Gujarat RBSK 2.0 Guidelines 2026: Quality Standards & Framework

!ુજરાત RBSK એ(સેલ,સ -ટા,ડ01સ 2026
5ે6તા અને !ુણવ;ા <ુધારણાના ધોરણો માટે !ુજરાત આરબીએસકે માગEદGશIકા 2026 - ડૉ જે એલ મીના પાMું 1 / 41
!ુજરાત આરો)ય અને પ/રવાર ક2યાણ 4વભાગ
National Health Mission – Gujarat
!ુજરાત RBSK એ(સેલ,સ -ટા,ડ01સ
અને $ુણવ(ા *ુધારણા માગ/દ1શ3કા – 2026
Rashtriya Bal Swasthya Karyakram (RBSK 2.0) ના અસરકારક, measurable, accountable અને outcome-oriented
અમલ માટે
"Every Child Screened, Every Condition Identified Early, Every Eligible Child Linked to Care, Every
Treatment Completed, and Every Child Followed Until Outcome."
Dr J L Meena

સંદેશ (Foreword)
[ કચેર&'ું લેટરહેડ / Office Letterhead — જ1ર 2ુજબ ઉમેર6ું ]
રા23ય બાલ 6વા8ય કાય9:મ (RBSK) એ <ુજરાત રા@માં બાળ આરોEયની Gદશામાં એક મહKવLૂણ9 અને પGરણામલPી પહેલ છે.
RBSK 2.0 ના Rવ6Sૃત framework અંતગ9ત, રા@ના દરેક પાV બાળક Wુધી <ુણવYાસભર screening, સમયસર referral અને સંLૂણ9
સારવાર પહ[ચે તે Wુ]ન^_ત કર`ું એ આપણી સ]હયાર3 જવાબદાર3 છે.
Dr. J. L. Meena

Table of Contents
સંદ$શ (Foreword) ............................................................................................................2
દ&તાવેજ િવશે અને ઉપયોગ માટ$ની 7ૂચનાઓ..........................................................................6
!ુ#ય િસ'ાંતો.............................................................................................................................6
,ૂની Guideline vs RBSK 2.0 (2026) — !ુ#ય ફ1રફારો .......................................................................6
1. Regulatory & Evidence Base.......................................................................................7
2. Guidelineનો ;ુ=ય હ$?ુ...................................................................................................7
ચાર !ુ#ય 4િતબ'તાઓ ..............................................................................................................7
3. Gujarat RBSK — 10-Pillar Quality Framework ..............................................................8
10-Pillar િવગતવાર Standards...................................................................................................8
Pillar 1 — Universal Child Screening........................................................................................................8
Pillar 2 — Quality of Screening.................................................................................................................8
Pillar 3 — Early Identification...................................................................................................................9
Pillar 4 — Referral & Triage ......................................................................................................................9
Pillar 5 — DEIC Strengthening................................................................................................................ 10
Pillar 6 — Treatment & Surgical Linkage ................................................................................................ 10
Pillar 7 — Follow-up & Rehabilitation .................................................................................................... 10
Pillar 8 — Digital Health & Data Management........................................................................................ 11
Pillar 9 — Human Resources & Capacity Building.................................................................................. 11
Pillar 10 — Monitoring, Accountability & CQI......................................................................................... 11
4. RBSK Service Delivery Model — @ુજરાત Pathway....................................................... 12
Referral Pathway Flow ..........................................................................................................12
5. Mobile Health Team (MHT) Standards ....................................................................... 13
A. Team Composition............................................................................................................13
B. Annual Microplan..............................................................................................................13
C. Monthly Visit Plan Format (દર1ક MHT માટ1)...........................................................................13
D. Field Performance Standards — Outcome-based (Activity-based નહ>) ................................13
6. Screening Quality Standards — KPI Formula Sheet.................................................... 15
7. RBSK 2.0 — Expanded Screening Framework (4Ds + Emerging Priorities) .................... 16
8. DEIC (District Early Intervention Centre) Excellence Standards ................................. 18
DEIC Functionality Score (Recommended Gujarat State Standard).........................................18
9. Child Case Management System.............................................................................. 19
Case Status Stages (Dashboard Structure) ............................................................................19
10. Digital RBSK Dashboard — @ુજરાત Framework ........................................................ 20
Dashboard Modules .............................................................................................................20
11. Red Flag / Colour-Coded Alert System .................................................................... 21

Red Flag Situations, Timeline, Responsibility & Escalation .....................................................21
12. Referral Timeline Standards ................................................................................... 22
Priority Category-wise Timeline.............................................................................................22
13. Follow-up & Lost-to-Follow-up (LTFU) Prevention System ........................................ 23
બ?ુ-@તરAય Follow-up Reminder System..................................................................................23
SOP — Lost to Follow-up (LTFU).............................................................................................23
14. Human Resource Standards................................................................................... 24
Competency-based Training Matrix (સંBCDત Structure) ...........................................................24
15. Equipment Standards — MHT & DEIC...................................................................... 25
MHT Essential Equipment .....................................................................................................25
DEIC Essential Equipment ....................................................................................................25
16. Standard Operating Procedures (SOPs) — Master List ............................................. 26
17. Quality Assurance & Audit System.......................................................................... 27
Level 1 — MHT Self Audit (માિસક)............................................................................................27
Level 2 — Taluka Supervisory Audit (માિસક/િEમાિસક) ...............................................................27
Level 3 — District RBSK Quality Audit (િEમાિસક) ......................................................................27
Audit Checklist — સંBCDત ફોમFટ (Eણેય @તર માટ1 અJુKૂલનીય).......................................................27
18. RBSK Scorecard — 100 Marks (District / Taluka / MHT)............................................. 28
વૈNાિનક Justification (સંBCDત).................................................................................................28
Grading................................................................................................................................28
19. District Ranking Framework ................................................................................... 29
20. Child Outcome Indicators ...................................................................................... 30
21. Parent & Community Satisfaction........................................................................... 31
22. Gujarat માટ$ Special Focus Areas — Geographic/Demographic Strategy.................... 32
23. Innovation Framework ........................................................................................... 33
24. Continuous Quality Improvement (CQI) Framework................................................. 34
CQI Project — તબOા.............................................................................................................34
25. Documentation & Evidence File Index..................................................................... 35
26. Success Story Framework...................................................................................... 36
27. Monthly Review Meeting — Standard Agenda (District RBSK) ................................... 37
28. 30–60–90 Day RBSK Improvement Plan ................................................................... 38
4થમ 30 Qદવસ — Critical Gaps ઓળખ અને Tુધારણા ...................................................................38
60 Qદવસ — Referral, DEIC અને Follow-up TુVૃઢAકરણ.................................................................38

90 Qદવસ — Outcome-based Performance અને CQI..................................................................38
29. Gujarat RBSK Excellence Model – 2026.................................................................... 39
30. Final Deliverables — Tool Index.............................................................................. 40
Yિતમ સંદ1શ ...........................................................................................................................40

દ(તાવેજ -વશે અને ઉપયોગ માટેની 8ૂચનાઓ
આ માગ9દaશbકા Government of India ના RBSK 2.0 Operational Guidelines (2026), અગાઉની RBSK Operational
Guidelines (2013 અને Kયારપછ3ના Wુધારા), DEIC Operational Guidelines, NHM/MoHFW Child Health framework તથા
WHO/UNICEF ના સંબંRધત child-health iસjાંતોના આધારે તૈયાર કરવામાં આવેલ છે. @ાં <ુજરાત-Rવiશl સYાવાર પGરપV/SOP
ઉપલmધ ન હોય, Kયાં તે આંકડા/ધોરણને 6પl ર3તે “Recommended Gujarat State Standard” તર3કે Rચ]qત કરવામાં આવેલ છે,
જેને રા@ કPાએ સYાવાર મંજૂર3 બાદ જ અમલમાં લે`ું.
ન"ધ: આ દ'તાવેજમાં દશા0વેલ કોઈ પણ સં8ા9મક લ:યાંક (target %) બનાવટA રAતે રજૂ કરવામાં આવેલ નથી; Gાં national/state ધોરણ
ઉપલJધ ન હોય 9યાં તેને 'Recommended Gujarat State Standard' ગણNું અને District/State RBSK Nodal Officer Qારા સRાવાર માSયતા
મેળUા બાદ જ ઉપયોગ કરવો.
!ુ# $સ&ાંતો
● No Child Identified Without Follow-up
● No Eligible Child Left Unscreened
● No Confirmed Child Lost to Follow-up
● No Delay in Referral / Treatment
આ ચાર iસjાંતો સમr દ6તાવેજમાં દરેક Rપલર, SOP, KPI અને Red Flag Gડઝાઇનનો આધાર છે. કાય9:મuું vૂwયાંકન ફyત 'કેટલા
બાળકોની તપાસ થઈ' તેના પરથી નહ|, પર}Sુ Screen → Identify → Confirm → Refer → Treat → Follow-up →
Rehabilitation → Outcome ની સંLૂણ9 સાંકળ (continuum) પરથી કરવામાં આવશે.
જૂની Guideline vs RBSK 2.0 (2026) — !ુ# ફેરફારો
પા#ું અગાઉની Guideline (2013 આધા2રત) RBSK 2.0 (2026)
વય જૂથ 0–18 વષ0 (4Ds પર કે]S^ત)
0–18 વષ0, 4Ds + NCD risk, Mental Health,
Behavioural concerns સaહત bવ'cૃત framework
Conditions મયા0eદત condition-list
~38 conditions iુધી bવ'cૃત (4Ds + emerging
priorities)
Digital Tracking jુ89વે manual/paper-based MIS
Digital/Longitudinal Health Card, Child ID
આધાeરત real-time tracking ભાર
Service Model Screening-focused MHT model
Hub-and-Spoke, DEIC-કે]S^ત, multi-sectoral
(Education + WCD) convergence પર ભાર
Outcome Focus Screening/Referral numbers પર ભાર
Screen-to-Outcome સંlૂણ0 pathway, Lost-to-
Follow-up ઘટાડવા પર ભાર
ન"ધ: oોત: MoHFW RBSK 2.0 Guidelines (2026), National Health Mission પોટrલ અને સંબંbધત સRાવાર sહેરાતો. ચોuસ કલમ-વાર
reference માટે jૂળ Government of India દ'તાવેજ સાથે vોસ-ચેક કરવો આવwયક છે.

