Maternal and Child Health Practice Questions

Q: Injectable medroxyprogesterone IP 150 mg/mL contraceptive injection is available in Family Health Programme of the Government of India under the name

Antara. ***Antara*** - **Antara** is the brand name under which the **injectable contraceptive medroxyprogesterone acetate (DMPA)**, 150 mg/mL, is available in the Family Health Programme of the Government of India. - It is a **long-acting reversible contraceptive (LARC)** providing contraception for three months with a single injection. *Saheli* - **Saheli** is the brand name for **Centchroman (Ormeloxifene)**, a non-steroidal oral contraceptive pill used once a week in India. - It is **not an injectable contraceptive** and has a different mechanism of action than medroxyprogesterone. *Sahiba* - **Sahiba** is not a recognized brand name for a contraceptive product available within the Indian Government's Family Health Programme. - This option is a **distractor** and does not correspond to any known contraceptive. *Sayana Press* - **Sayana Press** is a brand name for **depot medroxyprogesterone acetate (DMPA) subcutaneous injection**, often used in self-administration programs in some countries. - While it contains MPA, the specific program and formulation mentioned in the question (150 mg/mL intramuscular) under the Indian Government's FHP is represented by **Antara**.

Q: As per the definition of the World Health Organization, 'late maternal death' is defined as the death of a woman from direct or indirect obstetric causes, after more than X days but less than one year after termination of pregnancy. Which one among the following is the correct value of X?

42. ***Correct: 42*** - According to the **World Health Organization (WHO)**, **late maternal death** is defined as the death of a woman from direct or indirect obstetric causes occurring **more than 42 days** but less than one year after termination of pregnancy. - This definition helps in categorizing and understanding the timeframe and causes of maternal mortality beyond the immediate postpartum period. - The **42-day threshold** distinguishes between direct maternal deaths (within 42 days) and late maternal deaths (42 days to 1 year). *Incorrect: 21* - This value is not used in the WHO definition for the onset of late maternal death. - The **42-day mark** is the internationally recognized threshold for distinguishing between the immediate postpartum period and late maternal complications. *Incorrect: 7* - Seven days is too short a period for a death to be classified as **"late maternal death"**; deaths within this timeframe fall under **direct maternal deaths** in the immediate postpartum period. - This period is often associated with immediate postpartum complications such as **postpartum hemorrhage**, **eclampsia**, or **early-onset puerperal sepsis**. *Incorrect: 84* - While 84 days (12 weeks) is a significant period in postpartum recovery for some physiological changes, it is not the specific threshold used by the **WHO** to define the beginning of **late maternal death**. - The international standard remains **42 days** (6 weeks) as the transition point between direct and late maternal deaths.

Q: Which of the following are the principal causes of infant mortality in India? 1. Acute respiratory infections 2. Congenital anomalies 3. Childhood cancers 4. Diarrhoeal diseases

1, 2 and 4. ***1, 2 and 4*** - **Acute respiratory infections (ARIs)** and **diarrhoeal diseases** are major contributors due to prevalent infections and inadequate sanitation. - **Congenital anomalies** represent a significant cause, indicating the importance of prenatal care and early diagnosis. *2, 3 and 4* - This option incorrectly includes **childhood cancers** as a principal cause. While tragic, **childhood cancers** contribute to a smaller proportion of infant deaths compared to infectious diseases and congenital issues in India. - **Acute respiratory infections** are a critical component of infant mortality, and their exclusion makes this option incomplete. *1, 2 and 3* - This option incorrectly excludes **diarrhoeal diseases**, which are a leading cause of infant mortality in India due to factors like poor hygiene and contaminated water. - While **acute respiratory infections** and **congenital anomalies** are key, the omission of diarrhoeal diseases makes this answer incomplete. *1, 3 and 4* - This option incorrectly includes **childhood cancers** as a principal cause of infant mortality. - It also omits **congenital anomalies**, which are a significant and well-documented cause of infant deaths in India.

