Health Policy and Management Practice Questions

Q: Which of the following indicates the recommended health manpower ratio?

1 doctor per 3,500 population. This question tests your knowledge of the **Health Manpower Norms** recommended by the **Bhore Committee (1946)** and subsequent health planning guidelines in India. ### **Explanation of the Correct Option** **Option A (1 doctor per 3,500 population)** is the correct historical recommendation based on the Bhore Committee's long-term goals for primary healthcare. While the WHO recommends a ratio of 1:1,000, for the purpose of Indian health planning exams, the 1:3,500 ratio is the standard benchmark often cited in textbooks like Park’s Preventive and Social Medicine. ### **Analysis of Incorrect Options** * **Option B (1 ANM per 10,000 population):** This is incorrect. The standard norm is **1 ANM per 5,000 population** in plain areas and **1 ANM per 3,000 population** in hilly/tribal/difficult areas (at the Sub-Centre level). * **Option C (1 lab technician per 10,000 population):** This is incorrect. According to IPHS (Indian Public Health Standards) norms, there should be **1 Lab Technician per 10,000 population** at the PHC level (since a PHC serves 20,000–30,000 people and usually has 2-3 LTs). However, in the context of this specific question, the doctor ratio is the primary established manpower norm. * **Option D (1 pharmacist per 100,000 population):** This is incorrect. The norm is generally **1 Pharmacist per PHC** (serving 20,000–30,000 people). ### **High-Yield Clinical Pearls for NEET-PG** * **WHO Norm:** 1 Doctor per 1,000 population (India has technically achieved this if AYUSH doctors are included). * **Nurse to Patient Ratio:** 1:3 in Teaching Hospitals; 1:5 in General Wards. * **Health Worker Female (ANM):** 1 per 5,000 (Plain) / 3,000 (Hilly). * **Health Worker Male:** 1 per 5,000 (Plain) / 3,000 (Hilly). * **ASHA:** 1 per 1,000 population (1 per habitation in tribal areas). * **Anganwadi Worker:** 1 per 400–800 population.

Q: What are the functions of a female health worker?

Enlist dais of the sub-center. **Explanation:** The **Female Health Worker (FHW)**, also known as the **Auxiliary Nurse Midwife (ANM)**, is the key paramedical functionary at the Sub-center level under the Multipurpose Worker (MPW) scheme. Her primary role is to provide integrated maternal and child health (MCH), family planning, and immunization services to a population of 5,000 (3,000 in hilly/tribal areas). **Why Option B is Correct:** One of the core administrative and technical functions of the ANM is to **enlist and train Traditional Birth Attendants (Dais)**. She acts as a bridge between the community and the formal health system, supervising Dais to ensure safe delivery practices and timely referrals for high-risk pregnancies. **Analysis of Incorrect Options:** * **Option A (Visit 4 subcenters):** This is incorrect. The ANM is *posted* at one sub-center. Visiting multiple sub-centers for supervision is typically the role of the **Health Assistant Female (LHV)**. * **Option C (Conduct 50% of deliveries):** While the ANM is trained to conduct deliveries, there is no fixed percentage mandate like "50%." Her goal is to ensure 100% institutional delivery or safe attended delivery; however, she primarily manages normal deliveries at the sub-center or home. * **Option D (Chlorination of water):** This is primarily the responsibility of the **Male Health Worker (MPW-M)** and the Village Health Sanitation and Nutrition Committee (VHSNC). **High-Yield Pearls for NEET-PG:** * **Population Norms:** 1 ANM per 5,000 (Plain) / 3,000 (Hilly). * **Supervision:** One Female Health Assistant (LHV) supervises 6 ANMs. * **Key Registers:** The ANM maintains the **Eligible Couple Register** and the Maternal & Child Health Register. * **Job Role:** She is the frontline worker for the **RMNCH+A** strategy at the grassroots level.

Q: Which of the following is NOT a step used in Six Sigma methodology?

