Health Policy and Management Practice Questions

Q: Consider the following definitions: 'Effectiveness measures the extent to which predetermined objectives are achieved. Efficiency measures how well the resources are utilized.' In view of these definitions, which of the following assertions are true? 1. Percentage of bed occupancy measures effectiveness 2. Immunization coverage rate measures efficiency 3. Cost per patient treated measures efficiency 4. Reduction in mortality measures effectiveness Select the correct answer using the code given below:

3 and 4 only. ***Correct: 3 and 4 only*** **Analysis of each assertion:** - **Assertion 1 (Percentage of bed occupancy measures effectiveness)** - FALSE - Bed occupancy rate reflects how well bed resources are being utilized - This is an **efficiency** measure, not effectiveness - **Assertion 2 (Immunization coverage rate measures efficiency)** - FALSE - Immunization coverage measures the proportion of target population vaccinated, indicating achievement of a public health objective - This is an **effectiveness** measure, not efficiency - **Assertion 3 (Cost per patient treated measures efficiency)** - TRUE ✓ - This directly measures how well resources (money, staff, supplies) are utilized per unit output - This is an **efficiency** measure - **Assertion 4 (Reduction in mortality measures effectiveness)** - TRUE ✓ - This directly reflects achievement of predetermined health objectives (saving lives) - This is an **effectiveness** measure **Therefore, only assertions 3 and 4 are correct.** *Incorrect: 2 and 3 only* - While assertion 3 is correct (efficiency), assertion 2 is incorrect because immunization coverage rate measures effectiveness, not efficiency *Incorrect: 1 and 2* - Assertion 1 is incorrect because bed occupancy measures efficiency, not effectiveness - Assertion 2 is incorrect because immunization coverage measures effectiveness, not efficiency *Incorrect: 2, 3 and 4* - Assertion 2 is incorrect because immunization coverage rate measures effectiveness, not efficiency - While assertions 3 and 4 are correct, including assertion 2 makes this option wrong

Q: In India, for providing HIV treatment services Link ART Centres are situated at:

Sub-district level hospitals and Community Health Centres. ***Sub-district level hospitals and Community Health Centres*** - **Link ART Centres** are strategically established at **sub-district level hospitals** and **Community Health Centres (CHCs)** as part of the **National AIDS Control Programme (NACO)**. - These centres were created to **decentralize HIV treatment services** and bring them closer to patients, reducing the burden on main ART centres. - They provide **first-line antiretroviral therapy (ART)** and follow-up care for stable patients, improving accessibility and adherence. *Medical colleges and district level hospitals* - These facilities host **main ART Centres** (not Link ART Centres), which serve as primary hubs for HIV treatment. - Main ART Centres handle more complex cases, second-line therapy, and provide training and support to Link ART Centres. *Select medical colleges* - Medical colleges typically host **ART Centres** or **Centres of Excellence (CoE)** for HIV care. - These are tertiary care facilities providing comprehensive HIV services including specialized care and second-line treatment. *Primary Health Centres* - **PHCs** serve as the first point of contact in rural healthcare but lack the infrastructure and specialized staff for ART services. - They play a role in **HIV testing, counseling, and referral** to ART/Link ART Centres but do not provide ART themselves.

Q: What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCDs) by year 2030? Consider the following statements: 1. Impact 2. Coverage/risk factor 3. Risk factor/determinants Which of the above statement(s) correctly identifies the type of indicator?

1 only. ***1 only*** - Sustainable Development Goal target 3.4, aiming for a one-third reduction in **premature mortality** from NCDs, is an **impact indicator**. - **Impact indicators** measure the overall effect of interventions on health outcomes, such as mortality rates. *2 and 3* - **Coverage/risk factor indicators** measure the proportion of the target population receiving an intervention or the prevalence of risk factors. - While reducing NCD mortality is related to controlling risk factors, the target itself directly measures a reduction in **death (an impact)**, not the risk factor prevalence or intervention coverage. *3 only* - **Risk factor/determinant indicators** specify factors that contribute to the disease or health outcome, like smoking rates or unhealthy diet. - The target of reducing **premature mortality** is a direct outcome of these risk factors, making it an impact indicator rather than a separate risk factor indicator. *1 and 3* - Although risk factors are determinants of NCD mortality, the **reduction in mortality** itself is a measure of the ultimate outcome or impact, not solely a risk factor. - The core of SDG 3.4 is the decrease in deaths, which unequivocally points to it being an **impact indicator**.

