Cleft Care and Sustainable Development Goals: Advancing Health Equity for Every Child

India’s commitment to the UN Sustainable Development Goals (SDGs), particularly SDG 3, Good Health and Well-being reflect a national vision of “Health for All” by 2030. A cornerstone of this vision is ensuring early detection and treatment of conditions that affect newborns and children. One of the government’s most strategic initiatives to realize this goal is the Rashtriya Bal Swasthya Karyakram (RBSK), a flagship program under the Ministry of Health C Family Welfare.

The RBSK ensures screening and management for child health through the 4Ds approach:

• Defects at birth
• Diseases
• Deficiencies
• Developmental delays

Through systematic screening and early intervention, RBSK aims to improve child development outcomes and promote equity in health services particularly for children from underserved and rural communities.

Impact of RBSK in India

As per the Sample Registration System Report (SRS) of Registrar General of India (RGI), the Neonatal Mortality Rate (NMR) is 19 per 1000 live births, Infant Mortality Rate (IMR) is 25 per 1000 live births and Under 5 Mortality Rate (U5MR) is 29 per 1000 live births at National level for the year 2023.These outcomes underline how RBSK is strengthening India’s journey toward healthier childhoods, reduced mortality, and the achievement of SDG targets.

Over the years, RBSK has played a pivotal role in improving child health in India. Through its extensive reach at the community level, RBSK has enabled timely interventions, better referral services, and improved access to care for millions of children at no- cost to the families, thereby reducing Out-of-pocket expenditure.

District Early intervention Centre provides therapeutic management of the identified children with delays and also acts as a referral hub for coordination of surgeries and treatment of the children identified by Mobile Health Team.

Cleft Lip and Palate: An Often-Neglected Birth Defect

Clefts affect over 35,000 babies in India every year. Left untreated, cleft can severely impact a child’s ability to eat, breathe, hear, and speak, leading to malnutrition, infections, speech delays, and social exclusion. Despite being a surgically treatable condition, many children still go without care due to misinformation or lack of awareness for access to services. Families too often face myths, shame, or misinformation, delaying or preventing access to treatment.

Timely, Comprehensive Care is Life-Changing

With timely medical intervention, cleft can be fully treated. A single safe surgery can dramatically improve a child’s quality of life. RBSK plays a pivotal role in addressing clefts under the “Defects at Birth” category. The department is actively working to strengthen these early identification and referral systems, striving to ensure every child receives the necessary care.

Strategic Partnerships for Stronger Health Systems

The government is consistently investing in bolstering healthcare infrastructure, ensuring access to treatment even in the farthest corners. Awareness and capacity-building initiatives are strengthening frontline health workers, increasing community awareness, and supporting early identification and referral for timely, compassionate cleft care within India's public health system.

Innovative collaborations are driving real change at the grassroots level. Cleft care organizations are also partnering with both public and private health institutions across central and state levels to provide the best possible cleft care to children in need.

Cleft Care as a Public Health Priority

To achieve the targets outlined in SDG 3, the Government of India emphasizes the critical need for public and private institutions to unify their efforts. Recognizing cleft care as a fundamental element of child health policy is not merely a strategic move; it's an ethical commitment. This goes far beyond correcting a facial difference; it's about ensuring every child has an equitable opportunity for a healthy and dignified life.

Co-authored by Dr. Shobhna Gupta, Deputy Commissioner – Child Health and RBSK, Ministry of Health & Family Welfare, and Dr. Karoon Agrawal, Senior Consultant, Plastic Surgery at National Heart Institute, Delhi