Publication:

Coverage gaps in child health screening under Rashtriya Bal Swasthya Karyakram: a Tanahashi framework analysis using national and state-level data from India

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.