Published: 2017-02-05

Estimation of magnitude of various health conditions under 4Ds approach, under RBSK Programme in Devendranagar block of Panna District, Madhyapradesh, India

Jyoti Tiwari, Abhishek Jain, Yaduvendra Singh, Anoop Kumar Soni


Background: The Rashtriya Bal Swasthya Karyakram (RBSK) aims early detection and management of the 4Ds - Defects at birth, Diseases in children, Deficiency conditions and Developmental Delays including Disabilities in children in the community which are hidden may be due to unawareness or unaffordbility for treatment.

Methods: We followed the operational guidelines of ‘Child Health Screening and Early Intervention Services’ under RBSK. Surveys done along with RBSK team for 6 months.

Results: Total 26977 children were screened. Out of which 53 children were found to have birth defects, 434 children were found to have some kind of deficiency, 21768 children were found to have diseases and 113 children were found with developmental delay including disabilities. Globally, 200 million children do not reach their developmental potential in the first five years because of poverty, poor health, nutrition and lack of early stimulation. Here in our study 83% children deprived of good health due to 4Ds.

Conclusion: We observed that still there are many children are undiagnosed and deprived of treatment for curable diseases. Child Health Screening and promotion of Early Intervention Services is most beneficial for improvement in health status of children in rural community.


RBSK, 4Ds, District Panna

Full Text:



Operational guidelines Rastriya Bal swasthya karyakram (RBSK) Child Health Screening and Intervention Services under NRHM, Ministry of Health and Family welfare, Feb 2013.

Christianson A, et al. March of Dimes Global Report on birth defects. The hidden toll of dying and disabled children, 2006.

Annual Health survey, Madhya Pradesh, 2011-2012.

Khalil A, Aggarwal R, Thirupuram S, Arora R. Incidence Of Congenital Heart Disease Among Hospital Live Births In India. Indian J Pediatric. 1994;31:519-27.

Verma IC, Mathew S, Elango R, Shukla A. cytogenetic study in Down’s syndrome, Indian Pediatr. 1998;28:991-6.

Prevalence of Vitamin A Deficiency among Rural Preschool Children. Hyderabad, India: National Institute of Nutrition, Indian Council of Medical Research. Report No 23; 2006.

lndian Council for Medical Research (ICMR), 2006.

Thakur N, Chandra J, Pemde H, Singh V. Anemia in severe acute malnutrition. IJP. 2014;30(4):440-2.

Sambo MN, Idris SH, Umar AA, Olorukooba AA. Prevalence of scabies among school-aged children in Katanga rural community in Kaduna state, Northwestern Nigeria. Annals of Nigerian Medicine. 2012;6(1):26-9.

Technical reports on Operational Status of SNCUs in India, ministry of health and family welfare, 2012.

Lancet series on Child Development in developing country, September 23, 2011.

Kamble M1, Chatruvedi P. Epidemiology of sickle cell disease in a rural hospital of central India. Indian Pediatr. 2000;37(4):391.

Nair MK, George B, Padmamohan J, Sunitha RM, Resmi VR, Prasanna GL, et al. Developmental delay and disability among under--5 children in a rural ICDS block. Indian Pediatr. 2009;46:s75-8.

National Family Health Survey – 3 (NFHS-3), 2005-06.