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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.

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.

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

1. Defects of Birth

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

2. Developmental delays

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

3. Disease of Childhood

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

4. Deficiencies

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

5. Adolescent Health

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

6. Others

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