Q: Which of the following services are provided to pregnant women under the Integrated Child Development Scheme (ICDS)?

Supplementary nutrition. ***Supplementary nutrition*** - **Supplementary nutrition** is the most direct and primary tangible service provided under ICDS specifically targeting pregnant women as beneficiaries. - Under ICDS, pregnant women receive **300 calories and 10-12 grams of protein** for at least 90 days during pregnancy to bridge the calorie and protein gap in their diets. - This is a core service directly provided at Anganwadi centers, ensuring better health outcomes for both mother and developing fetus. - Among all ICDS services for pregnant women, supplementary nutrition is the **most distinctive and substantial direct benefit** that pregnant women receive. *Health check-up* - While health check-ups are part of ICDS package services, they are primarily conducted by ANMs and medical officers from the health system. - Anganwadi Workers facilitate identification, weight monitoring, and referrals, but the comprehensive health examinations are delivered through convergence with the health department rather than as a direct standalone ICDS service. *Nutrition and health education* - Nutrition and health education is indeed provided under ICDS to pregnant women and mothers. - However, it is an **enabling/educational service** rather than a direct tangible provision like supplementary nutrition. - The question likely seeks the most characteristic direct service, which is supplementary nutrition. *Immunization against tetanus* - Immunization services including tetanus toxoid are part of the integrated ICDS-health system approach. - However, vaccines are administered by health workers (ANMs), not by Anganwadi Workers themselves. - ICDS role is primarily facilitative through awareness generation and referral linkages to health facilities.

Q: Amongst the following, the Pearl Index is highest with

calendar rhythm method. ***calendar rhythm method*** - The **Pearl Index** measures the number of unintended pregnancies per 100 women-years of exposure. A higher Pearl Index signifies a **less effective** contraceptive method. - The calendar rhythm method, due to its reliance on estimations and user adherence, has a significantly higher failure rate compared to other methods, leading to the **highest Pearl Index**. *combined oral contraceptives* - **Combined oral contraceptives** have a relatively low Pearl Index, especially with perfect use, as they are highly effective in preventing ovulation. - Their effectiveness can be reduced by **missed pills** or interactions with certain medications. *barrier contraceptives* - **Barrier methods** like condoms or diaphragms have a moderate Pearl Index, as their effectiveness depends on consistent and correct use. - Breakage or incorrect application can lead to **method failure**. *intrauterine contraceptive devices* - **Intrauterine contraceptive devices (IUCDs)**, both hormonal and copper, are among the most effective long-acting reversible contraceptives, resulting in a very low Pearl Index. - Once inserted, they require no daily user action, contributing to their **high efficacy**.

Q: ICDS Scheme does not include

Primary school children. ***Primary school children*** - The **Integrated Child Development Services (ICDS) Scheme** primarily targets vulnerable groups like children under **six years of age**, pregnant women, and lactating mothers for integrated health, nutrition, and early learning services. - **Primary school children** (typically aged 6 and above) fall outside the core beneficiary group of the ICDS Scheme, as they are covered by other educational and health programs. *Pregnant women* - **Pregnant women** are a key beneficiary group under ICDS, receiving nutritional supplements, health check-ups, and health and nutrition education. - These services aim to improve maternal health outcomes and the health of the unborn child. *Children in the age group of 0-6 years* - **Children aged 0-6 years** are the primary beneficiaries of the ICDS Scheme, receiving supplementary nutrition, immunization, health check-ups, and pre-school education. - This age group is critical for growth and development, making them a central focus of the program. *Lactating women* - **Lactating women** are a crucial beneficiary group under ICDS, similar to pregnant women, receiving nutritional support, health services, and counseling on infant and young child feeding practices. - Support for lactating mothers is essential for ensuring proper nutrition for both the mother and the breastfeeding infant.