Feed back. **Explanation:** Six Sigma is a data-driven quality management methodology used in public health administration to improve processes by reducing defects and variability. The standard framework used for existing processes is the **DMAIC** cycle. **Why "Feed back" is the correct answer:** "Feed back" is not a formal step in the Six Sigma DMAIC methodology. While feedback is a general management principle, Six Sigma uses a specific five-step structured approach. The final step in Six Sigma is "Control," which involves monitoring the process to sustain improvements, rather than just providing feedback. **Analysis of Incorrect Options:** * **A. Define:** This is the first step. It involves identifying the problem, the project goals, and the customer (patient) requirements. * **B. Analyze:** This is the third step. It focuses on analyzing the data to identify the root causes of defects or inefficiencies in the healthcare delivery system. * **C. Improve:** This is the fourth step. It involves developing and implementing solutions to eliminate the root causes identified in the analysis phase. **High-Yield Clinical Pearls for NEET-PG:** * **DMAIC Acronym:** **D**efine, **M**easure, **A**nalyze, **I**mprove, **C**ontrol. * **Statistical Goal:** Six Sigma aims for near perfection, allowing only **3.4 defects per million opportunities**. * **DMADV:** For designing *new* processes (instead of improving old ones), the methodology used is **D**efine, **M**easure, **A**nalyze, **D**esign, **V**erify. * **Origin:** Originally developed by Motorola, it is now widely used in hospital administration to reduce surgical errors and medication mishaps.

Q: All of the following are included in methods based on behavioral sciences, except?

System analysis. ### Explanation In Community Medicine and Health Management, methods are broadly categorized into those based on **Behavioral Sciences** and those based on **Quantitative/Mathematical Models**. **Why "System Analysis" is the correct answer:** System Analysis is a **quantitative management technique**. It is a systematic approach to problem-solving that involves analyzing a system's inputs, processes, and outputs to improve efficiency. It relies on mathematical modeling and logical structuring rather than human psychology or behavioral modification. Other quantitative methods include Network Analysis (PERT/CPM), Cost-Benefit Analysis, and Operations Research. **Analysis of Incorrect Options:** * **Personal Management:** This focuses on human resources, motivation, leadership, and interpersonal relationships within an organization. It is deeply rooted in behavioral science as it deals with human conduct and organizational psychology. * **Management by Objectives (MBO):** Proposed by Peter Drucker, MBO is a behavioral approach where managers and employees work together to set goals. It enhances motivation and commitment by involving individuals in the decision-making process. * **Communication:** This is the core of behavioral science. It involves the exchange of information and feelings between people to influence behavior, change attitudes, and ensure effective health education. **High-Yield Pearls for NEET-PG:** * **Behavioral Science Methods:** Include Personal management, MBO, Communication, Organizational design, and Community development. * **Quantitative Methods:** Include System analysis, PERT (Program Evaluation and Review Technique), CPM (Critical Path Method), and Cost-effectiveness analysis. * **PERT vs. CPM:** PERT is used for unpredictable activities (e.g., research), while CPM is used for predictable, repetitive activities (e.g., building a hospital). * **MBO Focus:** It shifts the focus from "activity" to "results."

Q: The Alma Ata conference was held in which year?

1978. **Explanation:** The **International Conference on Primary Health Care** was held in **Alma-Ata** (now Almaty, Kazakhstan) in **September 1978**. This landmark conference, co-sponsored by the WHO and UNICEF, established the goal of **"Health for All by the Year 2000 AD"** and identified **Primary Health Care (PHC)** as the key strategy to achieve it. **Analysis of Options:** * **1978 (Correct):** The year the Alma-Ata Declaration was signed, shifting the global focus from hospital-based care to community-based primary health care. * **1977:** This was the year the 30th World Health Assembly (WHA) decided that the main social target of governments should be the attainment of "Health for All" by 2000. The Alma-Ata conference followed a year later to define the strategy. * **1956:** This year is associated with the launch of the second Five-Year Plan in India, but it has no direct link to the Alma-Ata conference. * **1948:** This is the year the **World Health Organization (WHO)** was officially established (April 7th, celebrated as World Health Day). **High-Yield Facts for NEET-PG:** * **The 8 Elements of PHC:** Remember the acronym **E.L.E.M.E.N.T.S.** (Education, Local endemic disease control, Expanded program on immunization, Maternal and child health, Essential drugs, Nutrition, Treatment of common ailments, Sanitation and water). * **Health for All (HFA):** The target was set in 1977; the strategy (PHC) was defined in 1978. * **Astana Declaration (2018):** On the 40th anniversary of Alma-Ata, the world reaffirmed its commitment to PHC through the Astana Declaration.

