below 6 years of age would be screened by our up rbsk app used by teams for deficiencies, diseases, developmental delays at the Anganwadi/school centre. For developmental delays children would be screened using age specific tools and those suspected would be referred to DEIC for further management..

web portal screenshots
02.

Our RBSK Web portal..

Website of UP RBSK is designed for day to day tracking of diseases spread at different districts and create schedule for team of doctors to inspect and cure diseases in every possible manner.

Pending Cases, Referral Cases, Screening Cases etc. can be seen and updated by desired officer. This Up RBSK website also uses Artificial Intelligence (AI) for the identification of fake records if any.



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117/H-2/136,Pandu Nagar,
Kanpur,Uttar Pradesh,
India


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vdaibiosec@gmail.com

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