Q: All are components of Jai Vigyan Mission Mode project on community control of RF/RHD in India EXCEPT:

Vaccine development for streptococcal infection. ***Vaccine development for streptococcal infection*** - While **vaccine development** for Group A Streptococcus (GAS) is a long-term goal in controlling Rheumatic Fever (RF) and Rheumatic Heart Disease (RHD), it was **not an immediate component** of the Jai Vigyan Mission Mode project. - The mission focused on existing, actionable strategies for community control, rather than basic research and development of new interventions. *To study the epidemiology of streptococcal sore throats* - Understanding the **epidemiology of streptococcal sore throats** (the precursor to RF) is crucial for identifying high-risk populations and tailoring intervention strategies. - This component helps in mapping the incidence and prevalence of infections required to implement effective control strategies. *Antibiotic treatment of streptococcal sore throats* - **Prompt antibiotic treatment** of streptococcal sore throats is a cornerstone of primary prevention for RF, preventing the immune response that leads to the disease. - This is a direct, immediate intervention aimed at breaking the chain of infection and disease progression. *To establish registries for RF and RHD* - Establishing **registries for RF and RHD** is essential for monitoring disease burden, tracking outcomes, and evaluating the effectiveness of control programs. - Registries provide valuable data for public health planning and resource allocation.

Q: With regard to the Goals, Milestones and Targets for the Global Technical Strategy for Malaria (2016-2030), consider the following statements: 1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at least 90% by year 2030 2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year 2030 3. Eliminate malaria from at least 35 countries, where malaria was transmitted in 2015, by year 2030 Which of the above statements hold true?

1, 2 and 3. ***1, 2 and 3*** - All three statements accurately reflect the **core targets** set by the Global Technical Strategy for Malaria (2016-2030). - These ambitious goals aim to achieve significant reductions in malaria burden and eventual eradication in many regions. *1 and 3 only* - This option is incorrect because it omits statement 2, which is a verified goal for **reducing malaria case incidence**. - All three statements are indeed part of the strategy's published objectives. *1 and 2 only* - This option is incorrect as it excludes statement 3 regarding the **elimination of malaria** from at least 35 countries. - The strategy encompasses all three stated objectives for global malaria control. *2 and 3 only* - This option is incorrect because it fails to include statement 1, which specifies the target for **reducing malaria mortality rates**. - The strategy explicitly addresses all three aspects: mortality, incidence, and country-level elimination.

Q: Under Chapter XXI of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which of the following code range?

Z 72.0 – Z 72.5. ***Z 72.0 – Z 72.5*** - This **ICD-10 Chapter XXI** code range is specifically assigned to **problems related to lifestyle**, which includes issues such as unhealthy diet, lack of physical activity, and stress. - These codes are used to identify factors influencing health status and contact with health services, contributing to a holistic view of patient care. *U 50.0 – U 50.5* - The **"U" code series** (U00-U99) in ICD-10 is generally reserved for **codes for special purposes**, such as provisional assignment of new diseases of uncertain etiology or for research purposes. - This range does not categorize lifestyle-related problems; instead, it is designated for emerging or yet-to-be-classified conditions. *U 10.0 – U 10.5* - Similar to the previous option, this **"U" code range** is part of the category for **codes for special purposes** and is not used for classifying lifestyle factors. - These codes are typically used for emergency situations, specific research projects, or temporary classifications. *Z 10.0 – Z 10.5* - The **"Z" codes** (Z00-Z99) in ICD-10 are generally used for **factors influencing health status and contact with health services**, but the Z10-Z13 range is specifically for **routine general health examinations** of defined subpopulations. - This range does not classify general lifestyle-related problems but rather specific types of health screenings or check-ups.

