Lok Sabha Question No. 174 (STARRED), answered on 2024-08-02
Subject: Rashtriya Bal Swasthya Karyakram
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Selvam G

## GOVERNMENT OFINDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOKSABHA STARRED QUESTION NO. 174 TO BE ANSWERED ON THE 2 ND AUGUST, 2024

## RASHTRIYABALSWASTHYAKARYAKRAM

## *174 SHRI SELVAM G:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government is implementing Rashtriya Bal Swasthya Karyakram in the country including Tamil Nadu, if so, the details thereof and achievements made since its inception, year-wise/State-wise;
- (b) whether the Government has made any assessment of the said scheme through social audit, if so, the findings thereof, year-wise;
- (c) the details of the number of children covered under the said scheme in the State of Tamil Nadu along with the amount of funds allocated/utilized during the last three years, year-wise; and
- (d) whether the Government has taken any steps for children with any health condition to be referred to an appropriate health facility for further management, if so, the details thereof and if not, the reasons therefor?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

- (a) to (d) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 174 FOR 2 ND AUGUST, 2024

(a) to (d) Ministry of Health and Family Welfare (MoHFW) implements Rashtriya Bal Swasthaya Karyakram (RBSK) in all States/UTs, including Tamil Nadu, under National Health Mission (NHM) for children in the age group 0-18 years in Anganwadi centres, Government and Government aided schools with the objective of early identification and management for 32 selected health conditions - 4 D ' s i.e. Defects at Birth, Developmental delays, Diseases and Deficiencies.

As reported by States/UTs, 160.84 crore children have been screened through Mobile Health Teams (MHTs), 11.90 crore children have been identified with selected health conditions and 5.64 crore children have been provided secondary/tertiary care from FY 2014-15 till FY 2023-24 under RBSK. State/UT wise details are placed at Annexure-1 .

The RBSK Program is evaluated under NHM through review of quarterly reports, field visits and periodic meetings with State Nodal Officers, reviews done during the process of Annual Programme Implementation Plans (APIP) and Common Review Missions (CRM).

The financial support is provided to the States/UTs under the NHM for RBSK based on the Annual Program Implementation Plan (APIP) submitted by States/ UTs. The support is given for infrastructure, essential equipment, human resources including capacity building for comprehensive management. The State/UT-wise details of the budget allocation and utilization for RBSK is placed at Annexure-2.

The establishment of District Early Intervention Centre (DEIC) is an important component of the RBSK for management of children. They provide linkages with health facilities for free secondary and tertiary care including surgical management of selected health conditions at Medical colleges and empanelled private health facilities. As per the reports submitted by States/UTs, 430 DEICs are operational throughout the country. The Cumulative details of Children covered under RBSK State/UT wise are given at Annexure-3 .

## Annexure-1

## Children screened under Rashtriya Bal Swasthaya Karyakram (RBSK) As reported by State/UTs

(N in Lakhs)