Q: Which committee proposed the three-tier Panchayati Raj system?

Balwant Rai Mehta committee. **Explanation:** The **Balwant Rai Mehta Committee (1957)** is the correct answer as it was appointed to examine the working of the Community Development Programme. It recommended the establishment of a **three-tier Panchayati Raj system** to ensure democratic decentralization. This structure consists of: 1. **Gram Panchayat** at the village level. 2. **Panchayat Samiti** at the block level (the intermediate/pivotal tier). 3. **Zila Parishad** at the district level. **Analysis of Incorrect Options:** * **Kartar Singh Committee (1973):** Known for the concept of **"Multipurpose Workers" (MPW)**. It recommended that Auxiliary Nurse Midwives (ANMs) be replaced by Female Health Workers and introduced the Male Health Worker. * **Srivastav Committee (1975):** Recommended the creation of **"Refferal Services Complex"** and the establishment of the **Village Health Guide** scheme. It also proposed the "ROMES" (Reorientation of Medical Education) scheme. * **Mudaliar Committee (1962):** Also known as the Health Survey and Planning Committee. It recommended strengthening district hospitals and noted that the quality of care was more important than the quantity of Primary Health Centres (PHCs). **High-Yield Facts for NEET-PG:** * **Ashok Mehta Committee (1977):** Recommended a **two-tier** system (Mandal Panchayat and Zila Parishad). * **73rd Constitutional Amendment Act (1992):** Gave constitutional status to the Panchayati Raj. * **Panchayat Samiti** is the executive body responsible for the block's developmental activities and acts as the link between the Village and District levels.

Question 1

Which of the following indicates the recommended health manpower ratio?

Accepted Answer

1 doctor per 3,500 population

Answer

1 ANM per 10,000 population

Answer

1 lab technician per 10,000 population

Answer

1 pharmacist per 100,000 population

Question 2

Which of the following is NOT a guideline for sterilization?

Accepted Answer

The motivated couple must have 3 living children at the time of operation.

Answer

The age of the husband should not ordinarily be less than 25 years nor should it be over 50 years.

Answer

The age of the wife should not be less than 20 years or more than 45 years.

Answer

If the couple has 3 or more living children, the lower limit of age of the husband or wife may be relaxed at the discretion of the operating surgeon.

Question 3

What are the functions of a female health worker?

Accepted Answer

Enlist dais of the sub-center

Answer

Visit 4 subcenters per month

Answer

Conduct 50% of deliveries

Answer

Chlorination of water

Question 4

Which of the following is NOT a step used in Six Sigma methodology?

Accepted Answer

Feed back

Answer

Define

Answer

Analyze

Answer

Improve

Question 5

All of the following are included in methods based on behavioral sciences, except?

Accepted Answer

System analysis

Answer

Personal management

Answer

Management by objectives

Answer

Communication

Question 6

The Alma Ata conference was held in which year?

Accepted Answer

1978

Answer

1977

Answer

1956

Answer

1948

Question 7

ASHA workers receive remuneration for all services except:

Accepted Answer

Administering zero dose of Oral Polio Vaccine (OPV) and Bacillus Calmette-Guérin (BCG)

Answer

Facilitating institutional delivery

Answer

Recording birth weight

Answer

Birth registration

Question 8

Primary health care, true are all except?

Accepted Answer

Health services are taken to the doors of people

Answer

Essential health care for all

Answer

Placing people's health in people's hands

Answer

Sectors like agriculture, animal husbandry, food, industry & communication are involved.

Question 9

With respect to the National Health Policy 2017, which of the following statements is true?

Accepted Answer

Shift focus from maternal and child health to non-communicable diseases.

Answer

Primary health care package which excludes geriatric health care and palliative care.

Answer

Greater emphasis on maternal and child health services.

Answer

Work towards centralizing health care across India.

Question 10

Which committee proposed the three-tier Panchayati Raj system?

Accepted Answer

Balwant Rai Mehta committee

Answer

Kartar Singh committee

Answer

Srivastav committee

Answer

Mudaliar committee

Health Policy and Management — MCQs

Health Policy and Management — MCQs

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