Despite a decade of RBSK, India still faces a high burden of birth defects and developmental delays. Critically analyse.

Launched in February 2013 under the National Health Mission, the Rashtriya Bal Swasthya Karyakram (RBSK) screens children from birth to 18 years for the 4Ds — Defects at birth, Diseases, Deficiencies and Developmental delays [1][3]. Yet a decade on, congenital disorders and developmental delays remain a leading cause of child morbidity, exposing a gap between design and delivery.

Achievements of the decade

• Institutionalised universal, community-based screening via block-level Mobile Health Teams, expanding coverage to 32 conditions [3].
• Created a referral continuum to District Early Intervention Centres, with free tertiary surgeries for cardiac and congenital cases [3].

Why the burden persists

• Screening–treatment gap: detection outpaces DEIC capacity, so referrals stall before intervention [3].
• Episodic, not continuous care — one-off camps miss developmental delays needing longitudinal tracking [1].
• Narrow scope: original design excluded mental-health and behavioural concerns and NCD risk factors [1].
• Equity deficit: tribal and aspirational districts face MHT vacancies and weak follow-up.

RBSK 2.0 as course-correction (May 2026)

• Adds NCDs, mental health and behavioural screening, and a lifecycle continuum of care [1].
• Introduces digital health cards and real-time data systems for referral tracking, aligning with digital-health architecture [1].

The persisting burden reflects not flawed intent but weak last-mile execution and fragmented follow-up. RBSK 2.0's digital and continuum-based reforms are promising, but must be matched by DEIC strengthening and human-resource filling in underserved districts to convert early detection into timely treatment — advancing SDG-3's child-health goals.