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Background: During COVID-19 pandemic, service providers and beneficiaries of Rashtriya Bal Swasthya Karyakram (RBSK) faced certain challenges. Objectives: The objective was to assess the perception and challenges faced by service providers and beneficiaries in general and amid the pandemic for availing the services at an urban health center in Ahmedabad. Methodology: Data of registered cases under RBSK at Urban Health Center (UHC) Ognaj in 2018–2019 and 2019–2020 were compared. In depth interviews (IDIs) of Medical Officer RBSK were done. Home visits were done to document the perception and challenges of beneficiaries through semi/unstructured questionnaire. Results: Considering the cases of 2018–2019 as base, registered cases decreased by 22.8% in 2019–2020 and 92.4% in 2020–2021. The pandemic affected 15.6% of beneficiaries in availing the services. Program was affected due to: (1) less workforce (vacant pharmacist post), (2) target-based approach, and (3) birth defects, deficiency disorders, chronic diseases, and development delays, especially deficiency not perceived a serious health issue by beneficiaries. Corona-specific reasons included: (1) staff deployment in COVID-19 activities, (2) reluctance/fear in visiting District Early Intervention Center (DEIC)/health facility, (3) reduced screening due to the closure of schools/Anganwadi Kendras, and (4) enforced lockdown. Conclusions: RBSK mobile health teams found it difficult to reach all 4Ds, more so for follow-up. RBSK was badly affected due to the engagement of providers in COVID-19 work, the closure of facilities, perception of beneficiaries that 4Ds are not of urgent medical concern, prevailing myths. A clear strategy is required to address such problems when the same or a similar type of pandemic strikes us in future.

Introduction: Rashtriya Bal Swasthya Karyakram (RBSK) is a systemic approach of 4‘D’s (Defect, Diseases, Deficiency, Developmental delay) for early identification and linkage with care, support and treatment. Objectives: (1) Document utilization of RBSK services within a year of referral, (2) Assess reasons for non-utilization of services and (3) Assess out of pocket expenditure (OOPE) among users and non-users of the program. Method: Retrospective Cohort Study was conducted at an Urban Health Centre (UHC) taking two cohorts of children referred for 4‘D’s during April 2018-March 2020 under RBSK. A total of 102 cases were sampled. Probability Proportionate to size (PPS) method was used to ensure proportionate representation of each of 4‘D’s in the sample. Required number of participants in each category were selected randomly. Results: Out of 102 sampled cases, 97 were covered. Utilization of services was 50.5%; major reasons for non-utilization were preference for private providers and reluctance to stay at Comprehensive Malnutrition Treatment Centre (CMTC). Mean OOPE in users was Rs. 21545, significantly less (p

Background: Under Rashtriya Bal Swasthya Karyakram (RBSK), children (0–18 years) are screened for a spectrum of 30 health conditions, categorized under 4D's namely defect (birth), disease (chronic), deficiency disorders, and developmental delay, and referred for treatment at higher centers. The aim of this study is to document demographic, clinical profile of children detected with any of 4D's during 2018–20 at one Urban Primary health center to assess their Quality of Life (QOL) and client satisfaction. Materials and Methods: A total of 102 children

Introduction: Medical Officer (MO) of an Urban Health Centre (UHC) is responsible for implementing all activities grouped under Health and Family Welfare delivery system in UHC area. While RBSK MO of UHC works under Rashtriya Bal Swasthya Karyakaram (RBSK). Objective: To assess various activities carried out by MBBS MOs and RBSK MOs at UHCs with proportion of time spent on each of activities. Method: The study was conducted at randomly selected 12 UHCs from randomly selected 3 zones of Ahmedabad city. Data regarding activities of MBBS and RBSK MOs were collected using predesigned matrix time log sheet wherein the MOs had to fill up their activities on 15 minutes slots for 2 weeks. Data were entered and analyzed using MS Excel. Results: Effective working time per day was 7 + 1/2 hours &6+1 hours for an MBBS & RBSK MO respectively. Majority of time spent per day by the MBBS MO was in conducting general OPD (mean 149 minutes) followed by preparing/checking reports. While, for RBSK MO, it was in health checkup at Anganwadis & Schools(118& 93 minutes respectively) followed by preparation of reports. Both MOs spent maximum time towards clinical work (48.51% by MBBS& 68.45% RBSK MOs) followed by administrative work (33.73% by MBBS & 18% by RBSK), field visits (11.5% by both), CME/workshops/trainings (2.02% by MBBS and 0.66% by RBSK) and other activities (4.2% by MBBS and 0.8% by RBSK). Conclusion: Frequency of various major activities was as per the recommendations for most of the MOs. However, many of them were not able to cover all the activities mentioned under guidelines.

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Context: Rabies is a deadly Zoonotic disease most often transmitted to humans through a dog bite. Most of these deaths could be prevented through post-exposure prophylaxis (PEP), including immediate wound washing, rabies immunoglobulin administration and vaccination. Aims: To study attitude and pre-treatment practices among the study population. Methods: Cross sectional study was carried out by conducting exit interview of 100 cases of animal bite each from three hospitals run by Ahmedabad Municipal Corporation. Observations: Total 300 cases of animal bites were studied in the present study. Most common biting animal was dog as 97.33% cases gave history of dog bite. Almost half of the cases belonged to age group less than 20 years with mean age of 19+ 20.2 years and male to female ratio was 3:1. Right lower limb was the most common (45.7%) biting site and majority (59%) had category III bites. Immediate pre-treatment of wound was practiced by 72% of cases before visiting hospitals however only 5.7% had gone for immediate washing of wound with soap and water. The local applications at the site of bite were tobacco snuff, red chilli, turmeric, and miscellaneous things like Garlic, Jaggery, Kerosene, Lime, Bandage, Soframycine, Ghee, Wheat flour etc. which were practiced by 66% of cases. The average time interval between bite and visiting the hospital was 32 hours. Conclusions: With the availability of safe and effective tissue culture vaccines prevention of rabies is virtually assured by immediate and appropriate post exposure treatment. There is need for creating awareness in public and medical community about proper wound management, judicious use of anti-rabies serum and use of modern tissue culture vaccine after animal bite.