Rapid assessment of rashtriya bal swasthya karyakram program implementation and beneficiary feedback at two district early intervention centers in Chhattisgarh State in India

Abstract

Background: The Government of India launched the child health screening and early Intervention programme called Rashtriya Bal Swasthya Karyakram in 2014 to screen children from 0 to 18 years for the early detection of 4 D's (Defects, Diseases, Deficiency, and Developmental Delays including disabilities). Under this program, district early intervention centers (DEICs) are set up as nodal centers at the district level to manage the cases of 4Ds. There are few studies published evaluating the functioning of DEICs or reflecting the feedback from beneficiaries. Aims: The aim of this study is to assess the functioning and infrastructure of DEIC and beneficiary feedback. Methods: One good performing district (Raigarh) and one poor performing district (Raipur) were selected for rapid assessment. Observational check list according to norms was used for assessment of facilities, staffing pattern, and semi-structured questionnaire used for beneficiary feedback. Data were entered in Microsoft excel for the analysis. Results: DEIC Raipur was deficient in staff and infrastructure. Among all the referred cases, only 38.9% and 31.5% reached DEIC Raipur and Raigarh, respectively. DEIC Raigarh deserves special mention. It has special Orthotics unit, “Sensory garden,” and Disability Rehabilitation Center. Beneficiaries face many difficulties at DEIC despite having necessary referral forms. 73.4% parents said loss of daily wages was a deterrent to go to DEIC repeatedly for follow-up. Conclusion: There was a deficiency of staff and infrastructure in DEIC Raipur. DEIC Raigarh had a well-equipped rehabilitation center. It should be developed as “Model DEIC” for Chhattisgarh and explore the possibility of telemedicine to provide services to neighboring underserved districts. Beneficiary feedback was below satisfaction.