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CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2021; 57(04): 237-243
DOI: 10.1055/s-0041-1739032
Original Article

Challenges, Barriers, and Good Practices in the Implementation of Rashtriya Bal Swasthya Karyakram in Jodhpur, India

Niraj Kumar
1   School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Nitin Kumar Joshi
1   School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Yogesh Kumar Jain 
1   School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Kuldeep Singh
1   School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Pankaj Bhardwaj
2   Department of Community Medicine and Family Medicine, School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Praveen Suthar
1   School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Balwant Manda
3   Chief Medical and Health Officer, Jodhpur, Rajasthan, India
,
Ravi Kirti
4   District Early Intervention Centers, Rashtriya Bal Swasthya Karyakram, Jodhpur, Rajasthan, India
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Abstract

Introduction The Rashtriya Bal Swasthya Karyakram of the Government of India subsumes the existing school health program to provide care and treatment to children below 18 years through screening and early interventions. Benefitting an estimated 270 million children for 30 preidentified conditions is a step toward “health for all.” Although the program is running since 2013, due to paucity of studies particularly in Thar desert region and its associated challenges, this study was planned to assess challenges and good practices in the implementation of RBSK in Jodhpur.

Objectives To assess the challenges, barriers, and good practices in the implementation of RBSK among the mobile health team (MHT) in Jodhpur, Rajasthan.

Methods A community based descriptive cross-sectional study in all 11 medical blocks of Jodhpur district, with purposive sampling to invite all members of MHT to participate in the study as grassroot workers was planned. A pretested, semistructured questionnaire was processed using SPSS for quantitative component and in-depth interviews were reported using qualifiers for qualitative observations.

Results As much as 74.1% (n = 40) of the staff perceived the trainings to be sufficient for daily work needs but needed more sessions for birth defects (33.3%) and development delays (29.6%). As much as 96.3% (n = 52) of the staff considered salaries to be low and 55.5% were dissatisfied with the jobs. However, 70.4% found targets to be achievable and 76% found the work environment helpful. Taboos and superstitions in community, harsh climate, dual workload on pharmacists as data operators, and noninclusion of AYUSH medicines for AYUSH medical officers (MOs) were few of the challenges, while good practices such as fully equipped MHTs, readily available vehicles, information education communication (IEC) materials, and treatment coverage under Bhamashah Bima Yojana (BSBY) were also observed.

Conclusion Many good practices were observed during the study which can be adopted by other states for better implementations elsewhere. Certain challenges such as belief in quackery, superstitions and taboos could be minimized by conducting rapport-building meetings with community stakeholders. Feedback and regular trainings of MHT staff can further increase the success manifold.

Keywords

RBSK - challenges - barriers - implementation - Rajasthan


Publication History

Article published online:
26 October 2021

© 2021. National Academy of Medical Sciences (India). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 National Health Portal of India. Rashtriya Bal Swasthya Karyakram (RBSK). Available at: https://www.nhp.gov.in/rashtriya-bal-swasthyakaryakram-(rbsk)_pg. Accessed July 23, 2020
  • 2 Ministry of Health and Family Welfare. Government of India. Review of Performance Chapter IV. Available at: https://main.mohfw.gov.in/sites/default/files/Review_of_Performance.pdf. Accessed July 23, 2020
  • 3 Rashtriya Bal Swasthya Karyakram. Ministry of Heallth & Family Welfare, Government of India. Available at: https://rbsk.gov.in/RBSKLive/. Accessed July 14, 2020
  • 4 March of Dimes Birth Defects Foundation. Global Report on Birth defects. Available at: https://www.marchofdimes.org/global-report-on-birth-defects-the-hidden-toll-of-dying-and-disabled-children-full-report.pdf. Accessed July 14, 2020
  • 5 Sharma R. Birth defects in India: hidden truth, need for urgent attention. Indian J Hum Genet 2013; 19 (02) 125-129
    CrossrefPubMedGoogle Scholar
  • 6 Bhide P, Gund P, Kar A. Prevalence of congenital anomalies in an indian maternal cohort: healthcare, prevention, and surveillance implications. PLoS One 2016; 11 (11) e0166408
    CrossrefPubMedGoogle Scholar
  • 7 Sharma N, Masood J, Singh SN. et al Assessment of risk factors for developmental delays among children in a rural community of North India: a cross-sectional study. J Educ Health Promot 2019; 8: 112
    PubMedGoogle Scholar
  • 8 World Health Organization. Regional Office for South-East Asia. (2013). Birth defects in South-East Asia: a public health challenge: situation analysis. WHO Regional Office for South-East Asia. Available at: https://apps.who.int/iris/handle/10665/204821
  • 9 Ministry of Health & Family Welfare. Government of India. Operational Guidelines Rashtriya Bal Swasthya Karyakram (RBSK). Child Health Screening and Intervention Services under NRHM. Available at: https://nhm.gov.in/images/pdf/programmes/RBSK/Operational_Guidelines/Operational%20Guidelines_RBSK.pdf. Accessed July 15, 2020
  • 10 Marrus N, Hall L. Intellectual disability and language disorder. Child Adolesc Psychiatr Clin N Am 2017; 26 (03) 539-554
    CrossrefPubMedGoogle Scholar
  • 11 Deloitte Touche Tohmatsu India LLP. UNICEF. Formative Research Report on RBSK. From Survical to Healthy Survival. Available at: https://nhm.assam.gov.in/sites/default/files/swf_utility_folder/departments/nhm_lipl_in_oid_6/menu/schemes/Formative_Research_Report_on_RBSK.pdf. Accessed July 18 2020
  • 12 Parmar S, Bansal S, Raghunath D, Patidar A. Study of knowledge, attitude and practice of AYUSH doctors, evaluation of MHTs working in RBSK and client satisfaction. Int J Community Med Publ Health 2017; 3 (08) 2186-2190
    Google Scholar
  • 13 Parmar S, Raghunath D, Dixit S, Bansal SB, Patidar A. A cross-sectional study to evaluate the functioning and infrastructure of DEIC, and client satisfaction Ujjain and Indore districts established under RBSK. IOSR J Dent Med Sci 2016; 5 (09) 92-94
    CrossrefGoogle Scholar
  • 14 Singh AK, Kumar R, Mishra CK, Khera A, Srivastava A. Moving from survival to healthy survival through child health screening and early intervention services under Rashtriya Bal Swasthya Karyakram (RBSK. Indian J Pediatr 2015; 82 (11) 1012-1018
    CrossrefPubMedGoogle Scholar
  • 15 Sogarwal R, Bachani D, Venkatesh S. Challenges in HIV/AIDS prevention, care and treatment programme in India. SAARC J Tuberc Lung Dis HIV/AIDS 2010; 7 (01) 1-7
    Google Scholar
  • 16 Best ML, Kumar R. Sustainability failures of rural telecenters: challenges from the sustainable access in rural India (SARI) project. Inf Technol Int Dev 2008; 4 (04) 31-45
    CrossrefGoogle Scholar
  • 17 Sagar R, Pattanayak RD, Chandrasekaran R. et al Twelve-month prevalence and treatment gap for common mental disorders: Findings from a large-scale epidemiological survey in India. Indian J Psychiatry 2017; 59 (01) 46-55
    CrossrefPubMedGoogle Scholar
  • 18 Kaur S, Thapar K, Saini P, Kaur H, Kaur J. Myths & misconceptions of mental illness and health seeking behaviour of adults. Int J Com Health and Med Res 2016; 2 (03) 3-9
    Google Scholar