1. Regulatory & Evidence Base
નીચેના authoritative દ6તાવેજોના આધારે આ માગ9દaશbકા તૈયાર થયેલ છે. @ાં જૂની અને નવી guideline વ~ચે તફાવત છે, Kયાં
RBSK 2.0 (2026) ને current framework તર3કે •ાધા€ય આપવામાં આવેલ છે.
8ોત (Source)
:ુ; જ=2રયાત
(Requirement)
?ુજરાત
Applicability
Recommended
Operational Standard
Monitoring
Indicator
RBSK 2.0 Operational
Guidelines, 2026
(MoHFW)
0–18 વષ0ના તમામ બાળકોyું
4Ds + emerging conditions
માટે universal screening
તમામ 33
zજ{લા/કોપ|રેશનમાં
લા}ુ
100% eligible બાળકોyું
વા~ષ•ક ઓછામાં ઓછુ• 1
વખત screening
Screening
Coverage %
Previous RBSK
Guidelines (2013 व
सुधारा)
MHT structure, Referral
pathway, DEIC concept
Base structure તરAકે
ચાƒુ, Gાં 2026
guideline
bવરોધાભાસ ન કરે
Existing MHT/DEIC
ઈS„ા…†‡ચરyું upgrade
MHT Functional
Status %
DEIC Operational
Guidelines
DEIC ખાતે specialist
evaluation, therapy, case
management
દરેક zજ{લામાં
ઓછામાં ઓછુ• 1
functional DEIC
DEIC Level-1/2 …ટાSડડr
jુજબ …ટાˆફ•ગ
DEIC
Functionality
Score
NHM/MoHFW Child
Health Framework
RMNCAH+N સાથે
integration, newborn
screening linkage
SNCU/NBSU સાથે
RBSK linkage
Birth Point screening
SOP અમલ
Newborn
Screening
Coverage %
WHO/UNICEF Child
Health Standards
Growth monitoring,
developmental milestones,
early childhood
development
Anganwadi-level
integration (WCD
Dept સાથે)
ICDS/WCD સાથે
convergence meeting
Convergence
Meeting
Frequency
Government of Gujarat
/ NHM-Gujarat SOPs
(Gાં ઉપલJધ)
રાG-bવ]શŠ પeરપ‹ો, staffing
pattern, remuneration
લા}ુ પડતા તમામ
MHT/DEIC
State circular jુજબ પાલન
Compliance Audit
Score
ન"ધ: ઉપરો‡ત કોŠકમાં 'Recommended Operational Standard' કૉલમના આંકડા Gાં સRાવાર GoI/GoG પeરપ‹માં ઉ{લે]ખત ન હોય 9યાં
Recommended Gujarat State Standard ગણવા.
2. Guidelineનો ?ુA હેCુ
આ માગ9દaશbકાનો ઉ•ેશ ફyત screening ની સં‚ા વધારવાનો નથી, પર}Sુ દરેક બાળક માટે સંLૂણ9 care continuum Wુ]ન^_ત કરવાનો
છે:
Screen → Identify → Confirm → Refer → Treat → Follow-up → Rehabilitation → Outcome
ચાર !ુ# :;તબ&તાઓ
● No Child Identified Without Follow-up — ઓળખાયેલ દરેક બાળકuું follow-up Wુ]ન^_ત.
● No Eligible Child Left Unscreened — દરેક પાV બાળક ઓછામાં ઓછુ} વષ9માં એક વખત screen થાય.
● No Confirmed Child Lost to Follow-up — Confirmed case ˆારેય tracking વગર ન રહે.
● No Delay in Referral/Treatment — condition-wise ]નધા9Gરત સમયમયા9દામાં referral અને treatment.

3. Gujarat RBSK — 10-Pillar Quality Framework
નીચે દશા9વેલ 10 pillars સમr RBSK cycle ને આવર3 લે છે. દરેક pillar માટે Rવગતવાર Objective, Standard, Minimum/Ideal
requirement, Responsible Officer, Frequency, KPI, Evidence, Red Flag અને Corrective Action Rવભાગ 4 થી 17 માં
આપેલ છે.
@મ Pillar :ુ; Objective
1 Universal Child Screening 0–18 વષ0ના તમામ પા‹ બાળકોyું 100% coverage
2 Quality of Screening Standardised protocol jુજબ ચોકસાઈlૂણ0 screening
3 Early Identification 4Ds અને emerging conditions ની વહેલી ઓળખ
4 Referral & Triage Condition-severity jુજબ સમયસર, યો•ય-'તરે referral
5 DEIC Strengthening Confirmatory diagnosis, therapy અને case-management hub
6 Treatment & Surgical Linkage Free, સમયસર treatment/surgery linkage
7 Follow-up & Rehabilitation Lost-to-follow-up ટાળ• rehabilitation lૂણ0 કરNું
8 Digital Health & Data Management Real-time, accurate, actionable data
9 Human Resources & Capacity Building સ’મ, “]શ]’ત, motivated workforce
10 Monitoring, Accountability & CQI Objective scoring, audit અને સતત iુધારો
10-Pillar ;વગતવાર Standards
Pillar 1 — Universal Child Screening
ઘટક Eવગત
Objective 0–18 વષ0ના તમામ eligible બાળકોyું ઓછામાં ઓછુ• વષ0માં એક વખત screening.
Minimum Requirement
Anganwadi/School enrolled બાળકોના 90% (Recommended Gujarat State Standard) yું
વા~ષ•ક screening.
Ideal / Best Practice 100% coverage, out-of-school/migrant બાળકો સaહત house-to-house survey સાથે.
Responsible Officer MHT Team Leader → Taluka Health Officer → District RBSK Nodal Officer
Frequency સતત (Annual cycle, Monthly review)
KPI Screening Coverage % = (બાળકો screened / કુલ eligible બાળકો) × 100
Evidence Required Microplan, Visit register, Screening register, U-WIN/RBSK MIS entry
Red Flag Coverage < 70% સતત 2 મaહના (Recommended threshold)
Corrective Action Microplan revision, additional visit, School/AWC સાથે coordination
Pillar 2 — Quality of Screening
Objective Standardised checklist/protocol અyુસાર ચોકસાઈlૂણ0 clinical screening.
Minimum Requirement તમામ MHT members RBSK screening protocol પર “]શ]’ત; standard equipment ઉપયોગ.
Ideal / Best Practice Digital checklist-based screening + periodic inter-observer reliability check.

