Health Policy and Management Practice Questions

Q: According to the WHO, immunisation is a primary responsibility of:

States. **Explanation:** The World Health Organization (WHO) defines immunization as a global health and development success story, but emphasizes that the **primary responsibility** for the delivery, financing, and implementation of immunization programs lies with the **State (National Government)**. 1. **Why "States" is correct:** Immunization is considered a "Public Good." Under the principles of Public Health and the WHO’s Global Vaccine Action Plan (GVAP), national governments are the custodians of their citizens' health. They are responsible for establishing the National Immunization Schedule, ensuring vaccine procurement, maintaining the cold chain, and achieving universal coverage to reach "herd immunity." 2. **Why other options are incorrect:** * **International Community:** While organizations like WHO, UNICEF, and GAVI provide technical support, funding, and guidelines, they do not hold the sovereign responsibility for executing the program within a country. * **Voluntary Agencies:** NGOs and voluntary groups (e.g., Rotary International for Polio) act as supplementary partners to fill gaps but cannot replace the state’s structural role. * **An Individual:** While individual participation is necessary for success, the logistical and financial burden of a population-wide preventive measure cannot rest on an individual. **High-Yield Pearls for NEET-PG:** * **Levels of Prevention:** Immunization is a classic example of **Primary Prevention** (specifically, Specific Protection). * **Cold Chain:** The most critical link in state-run immunization; the "walk-in cold room" is at the regional level, while the **ILR (Ice-Lined Refrigerator)** is the backbone at the PHC level. * **Universal Immunization Programme (UIP):** Launched in India in 1985; it is one of the largest health programs in the world, entirely managed by the State.

Q: Which of the following health committees recommended the establishment of a medical and health education commission, similar to the University Grants Commission, for reforms in health and medical education?

Shrivastav Committee. **Explanation:** The **Shrivastav Committee (1975)**, formally known as the "Group on Medical Education and Support Manpower," was established to reform medical education and align it with national health needs. Its most distinctive recommendation was the creation of a **Medical and Health Education Commission**, modeled after the University Grants Commission (UGC), to oversee and standardize health education across the country. Additionally, this committee is famous for proposing the **Reorientation of Medical Education (ROME) scheme** and the creation of a cadre of **Health Assistants** to bridge the gap between community health workers and doctors. **Analysis of Incorrect Options:** * **Mukerji Committee (1965/1966):** Primarily focused on the strategy for the Family Planning program and the delinking of malaria activities from family planning to ensure better focus on the latter. * **Chadah Committee (1963):** Focused on the "Maintenance Phase" of the National Malaria Eradication Programme. It recommended that Vigilance Operations be handled by Basic Health Workers (BHW) at the block level. * **Kartar Singh Committee (1973):** Known as the "Committee on Multipurpose Workers under Health and Family Planning." It introduced the concept of **Multipurpose Workers (MPW)** and recommended that ANMs be replaced by Female Health Workers. **High-Yield NEET-PG Pearls:** * **Shrivastav Committee:** Think "Medical Education Commission" and "ROME Scheme." * **Kartar Singh Committee:** Think "Multipurpose Workers" and "1 PHC per 50,000 population." * **Jungalwalla Committee:** Known as the "Committee on Integration of Health Services" (Unified cadre). * **Bhore Committee (1946):** The "Health Survey and Development Committee" (Concept of Primary Health Centre).

Q: Which of the following statements regarding the International Classification of Diseases (ICD) is untrue?

The 10th revision (ICD-10) has 15 major chapters.. ### Explanation The **International Classification of Diseases (ICD)** is a global diagnostic standard maintained by the WHO for epidemiology, health management, and clinical purposes. **Why Option B is the correct (untrue) statement:** The ICD-10 does not have 15 chapters; it actually consists of **21 chapters**. These chapters categorize diseases based on their etiology (e.g., infectious diseases), anatomical site (e.g., diseases of the circulatory system), or special circumstances (e.g., external causes of morbidity). **Analysis of other options:** * **Option A:** Historically, the ICD has been revised approximately every **10 years** to reflect advancements in medical science. While the gap between ICD-10 (1990) and ICD-11 (2018) was longer, the 10-year cycle remains the traditional standard for the exam. * **Option C:** The ICD is the "core" classification of the **WHO Family of International Classifications (WHO-FIC)**. It serves as the foundation for related classifications like the ICF (Functioning, Disability, and Health) and ICHI (Health Interventions). * **Option D:** ICD-10 introduced an **alphanumeric coding system** (e.g., A00.0). Each code begins with a letter followed by three or four numbers, significantly expanding the coding capacity compared to the numeric-only system of ICD-9. **High-Yield Clinical Pearls for NEET-PG:** * **ICD-11:** The latest version (ICD-11) was adopted in 2019 and came into effect on **January 1, 2022**. It is fully digital and contains 26 chapters. * **Structure of ICD-10:** It is published in 3 volumes: * **Vol 1:** Tabular List (Main classifications) * **Vol 2:** Instruction Manual * **Vol 3:** Alphabetical Index * **Dual Coding:** ICD-10 uses a **Dagger (†) and Asterisk (*)** system to code both the underlying generalized disease and its localized manifestation.

