About the programme:

The ‘Child Health Screening and Early Intervention Services’ Programme under National Health Mission initiated by the Ministry of Health and Family Welfare aims at early detection and management of the 4Ds prevalent in children.

Health screening of children is a known intervention under the School Health Programme. It is now being expanded to cover all children from birth to 18 years of age. The Programme has been initiated as significant progress has already been made in reducing child mortality under the National Health Mission. However, further gains can be achieved by early detection and management of conditions in all age groups.

Launched across the country in February, 2013, Rashtriya Bal Swasthya Karyakram (RBSK) is a significant health initiative aiming at early identification and early intervention for children from birth to 18 years to cover 4 ‘D’s viz. Defects at birth, Deficiencies, Diseases, Development delays including disability. The launch of this programme assumes great significance as it corresponds to the release of Reproductive, Maternal, Newborn, Child Health and Adolescent Health strategy (RMNCH+A).

In Mizoram, RBSK was officially launched in July, 2013 and as of March, 2015, there are 23 functional RBSK Mobile Health Teams and each team conducts health screening among Govt and Govt. Aided School students and Anganwadi Children across the state. There is also provision of special care/ treatment to target beneficiaries through referral to District Early Intervention Center (DEIC), the first referral center under RBSK.

Target Group under Child Health Screening and Intervention Services:

Categories Age group Estimated Coverage
Babies born at public health facilities and home Birth to 6 weeks 22606
Preschool children in rural areas and urban slums (Anganwadi Center) 6 weeks to 6 years 101681
Children enrolled in classes 1st to 12th in Government and Government aided schools 6 to 18 years 92442
Health Conditions Identified for Screening under RBSK:

Defects at Birth

1. Neural Tube Defect

2. Down’s Syndrome

3. Cleft Lip & Palate / Cleft Palate alone

4. Talipes (club foot)

5. Developmental Dysplasia of the Hip

6. Congenital Cataract

7. Congenital Deafness

8. Congenital Heart Diseases

9. Retinopathy of Prematurity

Deficiencies 10. Anaemia especially Severe Anaemia 11. Vitamin A Deficiency (Bitot spot)

12. Vitamin D Deficiency (Rickets)

13. Severe Acute Malnutrition

14. Goiter

Childhood Diseases 15. Skin conditions (Scabies, Fungal Infection and Eczema)

16. Otitis Media

17. Rheumatic Heart Disease

18. Reactive Airway Disease

19. Dental Caries

20. Convulsive Disorders

Developmental Delays and Disabilities 21. Vision Impairment 22. Hearing Impairment

23. Neuro-Motor Impairment

24. Motor Delay

25. Cognitive Delay

26. Language Delay

27. Behaviour Disorder (Autism)

28. Learning Disorder

29. Attention Deficit Hyperactivity Disorder

30. Congenital Hypothyroidism, Sickle Cell Anaemia, Beta Thalassemia (Optional)
Composition of Mobile Health Team:

S. No Member Number
1 Medical Officers (AYUSH & BDS): 2
2 Pharmacist with proficiency in computer for data management 1
3 ANM (Health Worker) 1

About District Early Intervention Center (DEIC):

The purpose of setting up Early Intervention Center is to provide referral support to children detected with health conditions during health screening. A team consisting of Paediatrician, Medical Officer, Staff Nurses and other Paramedics are involved and engaged to provide services at the DEIC. Each DEIC is manned by a Center manager who is responsible for carrying out mapping of tertiary care facilities in Government institutions for ensuring adequate referral support. Support Fund for 13 surgical conditions under RBSK is provided under NHM for management at the tertiary level, at the rates fixed by the State Governments in consultation with the Ministry of Health and Family Welfare.

In the state of Mizoram, DEIC has recently been established in Aizawl and Lunglei Districts, both of which started functioning since February, 2015. Deic Managers are posted in all 9 (nine) Health Districts.

Composition of Staff at Aizawl West DEIC:

Member Number
Medical Officer 1
Dental Surgeon 1
Physiotherapist 1
Audiologist & Speech Therapist nil
Early Interventionist cum Special Educator 1
Social Worker 1
Clinical Psychologist 1
Optometrist 1
Lab Technician (Graduate) 1

Composition of Staff at Lunglei DEIC:

Member Number
Medical Officer 1
Dental Surgeon 1
Physiotherapist 1
Audiologist & Speech Therapist nil
Early Interventionist cum Special Educator 1
Social Worker 1
Clinical Psychologist 1
Optometrist nil
Lab Technician (Graduate) 1

Role of DEIC:


Role of the Center
1 Providing referral services to referred children for confirmation of diagnosis and treatment
2 Screening children at the “District Early Intervention Center”
3 Visit all newborns delivered at the District Hospital, including those admitted in SNCU, postnatal and children wards for screening all newborns irrespective of their sickness for hearing, vision, congenital heart disease before discharge
4 Ensure that every child born sick or preterm or with low birth weight or any birth defect is followed up at the District Early Intervention Center
5 All the referrals for developmental delay are followed and records maintained
6 The Lab Technician of the DEIC would screen the children for inborn error of metabolism and other disorders, at the District level depending upon the logistics and local epidemiological situations
7 Ensure linkage with tertiary care facilities through agreed MOU.
13 Surgical Conditions Identified under RBSK:

S.No Name of Conditions
1 Rheumatic Heart Disease
2 Dental Conditions
3 Otitis Media
4 Neural Tube Defect
5 Down Syndrome
6 Cleft Lip+ Cleft Palate
7 Talipes (Club Foot)
8 Developmental dysplasia of the hip
9 Congenital Heart Disease
10 Congenital Cataract
11 Congenital Deafness
12 Retinopathy of Prematurity
13 Vision Impairment (Starbismus)

Services rendered to public by RBSK, Mizoram so far:

  • 1.Health Screening of children in the age group of 6 weeks to 5 years of age for 4D’s enrolled in Anganwadi Center by District RBSK Mobile Health Teams.
  • 2.Health Screening of children in the age group of 6 years to 18 years of age for 4D’s enrolled in Govt. and Govt. Aided School by District RBSK Mobile Health Teams.
  • 3.Provision of IFA (Syrup) & Albendazole (NIPI) tablets to children in the age group of 6 weeks to 5 years of age enrolled in Anganwadi Centers.
  • 4.Provision of IFA (NIPI) & Albendazole (NIPI) tablets to Primary Level students enrolled in Govt. and Govt. Aided Schools.
  • 5.Provision of RBSK Essential Drugs free of cost to beneficiaries in need of such treatments.

Activity under RBSK:

  • 1.Formation of State and District RBSK Monitoring Cell- Meeting held in 2014
  • 2.Formation of State Level RBSK Pre-Operative Authorization Committee-Meeting held on 27th February, 2015
  • 3.Monitoring & Supervisory Visit to all 9 Health Districts by State RBSK Team-conducted in FY 2012-13 & 2013-14. Visit for FY 2014-15 planned for April, 2015
  • 4.All 23 RBSK Mobile Health Teams trained by RBSK Master Trainers at State Level.
  • 5.District Officials from Health, School Education and Social Welfare Departments given Orientation Training on RBSK.
  • 6.Identification of Tertiary Care Centers for 13 Surgical Conditions in process.