Responsible Officer Medical Officer (MHT) / Taluka RBSK Coordinator
Frequency Monthly supervisory observation
KPI Repeat Screening Rate, False Referral Rate
Evidence Required Screening checklist, Supervisory visit report, Equipment calibration log
Red Flag False Referral Rate > 20% (Recommended threshold)
Corrective Action On-job retraining, protocol refresher, supportive supervision
Pillar 3 — Early Identification
Objective 4Ds અને emerging conditions ની early-age detection.
Minimum Requirement
Birth Point + Anganwadi 'તરે 0–6 વષ0ના high-yield conditions (birth defects, hearing,
vision) પર ફોકસ.
Ideal / Best Practice Antenatal risk-flagging સાથે linkage; AI-assisted screening pilot Gાં યો•ય હોય.
Responsible Officer MO (MHT), DEIC Paediatrician
Frequency Continuous
KPI Early Identification Rate (0–2 વષ™ ઓળખાયેલ cases / કુલ confirmed cases)
Evidence Required Case sheet, DEIC referral slip
Red Flag 0–2 વષ™ identification rate માં ઘટાડો (trend-based)
Corrective Action Birth Point screening SOP reinforcement, SNCU/NBSU coordination
Pillar 4 — Referral & Triage
Objective
Condition-severity jુજબ Emergency/Urgent/Priority/Routine triage સાથે યો•ય-'તરે
referral.
Minimum Requirement તમામ referral case RBSK Referral Card સાથે, aનધા0eરત સમયમયા0દામાં.
Ideal / Best Practice Digital referral tracking + Tele-triage support.
Responsible Officer MO (MHT) → DEIC Medical Officer
Frequency દરેક referral પર; Weekly review
KPI Referral Rate, Confirmation Rate (bવભાગ 6 જુઓ)
Evidence Required Referral card, DEIC receiving register
Red Flag Referred પર•cુ 30 eદવસમાં DEIC/facility ખાતે ન પહ"ચેલ
Corrective Action ASHA/AWW ફોલોઅપ, ફોન eરમાઇSડર, Taluka escalation

Pillar 5 — DEIC Strengthening
Objective
Specialist evaluation, confirmatory diagnosis, therapy અને case-management hub તરAકે
DEIC ને સ’મ બનાવNું.
Minimum Requirement દરેક zજ{લામાં ઓછામાં ઓછુ• 1 functional DEIC, core specialist ટAમ સાથે.
Ideal / Best Practice
DEIC ખાતે તમામ specialist (Paediatrician, ENT, Ophthalmologist, Dental, Physiotherapist,
Psychologist) ઉપલJધ.
Responsible Officer DEIC Manager / District RBSK Nodal Officer
Frequency Monthly DEIC performance review
KPI DEIC Functionality Score (bવભાગ 8 જુઓ)
Evidence Required DEIC OPD register, Therapy attendance register
Red Flag Specialist post > 30 eદવસ ખાલી
Corrective Action Contractual recruitment, visiting specialist arrangement, tele-consultation
Pillar 6 — Treatment & Surgical Linkage
Objective Confirmed cases માટે free, સમયસર treatment/surgery ની ખાતરA.
Minimum Requirement
Empanelled હો›'પટલ/Medical College સાથે cashless linkage; RBSK fund Qારા cost
coverage.
Ideal / Best Practice Treatment guarantee dashboard + pre-authorization SOP.
Responsible Officer DEIC Manager, District RBSK Nodal Officer
Frequency દરેક confirmed case પર
KPI Treatment Initiation Rate, Treatment Completion Rate
Evidence Required Treatment plan, Surgery register, Discharge summary
Red Flag Confirmed case > 60 eદવસ treatment વગર (condition-severity jુજબ)
Corrective Action Empanelled centre escalation, District Collector-level review જો જœરA
Pillar 7 — Follow-up & Rehabilitation
Objective Treatment પછA functional recovery iુધી follow-up અને rehabilitation.
Minimum Requirement Condition-wise aનધા0eરત follow-up schedule (દા.ત. surgery પછA 1, 3, 6 મaહને).
Ideal / Best Practice Tele-rehabilitation + School reintegration support.
Responsible Officer ASHA/AWW → MO (MHT) → DEIC Therapist
Frequency Schedule jુજબ
KPI Follow-up Completion Rate, Lost-to-Follow-up Rate
Evidence Required Follow-up register, Home visit report

Red Flag સતત 2 follow-up visit miss
Corrective Action Home visit, escalation SOP (bવભાગ 13 જુઓ)
Pillar 8 — Digital Health & Data Management
Objective Real-time, ચોકસાઈlૂણ0, actionable child-level data.
Minimum Requirement દરેક બાળક Unique Child ID સાથે MIS માં ન"ધાયેલ.
Ideal / Best Practice Longitudinal Digital Health Card + District/Taluka/MHT dashboard.
Responsible Officer Data Entry Operator, DEIC Manager, District Data Manager
Frequency Daily data entry, Weekly data quality check
KPI Data Completeness %, Data Timeliness %
Evidence Required MIS login report, Data audit report
Red Flag Data entry backlog > 7 eદવસ
Corrective Action Additional data-entry support, retraining
Pillar 9 — Human Resources & Capacity Building
Objective સ’મ, “]શ]’ત, motivated MHT/DEIC workforce.
Minimum Requirement તમામ MHT/DEIC …ટાફ induction training + વા~ષ•ક refresher.
Ideal / Best Practice Competency-based certification + career progression pathway.
Responsible Officer District Training Coordinator, State RBSK Cell
Frequency વા~ષ•ક training calendar
KPI Training Coverage %, Competency Assessment Score
Evidence Required Training attendance, Certification record
Red Flag Untrained …ટાફ 3 મaહનાથી વ•ુ ફરજ પર
Corrective Action Immediate orientation training, mentor assignment
Pillar 10 — Monitoring, Accountability & CQI
Objective Objective scoring, multi-level audit અને સતત }ુણવRા iુધારણા.
Minimum Requirement Monthly review meeting + Quarterly district audit.
Ideal / Best Practice Data-driven district ranking + Quarterly CQI project (દરેક zજ{લામાં).
Responsible Officer District RBSK Nodal Officer, State RBSK Cell
Frequency Monthly/Quarterly
KPI RBSK Scorecard (100 marks — bવભાગ 18)

Evidence Required Review minutes, Audit checklist, CQI report
Red Flag Score < 60 (Priority Improvement) સતત 2 quarter
Corrective Action State-level support visit, targeted action plan (30-60-90 day)
4. RBSK Service Delivery Model — Iુજરાત Pathway
<ુજરાત માટે 8-6તર3ય service delivery pathway નીચે vુજબ Gડઝાઇન કરવામાં આવેલ છે. દરેક 6તર પર screening/care ની
જવાબદાર3 અને next-level referral criteria 6પl છે.
Gતર Hાન/એકમ :ુ; KLૃNO Referral Trigger (આગલા Gતરે)
1
Birth Point
(SNCU/NBSU/Labour Room)
Newborn screening, birth-defect
identification, documentation
કોઈપણ visible defect/high-risk
newborn → DEIC/Level 6-7
2 Anganwadi (0–6 વષ0)
Growth/development assessment, 4Ds
screening
Red-flag sign → MHT/PHC (Level 4-
5)
3 સરકારA શાળા (6–18 વષ0)
Vision, Hearing, Dental, Nutrition,
Developmental/Behavioural, NCD risk
screening
Suspected case → MHT/PHC
4 Mobile Health Team (MHT)
Field screening, “ાથbમક aનદાન, referral card
generation
Confirmed suspicion → PHC/CHC
અથવા સી•ું DEIC
5 PHC / CHC / તાƒુકા હો›'પટલ
“ાર•zભક jૂ{યાંકન, stabilisation, referral
coordination
Specialist જœeરયાત → DEIC
6
DEIC (District Early Intervention
Centre)
Uાપક jૂ{યાંકન, specialist evaluation,
therapy, counselling, case management
Surgical/tertiary care જœeરયાત →
Level 7-8
7 zજ{લા હો›'પટલ / મેeડકલ કોલેજ
Specialist care, aનદાન confirmation, surgical
management
Super-specialty જœeરયાત → Level 8
8
Empanelled Private/Tertiary
Centre
bવ]શŠ સારવાર, surgery, cochlear implant
વગેરે
Outcome reporting → DEIC → MIS
Referral Pathway Flow
Birth Point / Anganwadi / School → MHT (Field Screening) → PHC/CHC → DEIC (Confirmatory Assessment) →
$જ&લા હો+,પટલ/મે1ડકલ કોલેજ → Empanelled Tertiary Centre → Treatment/Surgery Completion → Follow-up &
Rehabilitation → Outcome Recorded in MIS
ન"ધ: 'તર 1-3 primary identification points છે; 'તર 4 (MHT) field-level triage કરે છે; 'તર 6 (DEIC) confirmatory hub છે. કોઈપણ
'તરેથી emergency case સીધા Level 7 પર refer કરA શકાય (bypass-with-documentation).