| States/UTs          | 2014-15   | 2015-16   | 2016-17   | 2017-18   | 2018-19   | 2019-20   | 2020-21   | 2021-22   | 2022-23   | 2023-24   |
|---------------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
| Andaman& Nicobar    | 0.2       | 0.1       | 0.2       | 0.3       | 0.3       | 0.3       | 0.0       | 0.1       | 0.2       | 0.3       |
| Andhra Pradesh      | 3.8       | 15.2      | 71.4      | 74.2      | 48.6      | 61.3      | 4.4       | 7.2       | 6.1       | 15.8      |
| Arunachal Pradesh   | 2.3       | 3.3       | 2.7       | 4.8       | 2.2       | 1.9       | 0.0       | 1.2       | 1.5       | 3.0       |
| Assam               | 29.4      | 48.7      | 63.2      | 68.1      | 75.9      | 73.0      | 18.4      | 30.3      | 74.4      | 80.7      |
| Bihar               | 0.6       | 287.3     | 144.5     | 122.9     | 143.9     | 158.0     | 0.0       | 0.0       | 92.1      | 127.8     |
| Chandigarh          | 2.2       | 4.1       | 2.0       | 1.7       | 2.4       | 2.4       | 0.0       | 0.6       | 1.5       | 1.8       |
| Chhattisgarh        | 0.6       | 51.1      | 59.7      | 55.6      | 56.9      | 56.6      | 0.0       | 18.8      | 32.8      | 61.6      |
| Dadra &Nagar Haveli | 0.9       | 1.0       | 0.9       | 1.2       | 1.2       | 1.5       | 0.0       | 1.3       | 0.6       | 0.7       |
| Daman and Diu       | 0.4       | 0.3       | 0.4       | 0.4       | 0.4       | 0.4       |           |           |           |           |
| *Delhi              | -         | -         | -         | -         | -         | -         | -         | -         | -         | -         |
| Goa                 | 2.2       | 2.3       | 3.2       | 4.2       | 5.0       | 4.6       | 0.0       | 0.0       | 4.2       | 4.2       |
| Gujarat             | 123.4     | 164.0     | 196.1     | 245.6     | 115.5     | 180.5     | 0.0       | 75.3      | 198.3     | 195.1     |
| Haryana             | 28.4      | 34.6      | 34.0      | 31.2      | 33.1      | 35.4      | 5.8       | 16.7      | 38.4      | 44.2      |
| Himachal Pradesh    | 9.0       | 1.9       | 10.6      | 11.1      | 9.3       | 10.4      | 0.0       | 0.0       | 3.0       | 10.9      |
| Jammu &Kashmir      | 15.3      | 22.1      | 21.6      | 23.8      | 23.8      | 19.7      | 0.0       | 1.9       | 23.5      | 25.3      |
| Jharkhand           | 0.1       | 5.9       | 15.5      | 17.7      | 41.2      | 61.0      | 0.0       | 12.7      | 47.6      | 70.6      |
| Karnataka           | 92.0      | 120.8     | 118.5     | 127.9     | 133.1     | 125.4     | 92.8      | 99.4      | 128.3     | 126.6     |
| Kerala              | 36.5      | 38.9      | 42.9      | 33.8      | 40.1      | 49.5      | 0.0       | 0.5       | 16.8      | 27.5      |