Q: Which of the following key action areas are incorporated in the Ottawa Charter? 1. Building healthy public policy 2. Strengthening community action for health 3. Reorienting health services Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - The **Ottawa Charter for Health Promotion** delineates five key action areas, all of which are crucial for health improvement. These include **building healthy public policy**, **creating supportive environments**, **strengthening community action**, **developing personal skills**, and **reorienting health services**. - This option correctly identifies three of the five key action areas, demonstrating a comprehensive understanding of the Charter's framework. *1 and 2 only* - While **building healthy public policy** and **strengthening community action** are indeed key areas in the Ottawa Charter, this option is incomplete as it omits other important action areas. - The Charter's framework is holistic, requiring the integration of all five areas for effective health promotion. *2 and 3 only* - This option correctly includes **strengthening community action** and **reorienting health services**, but it fails to mention other fundamental aspects. - Focusing on only two of the areas would lead to an incomplete strategy for health promotion as envisioned by the Ottawa Charter. *1 and 3 only* - This option correctly identifies **building healthy public policy** and **reorienting health services** but overlooks other essential components of the Ottawa Charter. - A full understanding of the Charter requires recognition of all five action areas rather than just a subset.

Q: Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in which of the following infectious diseases? 1. Tuberculosis 2. Leprosy 3. Chronic empyema Select the correct answer using the code given below:

1 and 2 only. ***1 and 2 only*** - Under the **Employees' State Insurance (ESI) Central Rules, 1950**, extended sickness benefit is provided for specified long-term diseases requiring prolonged treatment. - The diseases covered include **Tuberculosis** and **Leprosy**, both of which require extended treatment periods and justify enhanced support. - **Chronic empyema is NOT included** in the list of diseases eligible for extended sickness benefit under the ESI Scheme. - Other diseases covered include mental illness and malignant diseases (cancer). *1, 2 and 3* - This option is incorrect because **chronic empyema** is not listed among the diseases eligible for extended sickness benefit under ESI regulations. - While empyema may require medical care, it does not qualify for the specific extended sickness benefit provision. *2 and 3 only* - This option is incorrect as it omits **Tuberculosis**, which is a major disease specifically listed for extended sickness benefit under the ESI Scheme. - It also incorrectly includes chronic empyema, which is not covered. *1 and 3 only* - This option is incorrect because it includes **chronic empyema**, which is not eligible for extended sickness benefit. - While Tuberculosis is correctly included, the combination is inaccurate per ESI regulations.

Q: A hospital wants to implement a policy requiring patients to access their lab results online before physician review. Some patients prefer to receive results from their doctor first. What is the most appropriate policy approach?

Allow patients to choose their preferred method. ***Allow patients to choose their preferred method*** - This approach respects **patient autonomy** and preferences, which is a core ethical principle in healthcare. - It ensures that patients who want to discuss results with their physician first can do so, while those who prefer immediate access are also accommodated. - This is the **most patient-centered approach** that balances access with individual needs. *Maintain physician review for all results* - While ensuring physician oversight, this policy might **delay access** for patients who prefer immediate online viewing. - It could create **unnecessary workload** for physicians reviewing results that patients could understand on their own. - This paternalistic approach **undermines patient autonomy**. *Immediate access for normal results, delayed for abnormal* - This approach aims to protect patients from potentially distressing abnormal results, but it still **limits patient choice**. - Patients might feel that their **right to information** is being restricted, even for abnormal findings they wish to review independently. - It assumes patients cannot handle abnormal results, which is **paternalistic**. *Implement immediate access for all patients* - This policy disregards the preferences of patients who desire **physician interpretation** before viewing results, potentially causing distress or misinterpretation. - It fails to recognize that not all patients are equally equipped to understand complex medical information without professional guidance. - While respecting autonomy for some, it **ignores the preferences** of others who want physician-mediated disclosure.

Q: As per the National Tuberculosis Elimination Program (NTEP), HIV TB prevalence of what percentage would deem a district a high priority district?