5. Mobile Health Team (MHT) Standards
A. Team Composition
Post સં;ા/ટSમ :ુ; જવાબદારS લVુOમ લાયકાત
Medical Officer (Ayush/MBBS) 1 Clinical screening, referral decision
MBBS/BAMS/BHMS +
RBSK training
Staff Nurse / ANM 1 Nursing assessment, vitals, documentation GNM/ANM
Pharmacist 1 દવા UવŸાપન, first-aid D.Pharm
Driver-cum-Attendant 1 વાહન UવŸા, logistics support Valid driving license
B. Annual Microplan
● Anganwadi mapping — દરેક AWC ની ભૌગોRલક/બાળક-સં‚ા Rવગત સાથે.
● School mapping — સરકાર3/rા•ટ-ઇન-એઇડ શાળાઓની yearly visit calendar.
● Population mapping — MHT કાય9PેVમાં 0–18 વષ9ની વ6તીનો અંદાજ.
● High-risk area mapping — તબીબી ર3તે વંRચત/high-morbidity Rવ6તાર.
● Remote/border/desert areas — Kutch, Banaskantha સીમાવત• Rવ6તાર માટે Rવશેષ visit frequency.
● Seasonal considerations — •ળાંતર (migration) ઋSુ •માણે visit re-scheduling.
C. Monthly Visit Plan Format (દરેક MHT માટે)
#ૂચક Yા;ા/Source
Planned Visits Microplan jુજબ aનધા0eરત AWC/School visit સં8ા
Completed Visits ખરેખર થયેલ visit સં8ા (MHT visit register)
Children Expected Enrolment register jુજબ
Children Screened Screening register jુજબ
Children Missed Expected − Screened
Referrals Generated Referral card count
Confirmed Cases DEIC confirmation feedback
Treatment Linkage Treatment-started case count
Follow-up Status Follow-up register — due/completed/overdue
D. Field Performance Standards — Outcome-based (Activity-based નહG)
MHT ના vૂwયાંકન માટે ફyત 'કેટલી visit થઈ' એ પયા9’ત નથી. નીચેના outcome-based indicators ઉપયોગમાં લેવા:
Outcome Indicator Formula Recommended Threshold
Visit Completion Rate (Completed Visits / Planned Visits) × 100 ≥ 95%
Effective Screening Rate (Children Screened / Children Expected) × 100 ≥ 90%
Referral-to-Confirmation Ratio Confirmed Cases / Referrals Generated ≥ 0.6 (60%)

Outcome Indicator Formula Recommended Threshold
Treatment Linkage Rate (Treatment Started / Confirmed Cases) × 100 ≥ 90%
Follow-up Adherence Rate (Follow-up Completed / Follow-up Due) × 100 ≥ 85%
ન"ધ: Threshold values Recommended Gujarat State Standard છે — State RBSK Cell Qારા baseline data ના આધારે annual review
કરA iુધારવા.

6. Screening Quality Standards — KPI Formula Sheet
માV 'કેટલા બાળકો screened થયા' LૂરSું ન ગણ`ું. નીચેના quality indicators ફર“જયાત tracking માટે ]નધા9Gરત કરવામાં આ”ા
છે — દરેક MHT/Taluka/District 6તરે માiસક ગણતર3 થવી જોઈએ.
Indicator Formula Data Source
Screening Coverage % (બાળકો Screened / કુલ Eligible બાળકો) × 100 Screening Register, MIS
Complete Screening %
(તમામ Parameter Screened થયેલ બાળકો / કુલ Screened
બાળકો) × 100
Screening Checklist
Repeat Screening Rate (Repeat Screened / કુલ Screened) × 100 Screening Register
Referral Rate (Referred બાળકો / કુલ Screened) × 100 Referral Register
Confirmation Rate (Confirmed Cases / Referred Cases) × 100 DEIC Register
False Referral Rate (Referred પર•cુ Not Confirmed / કુલ Referred) × 100 DEIC Feedback
Missed-Case Rate
(Symptomatic છતાં Not Referred, ऑ(डट-detected / Audit
Sample) × 100
Supervisory Audit
Treatment Initiation Rate (Treatment Started / Confirmed Cases) × 100 Treatment Register
Treatment Completion Rate (Treatment Completed / Treatment Started) × 100
Treatment/Discharge
Register
Follow-up Completion Rate (Follow-up Completed / Follow-up Due) × 100 Follow-up Register
Lost-to-Follow-up (LTFU) Rate (LTFU Cases / Total Cases Requiring Follow-up) × 100 Case Tracking Dashboard
ન"ધ: High Referral Rate + Low Confirmation Rate = Red Flag (bવભાગ 11 જુઓ) — over-referral/screening-quality સમ'યા iૂચવે
છે. High Referral Rate + Low Treatment Rate = DEIC/Treatment-linkage bottleneck iૂચવે છે.

7. RBSK 2.0 — Expanded Screening Framework (4Ds + Emerging Priorities)
RBSK 2.0 (2026) એ vૂળ 4Ds ને •ળવી, નવા-–ુગના પડકારો (mental health, behavioural concerns, childhood NCD risk)
ને ઉમેર3 ~38 conditions Wુધી framework Rવ6Sૃત ક–ુ˜ છે. નીચે condition-category vુજબ representative pathway table
આપેલ છે; સંLૂણ9 38-condition detailed annexure State RBSK Cell šારા official MoHFW condition-list ના આધારે તૈયાર
કર`ું.
Category
Represent
ative
Condition
s
Screening
Age
Screening
Method
Who Can Screen Red Flag
Confirmatio
n
Treatment/R
eferral
Follow-up
Defects at
Birth
8લે9ટ
:લપ/પેલેટ,
Neural
Tube
Defect,
Congenita
l Heart
Disease,
Talipes,
Down
Syndrome
જ=મ – 6
અઠવાDડયા
Clinical
inspection
, Pulse-
oximetry
(CHD),
Physical
exam
ANM/Staff
Nurse/MO
Visible
deformity,
abnormal
cry/feedin
g, cyanosis
DEIC/Paedia
trician
confirmatio
n
SNCU/DEIC/T
ertiary
Surgical
Centre
Condition-
wise
(surgery
પછ&
Jનય:મત)
Diseases
Rheumati
c Heart
Disease,
Reactive
Airway
Disease,
Congenita
l Cataract,
Congenita
l
Deafness,
Vitamin-A
Deficiency
Blindness
0–18 વષQ
(age-
appropriat
e)
Clinical
screening,
OAE/BERA
(hearing),
Vision
chart
MHT
MO/Ophthalmic
Assistant/Audiol
ogist
Symptom-
based red
flag
checklist
DEIC
Specialist
evaluation
DEIC →
District
Hospital/Emp
anelled
Centre
3-6-12
મJહને
(condition
2ુજબ)
Deficienci
es
Vitamin A,
D, Iron-
deficiency
Anaemia,
Protein
Energy
Malnutriti
on, Iodine
Deficiency
0–18 વષQ
Growth
chart, Hb
testing,
Clinical
sign
AWW (growth) /
ANM (Hb) / MO
Growth
faltering,
pallor,
stunting/w
asting
PHC/CHC
confirmatio
n, lab test
PHC →
Nutrition
Rehabilitation
Centre (જ1ર
પડે)
માTસક
Growth
Monitorin
g
Developm
ental
Delays
Motor,
Speech-
Language,
Cognitive,
Vision,
Hearing
developm
ental
delay,
Autism
Spectrum,
ADHD
0–18 વષQ
(mileston
e-based)
Developm
ental
milestone
checklist,
standardis
ed
screening
tool
AWW/MHT MO
→ DEIC
Psychologist
Milestone
miss,
behavioura
l red flag
DEIC
Developmen
tal
Assessment
DEIC
Therapy/Early
Intervention
3-6 મJહને
therapy
review

Category
Represent
ative
Condition
s
Screening
Age
Screening
Method
Who Can Screen Red Flag
Confirmatio
n
Treatment/R
eferral
Follow-up
Mental
Health &
Behaviour
al
Concerns
(RBSK
2.0)
Anxiety,
Depressio
n,
Behaviour
al
disorder,
Substance
-use risk
(adolesce
nt)
School-
age/Adole
scent (10–
18 વષQ)
School-
based
screening
tool,
Teacher/P
arent
referral
Teacher-flagged
→ MHT MO →
DEIC
Psychologist/Psy
chiatrist
Behavioura
l change,
academic
decline,
self-harm
sign
DEIC/Menta
l Health
Specialist
DEIC
Counselling
→ Tertiary
Psychiatry
(જ1ર પડે)
માTસક
counsellin
g follow-
up
Childhood
NCD Risk
Factors
(RBSK
2.0)
Obesity,
Hypertens
ion risk,
Pre-
diabetes/
Type-1
Diabetes
risk
School-
age/Adole
scent
BMI,
Blood
Pressure
measurem
ent
MHT MO/Staff
Nurse
High BMI-
for-age,
elevated
BP
PHC/DEIC
—
Paediatricia
n evaluation
PHC/District
Hospital NCD
Clinic
6 મJહને
lifestyle/cl
inical
review
ન"ધ: આ table illustrative/representative છે — Recommended Gujarat State Standard. સંlૂણ0 38-condition annexure MoHFW
RBSK 2.0 (2026) ના official condition-list jુજબ State RBSK Cell Qારા verify કરA annexure તરAકે ઉમેરNું.

