Introduction
- Flagship programme launched February 2013 under National Health Mission (NHM), Ministry of Health & Family Welfare
- Comprehensive child health screening and early intervention services for 0–18 years
- Aims to screen ~27 crore children for selected 32 conditions under 4 ‘D’s framework
- Free diagnosis, treatment, surgery, rehabilitation and follow-up to reduce disability and out-of-pocket expenditure
Objectives
- Early detection and management of Defects at birth, Deficiencies, Diseases, Developmental delays & disabilities (4 ‘D’s)
- Continuum of care from community to District Early Intervention Centre (DEIC) to tertiary level
- Improve quality of life and reduce long-term morbidity/mortality burden
Target Population
- All children 0–18 years
- Newborns at delivery points and home (HBNC/HBYC)
- 0–6 years at Anganwadi Centres
- 6–18 years at government and government-aided schools
The 4 ‘D’s and 32 Conditions
1. Defects at Birth (9 Conditions)
These are conditions identified at delivery points or through newborn screening:
- Neural Tube Defect
- Down’s Syndrome
- Cleft Lip & Palate (or Cleft Palate alone)
- Talipes (Club Foot)
- Developmental Dysplasia of the Hip
- Congenital Cataract
- Congenital Deafness
- Congenital Heart Disease
- Retinopathy of Prematurity (ROP)
2. Deficiencies (5 Conditions)
Common nutritional deficiencies identified during community and school screening:
- Anaemia (especially Severe Anaemia)
- Vitamin A Deficiency (Bitot’s Spot)
- Vitamin D Deficiency (Rickets)
- Severe Acute Malnutrition (SAM)
- Goiter
3. Childhood Diseases (6 Conditions)
Six common pediatric illnesses covered for treatment and management:
- Skin conditions (Scabies, Fungal Infection, and Eczema)
- Otitis Media
- Rheumatic Heart Disease
- Reactive Airway Disease (e.g., Asthma)
- Dental Caries
- Convulsive Disorders (e.g., Epilepsy)
4. Developmental Delays & Disabilities (9 Conditions)
Conditions affecting physical, cognitive, or behavioral development:
- Vision Impairment
- Hearing Impairment
- Neuro-motor Impairment
- Motor Delay
- Cognitive Delay
- Language Delay
- Behavior Disorder (Autism)
- Learning Disorder
- Attention Deficit Hyperactivity Disorder (ADHD)
5. Optional/State-Specific Conditions (3 Conditions)
States have the flexibility to include these based on local epidemiological needs:
- Congenital Hypothyroidism
- Sickle Cell Anaemia
- Beta Thalassemia
Screening Strategies
- Newborn screening at delivery points and home by ASHA
- Community-based screening (0–6 years) by Mobile Health Teams (MHT) twice yearly at Anganwadi Centres
- School-based screening (6–18 years) by MHT once yearly
- Use of standardized checklists, growth charts and age-appropriate developmental tools
- Convergence with Ministry of Women & Child Development and Ministry of Education
Implementation Mechanism
- Mobile Health Teams (MHT): One team per block (2 AYUSH doctors – male & female, 1 ANM/GNM, 1 Pharmacist); screen 100–110 children/day; issue referral cards
- Referral pathway: Positive cases referred to DEIC or higher centres
District Early Intervention Centre (DEIC)
- One per district at district hospital
- Multidisciplinary team: Pediatrician, Dentist, Psychologist, Physiotherapist, Speech therapist, Occupational therapist, Audiologist, Optometrist, Lab technician, Early interventionist
- Functions: Confirmation of diagnosis, multidisciplinary assessment, early intervention therapies, provision of assistive devices, counseling and follow-up
- Referral to tertiary centres for surgery/rehabilitation (free under RBSK)
Management
- All services free of cost (medical, surgical, rehabilitative)
- Empanelment of private providers where public facilities insufficient
- Integration with RBSK 2.0 (2026): Expanded to mental health, behavioral issues, NCD risk factors; digital health cards and real-time tracking via ABDM
Recent Developments (RBSK 2.0 – 2026)
- Lifecycle approach with continuous care
- Strengthened digital linkage with ABDM/ABHA and U-WIN
- Enhanced focus on community follow-up and multi-sectoral convergence