>10 %. ***>10%*** - As per the **National Tuberculosis Elimination Program (NTEP)** guidelines, a district is categorized as a **high-priority district** for HIV-TB co-infection if the prevalence of HIV among TB patients is **greater than 10%**. - This threshold helps in identifying regions that require enhanced focus and resources for **integrated HIV and TB care** and prevention strategies. - This is the specific cut-off defined by NTEP for prioritizing districts for targeted interventions. *>15%* - While 15% would also indicate a high prevalence, the specific threshold set by NTEP for deeming a district high priority is **>10%**, not >15%. - Districts with prevalence between 10% and 15% would already be classified as high priority at the >10% threshold. *>20%* - A prevalence of >20% would certainly indicate a severe problem, but the **NTEP's definition** for a high-priority district is specifically **>10%**. - Using a higher threshold like 20% would delay interventions in districts that already face significant challenges with HIV-TB co-infection. *>12%* - The NTEP guidelines use a specific cut-off of **>10%** for defining high-priority districts for HIV-TB co-infection. - While 12% exceeds the 10% threshold, it is not the defining threshold mentioned in the official guidelines for this classification.

Question 1

Consider the following definitions: 'Effectiveness measures the extent to which predetermined objectives are achieved. Efficiency measures how well the resources are utilized.' In view of these definitions, which of the following assertions are true?

1. Percentage of bed occupancy measures effectiveness
2. Immunization coverage rate measures efficiency
3. Cost per patient treated measures efficiency
4. Reduction in mortality measures effectiveness

Select the correct answer using the code given below:

Accepted Answer

3 and 4 only

Answer

2 and 3 only

Answer

1 and 2

Answer

2, 3 and 4

Question 2

In India, for providing HIV treatment services Link ART Centres are situated at:

Accepted Answer

Sub-district level hospitals and Community Health Centres

Answer

Select medical colleges

Answer

Primary Health Centres

Answer

Medical colleges and district level hospitals

Question 3

What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCDs) by year 2030?

Consider the following statements:
1. Impact
2. Coverage/risk factor  
3. Risk factor/determinants

Which of the above statement(s) correctly identifies the type of indicator?

Accepted Answer

1 only

Answer

2 and 3

Answer

3 only

Answer

1 and 3

Question 4

All are components of Jai Vigyan Mission Mode project on community control of RF/RHD in India EXCEPT:

Accepted Answer

Vaccine development for streptococcal infection

Answer

To study the epidemiology of streptococcal sore throats

Answer

Antibiotic treatment of streptococcal sore throats

Answer

To establish registries for RF and RHD

Question 5

With regard to the Goals, Milestones and Targets for the Global Technical Strategy for Malaria (2016-2030), consider the following statements:

1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at least 90% by year 2030
2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year 2030
3. Eliminate malaria from at least 35 countries, where malaria was transmitted in 2015, by year 2030

Which of the above statements hold true?

Accepted Answer

1, 2 and 3

Answer

1 and 3 only

Answer

1 and 2 only

Answer

2 and 3 only

Question 6

Under Chapter XXI of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which of the following code range?

Accepted Answer

Z 72.0 – Z 72.5

Answer

U 50.0 – U 50.5

Answer

U 10.0 – U 10.5

Answer

Z 10.0 – Z 10.5

Question 7

Which of the following key action areas are incorporated in the Ottawa Charter?

1. Building healthy public policy
2. Strengthening community action for health
3. Reorienting health services

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Question 8

Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in which of the following infectious diseases?

1. Tuberculosis
2. Leprosy
3. Chronic empyema

Select the correct answer using the code given below:

Accepted Answer

1 and 2 only

Answer

1, 2 and 3

Answer

2 and 3 only

Answer

1 and 3 only

Question 9

A hospital wants to implement a policy requiring patients to access their lab results online before physician review. Some patients prefer to receive results from their doctor first. What is the most appropriate policy approach?

Accepted Answer

Allow patients to choose their preferred method

Answer

Maintain physician review for all results

Answer

Immediate access for normal results, delayed for abnormal

Answer

Implement immediate access for all patients

Question 10

As per the National Tuberculosis Elimination Program (NTEP), HIV TB prevalence of what percentage would deem a district a high priority district?

Accepted Answer

>10 %

Answer

>15 %

Answer

>20 %

Answer

>12 %

Health Policy and Management — MCQs

Health Policy and Management — MCQs

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