Q: The crude death rate of a population is 8/1000. What is the recommended number of beds for this population?

4/1000. **Explanation:** The correct answer is **4/1000 (Option A)**. This question is based on the standard epidemiological formula used for health resource planning, specifically for calculating the required hospital bed capacity in a community. **The Underlying Concept:** According to standard public health guidelines (often cited in the context of the Bhore Committee or WHO norms for developing regions), the recommended number of hospital beds is calculated as **half of the Crude Death Rate (CDR)**. * **Formula:** Required Beds per 1000 population = CDR / 2 * **Calculation:** 8 / 2 = 4 beds per 1000 population. This ratio ensures that the healthcare infrastructure is proportional to the mortality burden of the population, allowing for adequate acute and chronic care management. **Analysis of Incorrect Options:** * **Option B (8/1000):** This equals the CDR. Providing one bed for every death in the population is an overestimation and economically unfeasible for most public health systems. * **Option C (10/1000):** This is a high ratio typically seen only in very advanced healthcare systems (like parts of Europe) and does not follow the CDR-based calculation provided in the prompt. * **Option D (2/1000):** This is half of the required amount. While many developing areas currently operate at this level, it is below the "recommended" norm based on a CDR of 8. **High-Yield Pearls for NEET-PG:** * **Bhore Committee (1946) Recommendation:** Initially aimed for 5.6 beds per 1000 population. * **Current Indian Target:** The National Health Policy aims for a more realistic target of **2 beds per 1000 population** in the short term, though the CDR-based formula remains a classic exam favorite. * **Bed Occupancy Rate:** The ideal bed occupancy rate for a hospital is considered to be **80-85%**. * **Average Length of Stay (ALOS):** A key indicator of hospital efficiency; shorter ALOS usually indicates better turnover and efficiency.

Q: The national health policy is based on which of the following principles?

Comprehensive health care. **Explanation:** The National Health Policy (NHP) of India is fundamentally rooted in the principle of **Comprehensive Health Care**. This concept, originally popularized by the Bhore Committee (1946), refers to health services that are integrated, continuous, and cover the entire spectrum of care—preventive, promotive, curative, and rehabilitative—for all sections of society, regardless of their ability to pay. **Analysis of Options:** * **A. Comprehensive Health Care (Correct):** The NHP aims to provide a "continuum of care" through the strengthening of primary, secondary, and tertiary levels. It focuses on addressing the holistic needs of the population rather than just treating specific diseases. * **B. Subsidized Health Care:** While the government provides services at a lower cost, "subsidized" is a financial mechanism, not the foundational philosophical principle of the national policy. * **C. Socialized Medicine:** This refers to a system where the government owns the facilities and employs the providers (e.g., the UK's NHS). While India has a public sector, the NHP encourages a "pluralistic" approach involving private sector participation and diverse systems of medicine (AYUSH). * **D. Equitable Distribution:** This is a key principle of **Primary Health Care** (as defined by the Alma-Ata Declaration), but the overarching framework of the National Health Policy itself is built upon the delivery of Comprehensive Health Care. **High-Yield Pearls for NEET-PG:** * **NHP 2017 Goal:** To achieve the highest possible level of health and well-being for all at all ages. * **Target:** Increase health expenditure to **2.5% of GDP** by 2025. * **Key Shift:** Moving from "Sickness care" to "Wellness care" via Health and Wellness Centers (HWCs) under Ayushman Bharat. * **Life Expectancy Target:** To raise life expectancy at birth from 67.5 to **70 years** by 2025.