8. DEIC (District Early Intervention Centre) Excellence Standards
ઘટક Minimum Standard Ideal / Best Practice
Infrastructure
OPD room, Assessment room, Therapy room,
Waiting area — District Hospital પeરસરમાં
અલગ child-friendly building, Sensory room,
Play-therapy area
Human Resources
DEIC Manager, Paediatrician, Medical Officer,
Staff Nurse, Audiologist, Optometrist,
Physiotherapist, Psychologist, Special Educator,
Data Entry Operator
+ ENT Surgeon, Dental Surgeon, Occupational
Therapist, Speech Therapist, Social Worker
(full core team)
Equipment
Vision testing kit, OAE machine, Growth charts,
Developmental screening kit, BP apparatus
BERA machine, Digital audiometer, Tele-
consultation setup
Functional Areas Registration, Assessment, Therapy, Counselling + Parent-training room, Resource library
Specialist Availability ઓછામાં ઓછુ• સ¡તાહમાં 2 eદવસ visiting specialist તમામ core specialist full-time/daily availability
Therapy Services
Basic physiotherapy/speech therapy referral
linkage
On-site multi-disciplinary therapy (Physio,
Speech, Occupational, Behavioural)
Counselling & Parent
Education
Case-wise counselling session
Structured Parent Training Programme +
peer-support group
Documentation Case file, Referral register, Therapy attendance Digital case management system સાથે EMR
Referral Coordination District Hospital/Medical College સાથે linkage
Empanelled tertiary centres સાથે formal MoU
+ tele-referral
Follow-up Manual appointment reminder
SMS/WhatsApp automated reminder +
home-visit escalation
DEIC Functionality Score (Recommended Gujarat State Standard)
દરેક DEIC ને Infrastructure (20), HR (30), Equipment (15), Service Delivery (20), Documentation & Data (15) —
કુલ 100 marks પર માiસક/RVમાiસક vૂwયાંકન કર`ું, જે Rવભાગ 18 ના overall District Scorecard માં integrate થાય.

9. Child Case Management System
દરેક ઓળખાયેલ બાળકને Unique Child ID / Case ID ફાળવવામાં આવે, જેના આધારે સંLૂણ9 case lifecycle track થાય. Child
ID ફોમœટ: [Taluka Code]-[Village/School Code]-[Year]-[Sequential Number] (Recommended Gujarat State
Standard).
Case Status Stages (Dashboard Structure)
@મ Status Stage વણ[ન Colour Code
1 Screened MHT/Anganwadi/School ખાતે “ાથbમક screening lૂણ0 Green
2 Suspected Screening માં red-flag sign મળેલ Amber
3 Referred Referral card જનરેટ, next-level ને મોકલેલ Amber
4 Seen by Specialist DEIC/Facility ખાતે specialist consultation થયેલ Amber
5 Diagnosis Confirmed Confirmatory test/evaluation lૂણ0 Amber
6 Treatment Planned Treatment/surgery plan તૈયાર Amber
7 Treatment Started સારવાર/therapy શœ Green
8 Treatment Completed સારવાર/surgery lૂણ0 Green
9 Rehabilitation Ongoing Therapy/rehabilitation ચાƒુ Green
10 Follow-up Due aનધા0eરત follow-up તારAખ ન£ક/પસાર Amber
11 Follow-up Completed Follow-up visit સંlૂણ0, outcome ન"ધાયેલ Green
12 Lost to Follow-up (LTFU) 3 “ય9નો છતાં contact ન થયો Red
ન"ધ: Dashboard પર દરેક case yું status real-time અપડેટ થNું જોઈએ; 'Referred' થી 'Seen by Specialist' વ¤ચે 30 eદવસથી વ•ુ સમય
પસાર થાય તો automatic Amber→Red escalation (bવભાગ 11 જુઓ).

10. Digital RBSK Dashboard — Iુજરાત Framework
District → Taluka → MHT → AWC/School → Child એમ multi-level drill-down dashboard Gડઝાઇન કરવામાં આવેલ છે,
જે State RBSK Cell, District Nodal Officer અને Taluka Coordinator ને real-time decision-making માટે સPમ બનાવે.
Dashboard Modules
Module :ુ; Content
Coverage Eligible vs Screened બાળકો, AWC/School-wise coverage map
Screening Condition-wise screening count, quality indicators (bવભાગ 6)
Referral Referral count, pending referral, referral-to-confirmation ratio
Confirmation DEIC/facility-wise confirmed case count
Treatment Treatment initiation/completion status, pending cases
Surgery Surgery scheduled/completed, empanelled-centre-wise
DEIC Performance DEIC Functionality Score, specialist availability, OPD load
Follow-up Follow-up due/completed/overdue, LTFU trend
Pending Cases Stage-wise pending case count with ageing (7/15/30/60 eદવસ)
Lost-to-Follow-up LTFU count, reason-wise breakup, re-contact attempts
High-Risk Cases Severity-flagged/emergency cases needing priority action
MHT Performance Team-wise visit completion, outcome indicators (bવભાગ 5D)
District Ranking 100-marks scorecard આધાeરત live ranking (bવભાગ 18-19)

11. Red Flag / Colour-Coded Alert System
Colour અથ[
🔴 RED તા9કાbલક action જœરA (Immediate)
🟠 AMBER aનધા0eરત સમયમયા0દામાં action જœરA
🟢 GREEN ધોરણ jુજબ compliant
Red Flag Situations, Timeline, Responsibility & Escalation
Red Flag Situation Timeline Responsible Officer Corrective Action Escalation Mechanism
Child referred but not
seen by specialist
>30 eદવસ
(Recommended)
MHT MO + DEIC
Manager
Phone/home-visit
reminder, appointment
re-scheduling
Taluka Coordinator →
District Nodal Officer
Confirmed case awaiting
treatment start
>30-60 eદવસ
(condition-
severity jુજબ)
DEIC Manager
Empanelled centre
coordination, pre-
authorization ઝડપી કરNું
District Nodal Officer →
State RBSK Cell
Surgery pending
>60 eદવસ
confirmed
surgical need
છતાં
DEIC Manager,
District Nodal
Officer
Empanelled/tertiary
centre slot booking, fund
release check
District Collector-level
review (જœર પડે)
Follow-up overdue
>1 follow-up
cycle miss
ASHA/AWW →
MHT MO
Home visit,
SMS/WhatsApp reminder
Taluka Coordinator
MHT repeatedly missing
visits
2 consecutive
મaહના < 80% visit
completion
Taluka RBSK
Coordinator
Microplan review,
additional support/vehicle
check
Screening coverage <
target
2 consecutive
મaહના coverage
ઘટાડો
MHT MO, Taluka
Coordinator
Root-cause identification,
revised outreach plan
High referral but low
confirmation
False Referral
Rate > 20%
MHT MO, Taluka
Coordinator
Screening protocol
retraining
High referral but low
treatment
Treatment
Initiation Rate <
70%
DEIC Manager
Treatment-linkage
bottleneck analysis
District Nodal Officer →
State RBSK Cell
DEIC backlog (pending
assessments)
>15 eદવસ waiting
for assessment
DEIC Manager
Additional OPD session,
specialist roster
optimisation

12. Referral Timeline Standards
Priority Category-wise Timeline
Priority ઉદાહરણ
Referral →
Specialist
Consultation
Investigation Treatment Start
Surgery (જો
જ=રS)
Emergency
Congenital Heart Disease with
cyanosis, Severe respiratory
distress
24 કલાકમાં 24-48 કલાકમાં
તા9કાbલક/48
કલાકમાં
તા9કાbલક/જœeરયાત
jુજબ
Urgent
Severe malnutrition, Suspected
malignancy, Severe hearing loss
3 eદવસમાં 1 અઠવાeડયામાં 2 અઠવાeડયામાં 4 અઠવાeડયામાં
Priority
Cleft lip/palate, Congenital
cataract, Moderate
developmental delay
1-2 અઠવાeડયામાં 2 અઠવાeડયામાં 4-6 અઠવાeડયામાં 8-12 અઠવાeડયામાં
Routine
Refractive error, Mild dental
caries, Mild deficiency
4 અઠવાeડયામાં 4 અઠવાeડયામાં 6-8 અઠવાeડયામાં
લા}ુ ન પડે /
જœeરયાત jુજબ
ન"ધ: ઉપરો‡ત timeline Recommended Gujarat State Standard છે, condition-severity ના clinical judgment ને આધીન. Emergency
case કોઈપણ 'તરેથી સીધા Level 7 (District Hospital/Medical College) પર bypass-refer કરA શકાય.

