Health Policy and Management Practice Questions

Q: According to WHO, which of the following is the primary strategy for achieving Universal Health Coverage?

Strengthening Primary Health Care. ***Strengthening Primary Health Care*** - WHO identifies **Primary Health Care (PHC)** as the **cornerstone and primary strategy** for achieving Universal Health Coverage (UHC). - PHC provides comprehensive, accessible, community-based care that addresses the majority of health needs throughout the life course. - The **Astana Declaration (2018)** reaffirmed PHC as the most inclusive, effective, and efficient approach to enhance health and well-being. - PHC focuses on **prevention, promotion, treatment, rehabilitation, and palliative care** at the first point of contact with the health system. *Increasing tertiary care hospitals* - While tertiary care is important for specialized services, it is **not the primary strategy** for UHC. - UHC emphasizes accessible, affordable care for all, which is best achieved through primary care rather than expensive tertiary facilities. - Over-emphasis on tertiary care can lead to inequitable access and financial barriers. *Promoting private health insurance* - Private insurance alone does not guarantee UHC as it may **exclude vulnerable populations** who cannot afford premiums. - WHO advocates for **prepayment and pooling mechanisms** that ensure financial risk protection for all, not just those who can afford private insurance. - UHC requires government commitment to equitable financing, not reliance on market-based private insurance. *Expanding medical tourism* - Medical tourism focuses on attracting **international patients for specialized care**, which does not address the health needs of the local population. - This is contrary to UHC principles of **equity and universal access** for all residents of a country. - Medical tourism can divert resources from essential health services needed by the general population.

Q: Which of the following diseases is not included in "Vision 2020 - Right to Sight" immediate goals?

Epidemic conjunctivitis. ***Epidemic conjunctivitis*** - While a common eye infection, **epidemic conjunctivitis** is typically **self-limiting** and rarely leads to permanent blindness, thus it was not a primary target for "Vision 2020" blindness prevention programs. - The "Vision 2020" initiative focused on conditions that were the leading causes of **avoidable blindness** globally, aiming to eliminate them as public health problems. *Trachoma* - **Trachoma** is a chronic infectious eye disease that can lead to irreversible blindness and was a major focus of the "Vision 2020" initiative. - It was targeted for elimination through strategies like improved hygiene, mass drug administration, and surgical interventions. *Onchocerciasis* - Also known as **river blindness**, onchocerciasis is caused by a parasitic worm and was a significant cause of blindness in endemic regions, making it a key component of the "Vision 2020" program. - The program aimed to control and eliminate the disease through mass drug administration of ivermectin. *Cataract* - **Cataract** is the leading cause of blindness worldwide and was a primary target for the "Vision 2020" initiative due to its high prevalence and the effectiveness of surgical treatment. - The initiative aimed to increase access to affordable cataract surgery to restore sight.

Q: Which of the following was NOT an actual goal of the WHO 'Health for All by 2000' strategy?

All people will be healthy by 2000 A.D. ***All people will be healthy by 2000 A.D*** - This statement represents an **absolute and unrealistic outcome** that was not a practical goal of the WHO's "Health for All by 2000" strategy. - The strategy aimed for a **significant improvement in health status** and equity, not the complete eradication of all illness. *Equal health status for people and countries* - This was a core aspiration of the "Health for All by 2000" strategy, focusing on **reducing health disparities** between different populations and nations. - The aim was to achieve a more **equitable distribution of health resources** and outcomes globally. *All will have socially and economically productive life* - This goal emphasized the importance of health as a prerequisite for **social and economic development**, allowing individuals to participate fully in society. - It highlights the concept that health is not merely the absence of disease but a state that enables a **productive and fulfilling life**. *All people are accessible to health care services* - **Universal access** to essential health care services was a fundamental pillar of the "Health for All by 2000" strategy. - This meant ensuring that **primary healthcare** was available and affordable to everyone, regardless of their location or socioeconomic status.

Q: About ASHA (Accredited Social Health Activist), all are true EXCEPT:

ASHA is a skilled birth attendant.. ***ASHA is a skilled birth attendant.*** - ASHA workers are primarily **community health facilitators and educators**, not skilled birth attendants. They motivate pregnant women to deliver in health facilities and provide basic maternal care information. - A **Skilled Birth Attendant (SBA)** is a healthcare professional (doctor, nurse, midwife) trained to manage normal deliveries and identify complications, which is beyond the scope of an ASHA. *They are preferably females.* - This statement is true; ASHA workers are indeed **preferably females**, particularly because their role often involves sensitive health discussions with women and families in the community. - Their gender facilitates better acceptance and communication regarding maternal and child health issues. *There is one ASHA worker per 1000 population.* - This statement is true; the ASHA program aims to deploy **one ASHA per 1000 population** or for every habitation in tribal, hilly, desert areas for effective community outreach. - This ratio ensures adequate coverage and accessibility of basic health services at the village level. *Provides primary medical care for minor ailments.* - This statement is true; ASHA workers are trained to provide **primary medical care for minor ailments** like diarrhea, fever, and common infections. - They also distribute basic medicines like **ORS, iron-folic acid tablets**, and paracetamol, and refer more serious cases to higher health facilities.