Q: Which of the following is a novel feature of the Revised National Tuberculosis Control Programme (RNTCP)?

Involvement of NGOs. ### Explanation The **Revised National Tuberculosis Control Programme (RNTCP)**, based on the WHO-recommended **DOTS (Directly Observed Treatment, Short-course)** strategy, shifted the focus from merely treating patients to ensuring a high cure rate through systematic monitoring and accountability. **Why "Involvement of NGOs" is correct:** One of the five pillars of the DOTS strategy is **Political and Administrative Commitment**. A novel feature of RNTCP was the decentralization of services and the formal integration of **Non-Governmental Organizations (NGOs)** and the private sector. This "Public-Private Mix" (PPM) was designed to increase the reach of the programme, improve case notification, and provide DOTS providers closer to the patient’s home, ensuring better treatment adherence. **Analysis of Incorrect Options:** * **A. BCG Coverage:** While BCG vaccination is part of the Universal Immunization Programme (UIP), it is a preventive measure and not a primary performance indicator or "novel feature" of the RNTCP’s treatment-centric DOTS strategy. * **B & C. Detection and Cure Rates:** The global targets for RNTCP were to achieve a **70% detection rate** of new smear-positive cases and an **85% cure rate**. Options B and C have the numerical values swapped, making them factually incorrect in the context of the programme's specific goals. **High-Yield Clinical Pearls for NEET-PG:** * **Current Status:** RNTCP was renamed the **National Tuberculosis Elimination Program (NTEP)** in 2020. * **Goal:** The target is to eliminate TB in India by **2025** (5 years ahead of the global SDG target of 2030). * **Nikshay:** The web-based portal for TB surveillance and monitoring in India. * **Diagnosis:** **CBNAAT (GeneXpert)** or **Truenat** is now the preferred initial diagnostic tool, replacing sputum microscopy for faster detection of Rifampicin resistance.

Question 1

Which of the following is NOT used in health planning?

Accepted Answer

Increasing demands for resources

Answer

Analysis of health situation

Answer

Assessment of resources

Answer

Fixing priorities

Question 2

According to the WHO, immunisation is a primary responsibility of:

Accepted Answer

States

Answer

International community

Answer

Voluntary agencies

Answer

An individual

Question 3

Which of the following health committees recommended the establishment of a medical and health education commission, similar to the University Grants Commission, for reforms in health and medical education?

Accepted Answer

Shrivastav Committee

Answer

Mukerji Committee

Answer

Chadah Committee

Answer

Kartar Singh Committee

Question 4

Which of the following statements regarding the International Classification of Diseases (ICD) is untrue?

Accepted Answer

The 10th revision (ICD-10) has 15 major chapters.

Answer

It is revised approximately every 10 years.

Answer

It serves as the basis for use in other health fields.

Answer

The coding system in the 10th revision (ICD-10) is alphanumeric.

Question 5

The crude death rate of a population is 8/1000. What is the recommended number of beds for this population?

Accepted Answer

4/1000

Answer

8/1000

Answer

10/1000

Answer

2/1000

Question 6

In the critical path method, illness is maximum if the causal factors affect a particular period of life. What is the term for this vulnerable period?

Accepted Answer

Longest

Answer

Shortest

Answer

Cheapest

Answer

Costliest

Question 7

Which one of the following Union Ministries administers the "Nutritional Programme for Adolescent Girls"?

Accepted Answer

Ministry of Women and Child Development

Answer

Ministry of Health and Family Welfare

Answer

Ministry of Social Justice and Empowerment

Answer

Ministry of Housing and Urban Poverty Alleviation

Question 8

A health team visited primary schools and mosques in a village during a polio campaign, accompanied by community leaders and health workers. Community workers helped identify households with children under five years of age. This reflects which aspect of public health work?

Accepted Answer

Community participation

Answer

Management

Answer

Prioritization

Answer

Situation analysis

Question 9

The national health policy is based on which of the following principles?

Accepted Answer

Comprehensive health care

Answer

Subsidized health care

Answer

Socialized medicine

Answer

Equitable distribution of health resources

Question 10

Which of the following is a novel feature of the Revised National Tuberculosis Control Programme (RNTCP)?

Accepted Answer

Involvement of NGOs

Answer

Achieving 80% BCG coverage

Answer

Achieving 85% detection rate

Answer

Achieving 70% cure rate

Health Policy and Management — MCQs

Health Policy and Management — MCQs

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