13. Follow-up & Lost-to-Follow-up (LTFU) Prevention System
બહુ-IતરJય Follow-up Reminder System
● Telephonic reminder — Follow-up તાર3ખના 3 Gદવસ પહેલા (1st attempt).
● SMS/WhatsApp reminder — Automated, follow-up તાર3ખના 1 Gદવસ પહેલા.
● ASHA involvement — Local-level personal reminder/escort support.
● AWW involvement — Anganwadi-level tracking, ખાસ કર3ને 0-6 વષ9ના બાળકો માટે.
● School coordination — School-age બાળકો માટે Teacher/Principal મારફતે reminder.
● Home visit — 2 reminder છતાં response ન મળે તો ASHA/AWW šારા ફર“જયાત home visit.
● Parent counselling — Follow-up ના મહKવ અંગે DEIC/MHT šારા counselling.
● District tracking — DEIC Manager šારા સા’તા]હક pending follow-up review.
● Escalation to Medical Officer — 2 consecutive miss પર.
● Escalation to District RBSK Nodal Officer — 3 consecutive miss / LTFU risk પર.
SOP — Lost to Follow-up (LTFU)
પગ^ું 2@યા સમયમયા[દા જવાબદાર
1 Follow-up miss — 1st reminder (call/SMS) તારAખ પસાર થયાના 3 eદવસમાં MHT MO/ANM
2 2nd reminder + ASHA/AWW involvement 7 eદવસમાં ASHA/AWW
3 ફરzજયાત Home Visit 15 eદવસમાં ASHA/AWW + MHT
4 Escalation to Medical Officer 20 eદવસમાં Taluka Coordinator
5 Escalation to District RBSK Nodal Officer 30 eદવસમાં District Nodal Officer
6
'LTFU' તરAકે વગ§કરણ (3 “ય9નો છતાં contact
aન¨ફળ) + reason documentation
30 eદવસ પછA DEIC Manager
7
Quarterly LTFU review અને re-engagement
campaign
b‹મા]સક District RBSK Nodal Officer

14. Human Resource Standards
Gતર/Post Required Staff Training
Performance
Assessment
MHT — Medical Officer 1 per team
5-day RBSK Induction + વા~ષ•ક 2-
day Refresher
Quarterly supportive
supervision + outcome
KPI (bવભાગ 5D)
MHT — Staff Nurse/ANM 1 per team
Screening protocol training +
condition-wise checklist training
Monthly checklist
compliance review
DEIC — Manager 1 per district
DEIC management + case-
management system training
Quarterly DEIC
Functionality Score
DEIC — Specialists
(Paed/ENT/Ophthal/Dental/Physio/Psych)
Core team per
DEIC
Specialty-specific RBSK
orientation
Case-load & outcome-
based review
ASHA/AWW (Field-level)
Existing cadre —
RBSK role add-on
RBSK screening-support +
follow-up role orientation
Follow-up completion
contribution
Data Entry Operator
1-2 per
district/DEIC
MIS/Dashboard operation
training
Data completeness &
timeliness
Competency-based Training Matrix (સં$LMત Structure)
Training Level લ_ય જૂથ Frequency Certification
Induction Training નવા MHT/DEIC …ટાફ
ફરજ શœ કરતાં પહેલા (1
વખત)
Basic RBSK Certificate
Condition-specific Skill Training MHT MO/Nurse, DEIC Specialists વા~ષ•ક Competency Certificate
Refresher Training તમામ MHT/DEIC …ટાફ વા~ષ•ક Refresher Certificate
Leadership/Management
Training
DEIC Manager, Taluka/District
Coordinator
aQ-વા~ષ•ક Management Certificate
Digital Tools/Dashboard Training
Data Entry Operator, all
supervisory …ટાફ
System upgrade સમયે +
વા~ષ•ક
System-use Certificate

15. Equipment Standards — MHT & DEIC
MHT Essential Equipment
Equipment લVુOમ સં;ા Calibration/Maintenance
Vision Testing Chart (Snellen/E-chart) 1 set વા~ષ•ક ચકાસણી
Weighing Scale (Digital) 1 3-મા]સક calibration
Height/Length Board
(Infantometer/Stadiometer)
1 3-મા]સક ચકાસણી
BP Apparatus (Digital) 1 6-મા]સક calibration
Hearing Screening Tool (Otoscope/basic
OAE-linked)
1 વા~ષ•ક ચકાસણી
Developmental Screening Kit 1 set વા~ષ•ક content-update
First-aid Kit 1 મા]સક stock ચકાસણી
DEIC Essential Equipment
Equipment લVુOમ સં;ા Calibration/Maintenance
OAE/BERA Machine 1 વા~ષ•ક calibration (AMC સાથે)
Digital Audiometer 1 (Ideal standard) વા~ષ•ક calibration
Vision/Refraction Set 1 વા~ષ•ક ચકાસણી
Developmental Assessment Tools 1 set વા~ષ•ક content-update
Physiotherapy Equipment Basic set 6-મા]સક maintenance
Dental Screening Kit 1 set 3-મા]સક sterilisation ચકાસણી
Anthropometric Equipment 1 set 3-મા]સક calibration
દરેક MHT/DEIC ખાતે Equipment Stock Register •ળવ`ું, જેમાં Functional Status, છેwલી Calibration તાર3ખ,
Replacement જŸGરયાત ન[ધવામાં આવે — Monthly Self-Audit નો ભાગ (Rવભાગ 17).

16. Standard Operating Procedures (SOPs) — Master List
નીચેના 20 SOPs Gujarat RBSK Implementation માટે ફર“જયાત તૈયાર/અપડેટ કરવા. દરેક SOP uું Rવગતવાર દ6તાવેજ State
RBSK Cell šારા separate Annexure તર3કે develop કર`ું; અહ| Master List અને scope આપેલ છે (Deliverable J — SOP
Manual).
@મ SOP શીષ[ક Scope/:ુ; Eવષય
1 Newborn Screening SOP
Birth Point ખાતે તમામ newborn yું visible-defect/CHD/hearing
screening; SNCU/NBSU સાથે linkage
2 Anganwadi Screening SOP
0-6 વષ0 growth-development assessment, AWW-MHT joint visit
protocol
3 School Screening SOP શાળા-વાર annual screening calendar, class-wise checklist
4 Mobile Health Team SOP Daily/monthly visit protocol, documentation, equipment check
5 Vision Screening SOP Age-appropriate vision testing method, referral criteria
6 Hearing Screening SOP OAE-based/clinical hearing screening, BERA referral criteria
7 Dental Screening SOP Oral health checklist, caries/gum-disease identification
8 Nutrition Screening SOP Growth chart plotting, Hb testing, deficiency identification
9 Developmental Screening SOP Milestone-based checklist, age-band tool ઉપયોગ
10 Mental Health/Behavioural Concern SOP School-based screening tool, teacher-referral pathway, confidentiality
11 Referral SOP Referral card format, priority-triage, next-level hand-off
12 DEIC Assessment SOP Registration → Specialist evaluation → Confirmation → Care plan
13 Surgical Referral SOP Pre-authorization, empanelled-centre coordination, consent process
14 Follow-up SOP Condition-wise follow-up schedule, reminder cascade
15 Lost-to-Follow-up SOP 3-attempt re-contact protocol, escalation, documentation (bવભાગ 13)
16 Emergency Referral SOP 24-કલાક bypass-referral protocol for critical cases
17 Data Entry SOP
Timely, accurate MIS/Child-ID entry protocol, data-validation
checklist
18 Dashboard Monitoring SOP Daily/weekly dashboard review responsibility by level
19 Parent Counselling SOP
Diagnosis communication, informed consent, emotional support
protocol
20
Private Hospital/Empanelled Centre
Coordination SOP
MoU terms, cashless-claim process, outcome-reporting requirement
ન"ધ: દરેક SOP માં ફરzજયાત ઘટકો: Purpose, Scope, Responsibility, Step-by-step Procedure, Documentation Format, Timeline,
References (GoI/GoG guideline citation).

17. Quality Assurance & Audit System
Level 1 — MHT Self Audit (મા$સક)
● Visit register vs Microplan compliance ચકાસણી
● Equipment functional status ચકાસણી
● Screening checklist completeness ચકાસણી
● Referral card documentation ચકાસણી
● Follow-up register update ચકાસણી
Level 2 — Taluka Supervisory Audit (મા$સક/;Oમા$સક)
● MHT self-audit report ની cross-verification
● Field-visit spot-check (random AWC/School)
● MHT outcome-indicator (Rવભાગ 5D) સમીPા
● Red flag status review અને corrective action follow-up
● Training/competency gap ઓળખ
Level 3 — District RBSK Quality Audit (;Oમા$સક)
● Taluka-wise scorecard સમીPા (Rવભાગ 18)
● DEIC Functionality Score audit
● LTFU trend analysis
● Data quality audit (MIS completeness/timeliness)
● CQI project progress સમીPા
● Best/poor-performing Taluka ઓળખ + action plan
Audit Checklist — સં$LMત ફોમQટ (Oણેય Iતર માટે અTુકૂલનીય)
Audit Domain Check Item Compliance (Y/N) Remarks
Planning Microplan/Visit-plan અ©તન છે?
Screening Quality Checklist-based screening થાય છે?
Referral Referral card સંlૂણ0 ભરેલ છે?
Follow-up Follow-up register અ©તન છે?
Equipment તમામ સાધનો functional/calibrated છે?
Data MIS entry સમયસર/ચોuસ છે?
Documentation Evidence file (bવભાગ 25) સંlૂણ0 છે?
Red Flag Pending red flag પર action લેવાયેલ છે?