Q: True statement regarding RNTCP includes all except

Exclusion of private practitioners. ***Exclusion of private practitioners*** - The **Revised National Tuberculosis Control Program (RNTCP)** actively encourages and facilitates the engagement of **private practitioners** in TB care and management. - This involvement is crucial for expanding reach, ensuring correct diagnosis, and completing treatment in a country like India where a significant portion of healthcare is provided by the private sector. *Sputum microscopy* - **Sputum microscopy** is a cornerstone diagnostic tool within the RNTCP for identifying **acid-fast bacilli (AFB)** in patients suspected of having pulmonary tuberculosis. - It is a cost-effective and readily available method for confirming TB and monitoring treatment response. *Participation of all health workers* - The RNTCP emphasizes the engagement of **all health workers**, including community health workers, nurses, and doctors, across various levels of healthcare delivery. - This broad participation is essential for **case finding**, treatment adherence, and community education efforts regarding TB. *Provides latest equipment* - The RNTCP continually strives to upgrade its diagnostic and treatment infrastructure by providing **latest equipment** such as **Gene Xpert machines** for rapid molecular diagnosis and drug susceptibility testing. - This ensures access to modern diagnostic tools for more accurate and timely TB diagnosis and management, especially for drug-resistant forms of TB.

Q: According to WHO guidelines, the minimum number of health workers per 1000 population required to achieve universal health coverage is

2.3. ***Correct: 2.3*** - According to the **WHO World Health Report 2006**, the minimum threshold density of skilled health workers (physicians, nurses, and midwives) required to achieve adequate coverage of essential health interventions is **2.3 per 1000 population**. - This threshold was established based on achieving 80% coverage of skilled birth attendance, which serves as a proxy indicator for universal health coverage. - Countries falling below this threshold are considered to have a critical shortage of health workers. *Incorrect: 1.5* - This value is **below the WHO recommended threshold**. - Countries with 1.5 health workers per 1000 population would face significant challenges in achieving universal health coverage. - This density is insufficient to provide essential health services. *Incorrect: 3.0* - While this is **above the minimum threshold**, it is not the WHO-specified minimum value. - This represents a better health worker density but is not the official guideline answer. *Incorrect: 4.5* - This value is closer to the **WHO Global Strategy on Human Resources for Health (2016)** target of 4.45 health workers per 1000 population for achieving SDG health targets. - However, the question asks for the **minimum** threshold, which remains **2.3** as established in the 2006 World Health Report.

Q: The time taken for any project is estimated by:

Network analysis. ***Network analysis*** - **Network analysis** methods, such as **PERT (Program Evaluation and Review Technique)** and **CPM (Critical Path Method)**, are specifically designed for estimating project duration. - These techniques involve breaking down a project into individual tasks, establishing dependencies, and calculating the longest path (critical path) to determine the minimum project completion time. *Input/output analysis* - **Input/output analysis** is a quantitative economic technique that examines interdependencies between different sectors of an economy. - It is primarily used for **economic planning** and forecasting, and not for direct project time estimation. *System analysis* - **System analysis** is a problem-solving technique that decomposes a system into its component pieces to study how those components work and interact. - While it's crucial for understanding project requirements and design, it does not directly estimate the **time required for project completion**. *Work sampling* - **Work sampling** is a statistical technique used to determine the proportion of time workers spend on various activities. - It helps in **process improvement** and setting performance standards but is not a method for estimating the overall time of an entire project.

Q: National AIDS Control Programme was started in:

1987. ***Correct Option: 1987*** - The National AIDS Control Programme (NACP) in India was officially initiated in **1987** - Its objective was to prevent the transmission of **HIV** and manage the care of people living with **AIDS** - This was launched in response to the detection of the first HIV cases in India in 1986 *Incorrect Option: 1986* - The first case of **HIV** in India was detected in **1986** in Chennai among sex workers - While this discovery was pivotal, it prompted the establishment of NACP, which officially began the following year in 1987 - This marks the recognition phase rather than the program launch *Incorrect Option: 1985* - While significant early efforts against **HIV/AIDS** were underway globally around this time, NACP was not formally launched in India until later - The initial **HIV case** in India was identified in 1986, making a 1985 program launch chronologically impossible *Incorrect Option: 1984* - In 1984, the global understanding of **HIV/AIDS** was still rapidly evolving - Comprehensive national programs like NACP were not yet established in India - This period predates the official recognition of **HIV** as a major public health concern in the country

Q: Which of the following is the most peripheral laboratory under RNTCP?