| Ladakh              |           |           |           |           |           | 0.7       | 0.0       | 0.1       | 1.0       | 0.9       |
| **Lakshadweep       | -         | -         | -         | -         | -         | -         | -         | -         | -         | 0.1       |
| Madhya Pradesh      | 90.8      | 136.1     | 108.8     | 91.3      | 87.3      | 79.2      | 22.2      | 89.8      | 140.8     | 139.1     |
| Maharashtra         | 193.4     | 317.2     | 258.1     | 247.8     | 229.8     | 240.4     | 28.4      | 158.6     | 247.3     | 254.7     |
| Manipur             | 0.8       | 2.7       | 1.6       | 1.7       | 1.7       | 1.9       | 0.0       | 0.0       | 2.4       | 2.9       |
| Meghalaya           | 0.4       | 4.1       | 5.8       | 9.0       | 11.9      | 10.8      | 0.7       | 3.3       | 8.6       | 9.2       |
| Mizoram             | 2.5       | 3.7       | 2.5       | 2.7       | 2.4       | 2.8       | 0.0       | 0.4       | 3.2       | 3.6       |
| Nagaland            | 0.4       | 1.6       | 2.2       | 2.2       | 1.8       | 1.9       | 0.1       | 0.6       | 1.3       | 1.6       |
| Odisha              | 49.0      | 46.4      | 95.8      | 102.1     | 83.6      | 99.4      | 13.2      | 40.5      | 122.3     | 122.2     |
| Puducherry          | 1.3       | 1.6       | 1.8       | 1.8       | 1.8       | 2.1       | 0.0       | 1.7       | 2.4       | 2.0       |
| Punjab              | 29.1      | 32.4      | 32.8      | 36.2      | 36.5      | 25.7      | 0.6       | 0.0       | 32.0      | 33.4      |
| Rajasthan           | 21.0      | 0.0       | 69.5      | 83.7      | 99.5      | 86.4      | 0.0       | 37.5      | 86.0      | 99.5      |
| Sikkim              | 0.9       | 1.0       | 0.9       | 0.9       | 0.7       | 0.8       | 0.0       | 0.3       | 0.8       | 0.9       |
| Tamil Nadu          | 65.6      | 108.3     | 144.1     | 135.8     | 134.2     | 120.2     | 5.7       | 167.8     | 252.9     | 144.9     |
| Telangana           | 0.0       | 0.0       | 21.6      | 9.1       | 13.5      | 21.2      | 0.0       | 10.7      | 40.0      | 52.6      |
| Tripura             | 1.4       | 2.6       | 5.7       | 3.1       | 4.6       | 6.8       | 1.3       | 3.6       | 5.2       | 8.0       |
| Uttar Pradesh       | 182.1     | 219.5     | 218.9     | 255.4     | 288.6     | 286.4     | 28.2      | 73.4      | 235.2     | 309.2     |
| Uttarakhand         | 13.8      | 40.0      | 19.4      | 17.5      | 20.1      | 14.3      | 0.9       | 12.0      | 20.9      | 19.7      |
| West Bengal         | 66.2      | 154.4     | 174.9     | 140.5     | 178.1     | 193.3     | 0.0       | 0.0       | 126.5     | 174.3     |
| Total               | 1066.0    | 1873.1    | 1951.5    | 1965.3    | 1929.0    | 2036.5    | 222.7     | 866.4     | 1998.1    | 2175.1    |