18. RBSK Scorecard — 100 Marks (District / Taluka / MHT)
Domain Marks :ુ; Metric
Coverage 15 Screening Coverage % (bવભાગ 6)
Screening Quality 15 Complete Screening %, False Referral Rate
Referral 10 Referral Rate, Timeline Compliance (bવભાગ 12)
Treatment Linkage 15 Treatment Initiation & Completion Rate
Follow-up 15 Follow-up Completion Rate, LTFU Rate (ઓછુ• સા«
• )
DEIC Performance 10 DEIC Functionality Score
Data Quality 5 Data Completeness & Timeliness %
HR/Training 5 Training Coverage %, Competency Score
Equipment 5 Equipment Functional %
Innovation/CQI 5 Quarterly CQI Project Completion
કુલ 100
વૈWા;નક Justification (સં$LMત)
Weight distribution 'Screen → Outcome' સંLૂણ9 continuum ને •Rત¡બbiબત કરે છે — Coverage+Screening Quality (30
marks) •ાર}“ભક તબ¢ાને, Referral+Treatment+Follow-up (40 marks) care-continuum ને (સૌથી વ£ુ weight, કારણ કે
outcome અહ| ]નધા9Gરત થાય છે), અને DEIC+Data+HR+Equipment+CQI (30 marks) supporting-system ને આવર3 લે છે.
આ weight distribution Recommended Gujarat State Standard છે — State RBSK Cell šારા 1-2 વષ9ના baseline data
બાદ statistically calibrate/revise કર`ું જોઈએ (દા.ત. regression-based weight validation).
Grading
Score Range Grade
90 – 100 RBSK Excellence
80 – 89 Very Good
70 – 79 Good
60 – 69 Needs Improvement
< 60 Priority Improvement District/Taluka/MHT

19. District Ranking Framework
<ુજરાતના તમામ “જwલાઓ માટે objective, data-driven ranking — ફyત screening volume પર નહ|, પર}Sુ સંLૂણ9 care-
continuum પર આધાGરત.
Ranking Factor Weight (Scorecard આધા2રત)
Coverage 15%
Screening Quality 15%
Referral & Treatment Linkage (Care-Continuum Core) 25%
Follow-up & Outcome (LTFU-adjusted) 25%
System Strength (DEIC + Data + HR + Equipment + CQI) 20%
માiસક/RVમાiસક District Ranking Dashboard પર •કાiશત કર`ું, જેમાં Top-3 અને Bottom-3 “જwલા સાથે trend
(improving/declining) દશા9વવો — Positive competition + accountability બંને ઉ•ેશ સાધવા.

20. Child Outcome Indicators
Outcome Indicator Formula/Measurement Method
Disability Identified Early (0-2 વષ™) (0-2 વષ™ confirmed disability cases / કુલ confirmed disability cases) × 100
Treatment Completed (Treatment Completed / Treatment Started) × 100
Surgery Completed (Surgery Completed / Surgery Planned) × 100
Functional Improvement Pre-post therapy assessment score તફાવત (condition-specific tool)
School Attendance Improvement Treatment પછA attendance % Nૃb¬ (School register)
Developmental Improvement Developmental milestone re-assessment score
Nutritional Improvement Growth chart પર weight-for-age/height-for-age iુધારો
Vision Correction
(Spectacle/Surgery Qારા sudhar◌ેલ vision cases / કુલ vision-defect cases) ×
100
Hearing Intervention
(Hearing-aid/Cochlear implant linked cases / કુલ confirmed hearing-loss
cases) × 100
Dental Treatment (Dental treatment completed / Dental referral cases) × 100
Rehabilitation Completion (Rehabilitation completed cases / Rehabilitation started cases) × 100
Parent Satisfaction Feedback survey score (bવભાગ 21)

21. Parent & Community Satisfaction
દરેક treated/referred બાળકના પGરવાર પાસેથી સરળ feedback mechanism (કાગળ-આધાGરત/SMS-link/Call-based) šારા
નીચેના પGરમાણો પર મા]હતી લેવી:
પ2રમાણ :ૂbયાંકન પcEત (1-5 Scale — Recommended)
Accessibility Facility iુધી પહ"ચવામાં સરળતા
Behaviour of Staff Staff yું વત0ન/આદર/સંવેદનશીલતા
Waiting Time OPD/Screening/Treatment માટે રાહ જોવાનો સમય
Referral Experience Referral process ની 'પŠતા અને સરળતા
Treatment Experience સારવારની }ુણવRા અને communication
Financial Burden Out-of-pocket ખચ0 (0 હોવો જોઈએ — RBSK free-care ]સ¬ાંત)
Overall Satisfaction એક•દર સંતોષ
Suggestions Open-ended feedback
Quarterly aggregate Parent Satisfaction Score District Scorecard અને Dashboard પર •કાiશત કરવો; સતત નીચો score
ધરાવતા DEIC/MHT માટે service-quality review ફર“જયાત.

22. Gujarat માટે Special Focus Areas — Geographic/Demographic Strategy
EવGતાર Kકાર ઉદાહરણ (?ુજરાત) Eવશેષ Outreach Strategy
†ાઇબલ bવ'તાર
Dahod, Chhota Udepur,
Narmada, Valsad-તાƒુકા
Tribal Sub-plan સાથે linkage, local-language IEC, community
health worker involvement વધારNું
દૂરŸ ®ા¯ય bવ'તાર Panchmahal, Dang ના hilly ગામ
Extended visit-frequency, 4-wheel vehicle provision, weather-
based re-scheduling
રણ (Desert) bવ'તાર Kutch
Seasonal camp-based screening, satellite-phone/connectivity
backup
સીમાવત§ bવ'તાર (Border) Kutch, Banaskantha સીમા-ગામ
Security-coordination સાથે visit planning, BSF/Army medical
camp સાથે convergence
તટAય (Coastal) bવ'તાર Saurashtra/Kutch coast Fisherfolk-community seasonal migration °યાનમાં લેNું
શહેરA ઝુંપડપ±A (Urban
Slums)
Ahmedabad, Surat, Vadodara,
Rajkot
NUHM સાથે convergence, Urban PHC/UHND linkage, high-
density outreach
Hard-to-reach ગામ
Island/river-crossing ગામ
(Bharuch, Narmada belt)
Boat/seasonal-access planning, pre-monsoon intensive
screening
Ÿળાંતeરત વ'તી
(Migrant)
²ટ-ભ³ા, બાંધકામ-Ÿળ,
sugarcane-cutting મજૂર પeરવાર
Source-destination tracking card, portable Child ID, employer-
site coordination
ઋcુગત Ÿળાંતર bવ'તાર
Saurashtra-North Gujarat
cotton/sugarcane belt
Migration-calendar આધાeરત microplan re-scheduling,
receiving-district data-sharing

23. Innovation Framework
Innovation Feasibility (ટૂgકમાં) Safeguards
Digital Screening (Tablet-based
checklist)
High — MHT પાસે પહેલેથી digital device હોય તો
ઝડપી roll-out શµ
Data privacy, offline-sync capability,
device maintenance
AI-assisted Screening (clinically
appropriate — દા.ત. vision/hearing
pre-screening)
Medium — pilot-basis; clinical validation જœરA
AI ફ‡ત decision-support તરAકે, final call
clinician નો; false-negative risk mitigation
Teleconsultation (DEIC-Specialist
↔ MHT/PHC)
High — હાલના e-Sanjeevani infrastructure સાથે
integrate શµ
Connectivity backup, consent,
documentation
GIS-based Microplanning High — Village/School mapping data ઉપલJધ Data accuracy, periodic map-update
QR-based Child Tracking High — Unique Child ID સાથે સી•ું integrate
Privacy-by-design, parent consent,
physical-card backup
WhatsApp/SMS Follow-up
Reminder
High — ઓછો ખચ0, high reach Opt-in consent, language-localisation
Automated Red-Flag Alerts High — Dashboard integration સાથે Alert-fatigue ટાળવા threshold-tuning
High-Risk Child Registry
Medium — cross-department data-sharing
protocol જœરA
Data-protection SOP, restricted access
Mobile DEIC Support (Outreach
DEIC camp)
Medium — remote/tribal bવ'તાર માટે ઉપયોગી
Specialist availability, equipment
portability
Tele-rehabilitation Medium — connectivity-dependent Parent-training જœરA, quality-monitoring
School Health Integration
(Ayushman Bharat School Health
Programme સાથે)
High — હાલના School Health Programme સાથે
convergence
Duplicate-data ટાળNું, joint-calendar

