European Journal of Biomedical and Pharmaceutical Sciences

QUANTITATIVE EVALUATION OF COST-EFFECTIVENESS IN THE RASHTRIYA BAL SWASTHYA KARYAKRAM (RBSK) PROGRAM: A CROSS-SECTIONAL STUDY IN GADAG DISTRICT, KARNATAKA

Dr. Nagashree Muraleedhar Nayak, Dr. Gulappa Devagappanavar*, Dr. Nagesh S. and Dr. Jyothi Naik*

ABSTRACT

Background: The Rashtriya Bal Swasthya Karyakram (RBSK) is a flagship child health screening and early intervention initiative under India’s National Health Mission (NHM). While its qualitative impact is well recognized, quantitative assessments of its cost-effectiveness over time are scarce. This cross-sectional study, adhering to STROBE guidelines, compares program reach, treatment adherence, and unit costs in Gadag district, Karnataka, across two reference(Budget) periods: April 2022-March 2023. Child health is a cornerstone of social and economic development. The World Health Organization emphasizes early detection and intervention for congenital defects, nutritional deficiencies, infectious diseases, and developmental delays to reduce morbidity, mortality, and long-term disability. In India, where nearly one in five children is estimated to live with a disability, the Government launched the Rashtriya Bal Swasthya Karyakram (RBSK) in 2013 under the National Health Mission. Materials and Methods: This was a descriptive, Cross-Sectional study using the available data obtained from the healthcare department. Two reference periods were analyzed: April 2022–March 2023 and January–December 2025. Data were collected from the district RBSK office and the District Early Intervention Centre (DEIC). Variables included the number of children treated in Anganwadi centres (0–6 years) and schools (6–18 years), treatment rates, and program costs. All children screened and treated under RBSK in Gadag during the study periods were included. All children who were screened and subsequently treated under the RBSK programme in Gadag district during these periods were included in the analysis. No exclusion criteria were applied. Treatment rate was calculated as the number of children treated divided by the number identified, expressed as a percentage. Total programme costs comprised annual human resource expenses (salaries for medical officers, nurses, optometrists) and operational outlays (vehicle maintenance, stationery, IEC materials). Cost per case treated was derived by dividing the total cost by the number of treated cases each year. To address missing 2025 school data, we imputed conservative estimates (38,500 identified; 36,000 treated) based on historical trends and conducted sensitivity analyses with ±10 % variation. All descriptive statistics and cost calculations were performed in Microsoft Excel, and findings are presented in tables and narrative form. Results: Total treated beneficiaries rose from 17,000 in 2022–2023 to 86,478 in 2024-25. Program expenditure increased from an estimated 78.37 lakhs to 2.33 crores, but cost per case treated declined from INR 461 to 269, i.e., 41.7% reduction. Anganwadi treatment rate improved from 85.9% to 96.7%, while school treatment rate rose from 93.1% to an estimated 93.5%. The five-fold expansion in covered children with concurrent unit cost reduction demonstrates robust economies of scale. Conclusion: RBSK in Gadag district achieved remarkable scale-up, adherence, and cost-efficiency between 2022–2023 and 2025. The stable or improved treatment rates alongside declining per-child costs underscore the program’s fiscal sustainability and public health impact. Investments in follow-up awareness, transport support, and data systems are recommended to sustain gains.

Keywords: RBSK; Cost-effectiveness; child health; Program Evaluation; Outcome; National Program.