Details of State Program Implementation Plan ( SPIP) Approvals and expenditure under Rashtriya Bal Swasthya Karyakram (RBSK) during the period from F.Y. 2021-22 to 2023-24

(Rs. In lakhs)

| Sl. No.   | State                            | 2021-22        | 2021-22     | 2022-23        | 2022-23     | 2023-24        | 2023-24     |
|-----------|----------------------------------|----------------|-------------|----------------|-------------|----------------|-------------|
| Sl. No.   | State                            | SPIP Approvals | Expenditure | SPIP Approvals | Expenditure | SPIP Approvals | Expenditure |
| 1         | Andaman and Nicobar Islands      | 140.47         | 97.40       | 40.98          | 11.83       | 38.51          | 23.81       |
| 2         | Andhra Pradesh                   | 2,699.79       | 2,588.46    | 2666.97        | 991.00      | 742.93         | 744.04      |
| 3         | Arunachal Pradesh                | 875.73         | 781.69      | 362.40         | 345.61      | 382.95         | 65.88       |
| 4         | Assam                            | 6,937.97       | 6,625.21    | 1988.05        | 1762.73     | 1,908.56       | 1,985.72    |
| 5         | Bihar                            | 3,464.51       | 5,364.53    | 4588.31        | 2831.79     | 4,637.23       | 3,362.91    |
| 6         | Chandigarh                       | 177.21         | 164.26      | 80.50          | 14.01       | 52.50          | 24.81       |
| 7         | Chhattisgarh                     | 6,416.74       | 5,139.74    | 2571.56        | 1976.74     | 2,602.08       | 1,767.17    |
| 8         | Dadra &NagarHaveli andDaman &Diu | 261.00         | 166.61      | 51.35          | 33.96       | 50.60          | 27.44       |
| 9         | Delhi                            | 389.56         | -           | 1127.67        | 674.48      | 963.40         | 571.26      |
| 10        | Goa                              | 367.68         | 253.36      | 119.64         | 49.37       | 101.65         | 85.50       |
| 11        | Gujarat                          | 16,491.77      | 14,768.49   | 7497.93        | 5614.82     | 7,000.65       | 9,342.25    |
| 12        | Haryana                          | 3,858.99       | 2,740.98    | 1849.16        | 1415.77     | 1,633.22       | 1,707.75    |
| 13        | Himachal Pradesh                 | 2,176.26       | 2,098.90    | 977.93         | 793.89      | 1,030.53       | 964.69      |
| 14        | JammuandKashmir                  | 5,176.20       | 4,966.26    | 1533.54        | 902.79      | 1,807.94       | 840.76      |
| 15        | Jharkhand                        | 5,515.02       | 1,668.88    | 1630.42        | 649.52      | 1,544.21       | 866.63      |
| 16        | Karnataka                        | 7,047.66       | 6,349.53    | 2805.64        | 1773.11     | 2,026.96       | 2,029.84    |
| 17        | Kerala                           | 5,738.44       | 6,119.49    | 4524.74        | 4351.30     | 4,367.06       | 1,253.76    |
| 18        | Ladakh                           | 444.77         | 397.78      | 157.60         | 106.73      | 153.40         | 144.54      |
| 19        | Lakshadweep                      | 10.54          | -           | 6.41           | 0.00        | 3.50           | -           |
| 20        | Madhya Pradesh                   | 15,461.51      | 13,346.65   | 6082.33        | 5562.25     | 6,268.15       | 5,876.47    |
| 21        | Maharashtra                      | 22,714.47      | 18,719.86   | 10336.18       | 6668.33     | 6,612.24       | 5,405.08    |
| 22        | Manipur                          | 2,575.41       | 320.39      | 2581.43        | 1742.88     | 1,100.70       | 233.34      |
| 23        | Meghalaya                        | 1,641.05       | 930.61      | 827.54         | 819.88      | 770.34         | 692.61      |
| 24        | Mizoram                          | 662.39         | 615.51      | 234.63         | 123.67      | 216.34         | 194.06      |
| 25        | Nagaland                         | 358.57         | 174.80      | 183.81         | 28.54       | 172.60         | 71.21       |
| 26        | Odisha                           | 11,997.79      | 10,627.72   | 4003.81        | 5149.23     | 3,458.60       | 3,773.59    |
| 27        | Puducherry                       | 105.87         | 51.81       | 58.45          | 9.42        | 52.78          | 23.44       |
| 28        | Punjab                           | 4,231.52       | 4,322.30    | 1912.08        | 1370.60     | 1,552.08       | 1,552.08    |
| 29        | Rajasthan                        | 12,875.76      | 5,206.94    | 4140.24        | 1949.51     | 4,140.24       | 1,739.96    |
| 30        | Sikkim                           | 228.57         | 59.72       | 83.64          | 67.93       | 63.85          | 40.89       |
| 31        | Tamil Nadu                       | 10,248.43      | 7,080.80    | 5368.93        | 3401.87     | 5,215.92       | 4,535.13    |
| 3         | Telangana                        | 6,417.94       | 5,723.84    | 2210.62        | 719.54      | 1,813.52       | 682.61      |
| 33        | Tripura                          | 1,007.92       | 613.34      | 531.05         | 283.33      | 434.16         | 235.97      |
| 34        | Uttar Pradesh                    | 35,703.40      | 23,127.42   | 8696.49        | 7253.34     | 10,914.11      | 7,356.60    |
| 35        | Uttarakhand                      | 3,534.96       | 3,280.54    | 1792.79        | 1073.90     | 1,611.49       | 1,168.97    |
| 36        | West Bengal                      | 14,419.37      | 9,773.06    | 4833.84        | 3244.90     | 4,707.27       | 3,352.01    |

## Note:

1. SPIP Approval and Expenditure is as per the available Financial Management Reports submitted by State/UTs and are provisional.
2. Expenditure includes Expenditure against Central Release, Corresponding State share release & unspent balances at the beginning of the year and are provisional.
3. Since 2022-23 approval of Human resource (Both for MHTs and DEIC) have been shifted from RBSK Financial Management Report (FMR) to Human Resources for Health (HRH) FMR.