24. Continuous Quality Improvement (CQI) Framework
Problem → Root Cause Analysis → Intervention → PDSA Cycle (Plan-Do-Study-Act) → Measurement
→ Reassessment → Scale-up
દરેક “જwલાએ દર RVમાiસકે ઓછામાં ઓછો 1 CQI Project (Recommended Gujarat State Standard) હાથ ધરવો, જે RBSK
Scorecard (Rવભાગ 18) ના સૌથી નબળા domain પર કેi€¤ત હોય.
CQI Project — તબXા
તબhો Eવગત
1. Problem Identification Scorecard/Dashboard data પરથી સૌથી નબ·ું indicator ઓળખNું (દા.ત. ¸ચો LTFU Rate)
2. Root Cause Analysis Fishbone/5-Why analysis — MHT, DEIC, Parent, System-level કારણ ઓળખવા
3. Intervention Design નાyું, testable change (દા.ત. SMS reminder timing બદલNું)
4. PDSA Cycle Plan → Do (નાના scale પર test) → Study (data જુઓ) → Act (adopt/adapt/abandon)
5. Measurement Pre-post indicator comparison (bવભાગ 6/18 ના formula વાપરAને)
6. Reassessment 1-2 PDSA cycle પછA sustained improvement ચકાસNું
7. Scale-up સફળ intervention ને Taluka/District-wide scale કરNું + State RBSK Cell ને report

25. Documentation & Evidence File Index
Inspection/Review વખતે ઝડપી ચકાસણી માટે દરેક MHT, Taluka અને District ખાતે નીચેની Evidence File (ભૌRતક/digital)
•ળવવી ફર“જયાત:
@મ દGતાવેજ
1 Annual Microplan
2 Monthly Visit Plan
3 Visit Schedule & Attendance Register
4 Screening Records/Checklist
5 Referral Records (Referral Card copies)
6 Treatment Records
7 Follow-up Records
8 DEIC Records (OPD, Therapy, Case files)
9 Equipment Checklist & Calibration Log
10 Training Records & Certificates
11 Meeting Minutes (Monthly Review — bવભાગ 27)
12 Review Reports (Supervisory/Audit — bવભાગ 17)
13 Dashboard Printouts (મા]સક Snapshot)
14 Corrective Action Reports (Red Flag follow-up)
15 Success Stories (bવભાગ 26 ફોમ™ટ jુજબ)
16 Parent Feedback Forms (bવભાગ 21)
17 CQI Project Documentation (bવભાગ 24)

26. Success Story Framework
RBSK ની impact-documentation માટે standardised format — District/State-level advocacy, media અને review
meetings માટે ઉપયોગી.
ઘટક વણ[ન
Child Profile ¹મર, zજ{લા/તાƒુકા, ટૂ•કA lૃº»ૂbમ (ઓળખ }ુ¡ત રાખવી — Initial/Consent-based)
Screening કયા 'તરે, µારે screening થ¼ું
Identification કઈ condition/red-flag ઓળખાઈ
Referral કયા 'તરે refer થ¼ું, timeline
Diagnosis DEIC/Specialist confirmation
Treatment કઈ સારવાર/surgery થઈ, µાં
Follow-up Follow-up schedule અને પાલન
Outcome Functional/health outcome — before-after
Family Feedback પeરવારનો “bતભાવ (quote — સંમbત સાથે)
Cost Saved RBSK ના મફત સેવા Qારા families ને બચેલ અંદાzજત ખચ0
ન"ધ: Success Story “કાશન પહેલા parent/guardian yું લે]ખત સંમbત (consent) ફરzજયાત; બાળકની ઓળખ }ુ¡ત રાખવી (child-
safety/privacy ]સ¬ાંત).

27. Monthly Review Meeting — Standard Agenda (District RBSK)
@મ એજiડા આઇટમ
1 અગાઉની Action Taken Report (ATR) સમી’ા
2 Screening Coverage સમી’ા (Taluka-wise)
3 Referral ›Ÿbત
4 Pending Cases (stage-wise ageing)
5 Treatment Status
6 Surgery Status
7 DEIC Performance
8 Lost-to-Follow-up (LTFU) સમી’ા
9 High-Risk Children ›Ÿbત
10 MHT Performance (outcome-based indicators)
11 Data Quality સમી’ા
12 Red Flags — Open/Closed status
13 Corrective Action Plan
14 Best-Performing Team ને Recognition
15 Poor-Performing bવ'તાર — Support Plan
16 આગામી મaહનાનો Action Plan

28. 30–60–90 Day RBSK Improvement Plan
:થમ 30 Zદવસ — Critical Gaps ઓળખ અને ]ુધારણા
● દરેક MHT/DEIC uું baseline assessment (Scorecard vુજબ)
● Microplan/Visit-plan ની ચકાસણી અને updation
● Equipment functional-status audit
● Pending referral/follow-up backlog ની ઓળખ
● Red Flag system શŸ કર`ું — dashboard/manual tracking
60 Zદવસ — Referral, DEIC અને Follow-up ]ુ_ઢJકરણ
● DEIC Functionality Score Wુધારણા (specialist gap-filling)
● Referral timeline compliance (Rવભાગ 12) uું ¥ે¦કbગ શŸ
● LTFU Prevention SOP (Rવભાગ 13) uું ફર“જયાત અમલ
● Empanelled Centre linkage/MoU ચકાસણી
● •થમ માiસક Review Meeting (Rવભાગ 27 ફોમœટ) યોજવી
90 Zદવસ — Outcome-based Performance અને CQI
● •થમ RBSK Scorecard (100 marks) generation
● District Ranking Dashboard live કર`ું
● •થમ RVમાiસક CQI Project શŸ કરવો
● Parent Satisfaction Survey શŸ કરવો
● 30-60-90 Day outcome ની State RBSK Cell ને Report

29. Gujarat RBSK Excellence Model – 2026
"Gujarat RBSK Excellence Model – 2026"
Universal Screening + Quality Screening + Digital Tracking + Fast Referral + Strong DEIC +
Treatment Guarantee + Follow-up + Outcome Measurement + Community Participation = EVERY
CHILD, EVERY CONDITION, EVERY OUTCOME
આ મોડેલ 10-Pillar Framework (Rવભાગ 3), Service Delivery Pathway (Rવભાગ 4), Red Flag System (Rવભાગ 11) અને
RBSK Scorecard (Rવભાગ 18) ને એક integrated cycle માં જોડે છે — @ાં દરેક ઘટક એકબી•ને support કરે છે અને છેwલે
measurable child outcome તરફ દોર3 •ય છે.

30. Final Deliverables — Tool Index
આ Master Manual ની અંદર A થી P Wુધીના 16 practical tools embed કરવામાં આવેલ છે (સંબંRધત Rવભાગ સંદભ9 સાથે).
State RBSK Cell ઈ~છે તો દરેકને field-use માટે અલગ, single-page laminated ફોમœટમાં પણ extract કર3 શકે.
Tool નામ સંદભ[ Eવભાગ
A Gujarat RBSK Standards Manual આ સંlૂણ0 દ'તાવેજ — Detailed Policy/Operational Document
B RBSK MHT Checklist Daily/Monthly/Quarterly — bવભાગ 5, 15, 17 આધાeરત
C RBSK DEIC Checklist bવભાગ 8, 17 આધાeરત
D District RBSK Assessment Checklist bવભાગ 17 (Level-3 Audit) આધાeરત
E Taluka RBSK Review Checklist bવભાગ 17 (Level-2 Audit) આધાeરત
F RBSK 100-Marks Scorecard bવભાગ 18
G RBSK Dashboard KPI Matrix bવભાગ 6, 10
H Referral & Follow-up Tracking Format bવભાગ 9, 12, 13
I Red Flag Escalation Matrix bવભાગ 11
J RBSK SOP Manual bવભાગ 16
K Training & Competency Matrix bવભાગ 14
L CQI Project Template bવભાગ 24
M Parent Feedback Form bવભાગ 21
N Success Story Format bવભાગ 26
O Monthly Review Meeting Template bવભાગ 27
P 30–60–90 Day Action Plan bવભાગ 28
અં;તમ સંદેશ
“Every Child Screened, Every Condition Identified Early, Every Eligible Child Linked to Care, Every
Treatment Completed, and Every Child Followed Until Outcome.”

Gujarat RBSK 2.0 Guidelines 2026: Quality Standards & Framework

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