Designated microscopy centre. ***Designated microscopy centre*** - The **Designated Microscopy Centre (DMC)** is the most peripheral laboratory under the **Revised National Tuberculosis Control Programme (RNTCP)**, responsible for initial **sputum smear microscopy**. - These centers are established at the **primary healthcare level** to ensure widespread access to basic tuberculosis diagnostic services. *Intermediate Reference laboratory* - An **Intermediate Reference Laboratory (IRL)** is a higher-level facility that provides **advanced diagnostic services** and quality assurance for multiple DMCs. - They are not the most peripheral but serve as a **referral center** for smaller labs and perform drug susceptibility testing. *Peripheral Reference laboratory* - The term **"Peripheral Reference Laboratory"** is not a standard designation within the RNTCP structure for a distinct laboratory tier at the most peripheral level. - The hierarchy typically includes DMCs, IRLs, and National Reference Laboratories. *Tuberculosis unit* - A **Tuberculosis Unit (TU)** is essentially an administrative and programmatic unit within the RNTCP responsible for **managing TB control activities** for a specific population. - While TUs coordinate laboratory services, they are not themselves laboratories or the most peripheral diagnostic facility.

Q: Vision 2020 "The right to sight" includes all except-

Measles induced blindness. ***Measles induced blindness*** - Vision 2020 primarily targets conditions that are either preventable or treatable with *cost-effective interventions* and contribute significantly to *avoidable blindness*. - While measles can cause blindness, the specific program focuses on a defined list of priority diseases for intervention, and measles-related blindness is generally addressed through broader public health initiatives (vaccination) rather than direct "right to sight" surgical or direct medical interventions for established blindness. *Onchocerciasis* - **Onchocerciasis** (river blindness) is a major focus of Vision 2020 due to its profound impact on sight, particularly in endemic areas. - It is a **preventable** and **treatable** cause of blindness through mass drug administration. *Trachoma* - **Trachoma** is recognized as one of the leading infectious causes of blindness globally and is explicitly targeted by Vision 2020 through the **SAFE strategy** (Surgery, Antibiotics, Facial cleanliness, Environmental improvement). - It is a highly **preventable** and **treatable** condition, fitting the program's objectives. *Cataract* - **Cataract** is the leading cause of blindness worldwide and is highly **treatable** through a relatively simple and cost-effective surgical procedure. - Providing cataract surgery is a cornerstone of the Vision 2020 initiative to restore sight.

Question 1

According to WHO, which of the following is the primary strategy for achieving Universal Health Coverage?

Accepted Answer

Strengthening Primary Health Care

Answer

Increasing tertiary care hospitals

Answer

Promoting private health insurance

Answer

Expanding medical tourism

Question 2

Which of the following diseases is not included in "Vision 2020 - Right to Sight" immediate goals?

Accepted Answer

Epidemic conjunctivitis

Answer

Trachoma

Answer

Onchocerciasis

Answer

Cataract

Question 3

Which of the following was NOT an actual goal of the WHO 'Health for All by 2000' strategy?

Accepted Answer

All people will be healthy by 2000 A.D

Answer

Equal health status for people and countries

Answer

All will have socially and economically productive life

Answer

All people have access to health care services

Question 4

About ASHA (Accredited Social Health Activist), all are true EXCEPT:

Accepted Answer

ASHA is a skilled birth attendant.

Answer

They are preferably females.

Answer

There is one ASHA worker per 1000 population.

Answer

Provides primary medical care for minor ailments.

Question 5

True statement regarding RNTCP includes all except

Accepted Answer

Exclusion of private practitioners

Answer

Sputum microscopy

Answer

Participation of all health workers

Answer

Provides latest equipment

Question 6

According to WHO guidelines, the minimum number of health workers per 1000 population required to achieve universal health coverage is

Accepted Answer

2.3

Answer

1.5

Answer

3.0

Answer

4.5

Question 7

The time taken for any project is estimated by:

Accepted Answer

Network analysis

Answer

Input/output analysis

Answer

System analysis

Answer

Work sampling

Question 8

National AIDS Control Programme was started in:

Accepted Answer

1987

Answer

1985

Answer

1984

Answer

1986

Question 9

Which of the following is the most peripheral laboratory under RNTCP?

Accepted Answer

Designated microscopy centre

Answer

Intermediate Reference laboratory

Answer

Peripheral Reference laboratory

Answer

Tuberculosis unit

Question 10

Vision 2020 "The right to sight" includes all except-

Accepted Answer

Measles induced blindness

Answer

Onchocerciasis

Answer

Trachoma

Answer

Cataract

Health Policy and Management — MCQs

Health Policy and Management — MCQs

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