## Annexure -3

## Rashtriya Bal Swasthaya Karyakram (RBSK) Cumulative Coverage from Financial Year 2014-15 to FY 2023-24

## As reported by State/UTs

(No. in Lakhs)

| State/UTs           | Children Screened   | Children Identified   | Children availed Secondary/ Tertiary Care for 4Ds   |
|---------------------|---------------------|-----------------------|-----------------------------------------------------|
| Andaman &Nicobar    | 2.08                | 0.79                  | 0.10                                                |
| Andhra Pradesh      | 308.3               | 13.07                 | 9.72                                                |
| Arunachal Pradesh   | 22.93               | 3.67                  | 0.92                                                |
| Assam               | 562.01              | 22.88                 | 16.85                                               |
| Bihar               | 1077.02             | 33.34                 | 16.48                                               |
| Chandigarh          | 18.70               | 4.69                  | 1.92                                                |
| Chhattisgarh        | 393.74              | 5.60                  | 1.02                                                |
| Dadra &Nagar Haveli | 9.10                | 0.91                  | 0.17                                                |
| Daman               | 2.36                | 0.39                  | 0.02                                                |
| *Delhi              | -                   | -                     | -                                                   |
| Goa                 | 30.00               | 1.52                  | 0.41                                                |
| Gujarat             | 1493.68             | 201.10                | 109.68                                              |
| Haryana             | 301.76              | 92.01                 | 45.31                                               |
| Himachal Pradesh    | 66.17               | 6.09                  | 0.08                                                |
| Jammu &Kashmir      | 177.06              | 18.56                 | 6.54                                                |
| Jharkhand           | 272.29              | 11.44                 | 5.29                                                |
| Karnataka           | 1164.86             | 97.78                 | 38.84                                               |
| Kerala              | 286.41              | 43.62                 | 16.13                                               |
| Ladakh              | 2.78                | 0.57                  | 0.04                                                |
| **Lakshadweep       | 0.11                | 0.00                  | 0.00                                                |
| Madhya Pradesh      | 985.43              | 87.02                 | 60.04                                               |
| Maharashtra         | 2175.67             | 88.69                 | 40.30                                               |
| Manipur             | 15.68               | 1.51                  | 0.43                                                |
| Meghalaya           | 63.77               | 4.62                  | 1.71                                                |
| Mizoram             | 23.79               | 2.24                  | 0.72                                                |
| Nagaland            | 13.66               | 1.43                  | 0.23                                                |
| Odisha              | 774.56              | 65.68                 | 37.62                                               |
| Puducherry          | 16.46               | 0.83                  | 0.42                                                |
| Punjab              | 258.79              | 17.67                 | 4.86                                                |
| Rajasthan           | 583.26              | 23.92                 | 14.01                                               |
| Sikkim              | 7.06                | 0.95                  | 0.24                                                |
| Tamil Nadu          | 1279.47             | 66.77                 | 29.82                                               |
| Telangana           | 168.82              | 7.45                  | 4.87                                                |
| Tripura             | 42.36               | 3.21                  | 1.14                                                |
| Uttar Pradesh       | 2096.87             | 88.10                 | 40.21                                               |
| Uttarakhand         | 178.64              | 13.95                 | 1.11                                                |
| West Bengal         | 1208.20             | 158.26                | 56.48                                               |
| Total               | 16083.61            | 1190.35               | 563.73                                              |

Note- Community level screening through Mobile Health teams were disrupted during Covid pandemic in 2020-21 and 2021-22 as Anganwadis and schools were closed.

* Delhi is not screening children under RBSK Programme

**Lakshadweep has started screening of children in the last quarter of FY 2023-24