Q: Among the causes of maternal mortality, which of the following is correct in descending order of maternal deaths in India ?

Haemorrhage, sepsis, abortion, obstructed labour. ***Haemorrhage, sepsis, abortion, obstructed labour*** - This order reflects the **leading causes of maternal mortality in India** as per data available during 2010-2013 period. - **Haemorrhage** (38%) is the primary cause due to postpartum hemorrhage, antepartum bleeding, and complications during delivery. - **Sepsis** (11%) includes puerperal sepsis and infections following unsafe deliveries. - **Abortion** (8%) complications, particularly from unsafe procedures, remain a significant contributor. - **Obstructed labour** causes have decreased with improved access to cesarean sections and skilled birth attendance. *Obstructed labour, haemorrhage, abortion, sepsis* - This order is incorrect as **haemorrhage** consistently ranks as the leading cause of maternal deaths in India, not obstructed labour. - Obstructed labour has significantly declined due to better access to emergency obstetric care. *Haemorrhage, obstructed labour, abortion, sepsis* - This order is incorrect because **sepsis** accounts for a higher percentage of maternal deaths than obstructed labour. - While haemorrhage is correctly placed first, sepsis should come before obstructed labour in the ranking. *Sepsis, obstructed labour, abortion, haemorrhage* - This order is completely incorrect as **haemorrhage** is overwhelmingly the leading cause of maternal mortality in India. - Placing haemorrhage last contradicts all epidemiological data on maternal deaths in India.

Q: Failure rate of contraceptive method is determined by:

Pearl index. ***Pearl index*** - The **Pearl index** is a common measure of the effectiveness of a birth control method, indicating the number of accidental pregnancies per 100 women-years of exposure. - A lower Pearl index signifies a **more effective contraceptive method**, meaning fewer pregnancies occur during its use. *Total fertility rate* - The **total fertility rate (TFR)** represents the average number of children born to a woman over her lifetime if she were to experience current age-specific fertility rates. - It reflects overall **population reproduction trends** and not the failure rate of a specific contraceptive method. *Age specific fertility rate* - The **age-specific fertility rate (ASFR)** measures the number of births to women in a particular age group per 1,000 women in that age group per year. - This rate provides insights into **fertility patterns across different age brackets** but does not quantify contraceptive effectiveness. *Half life index* - The term **"half-life index"** is not a standard epidemiological or public health measure for contraceptive failure rates. - Half-life usually refers to the **time it takes for a substance to decrease by half** (e.g., drug elimination) or for a radioactive isotope to decay.

Question 1

Injectable medroxyprogesterone IP 150 mg/mL contraceptive injection is available in Family Health Programme of the Government of India under the name

Accepted Answer

Antara

Answer

Saheli

Answer

Sahiba

Answer

Sayana Press

Question 2

As per the definition of the World Health Organization, 'late maternal death' is defined as the death of a woman from direct or indirect obstetric causes, after more than X days but less than one year after termination of pregnancy. Which one among the following is the correct value of X?

Accepted Answer

42

Answer

21

Answer

7

Answer

84

Question 3

With reference to determinants of 'neonatal mortality', consider the following statements:

1. Neonatal mortality is directly related to the birth weight of the newborn.
2. Neonatal mortality is directly related to the gestational age at which the birth takes place.
3. Neonatal mortality is closely related to the educational status of the mother.
4. Neonatal mortality is low if the mother's age is between 15–16 years.

Accepted Answer

3. Neonatal mortality is closely related to the educational status of the mother.

Answer

2. Neonatal mortality is directly related to the gestational age at which the birth takes place.

Answer

1. Neonatal mortality is directly related to the birth weight of the newborn.

Answer

4. Neonatal mortality is low if the mother's age is between 15–16 years.

Question 4

Regarding maternal health programs in Community Medicine, which of the following statements about public-private partnership schemes is CORRECT?

Accepted Answer

It is a voluntary scheme wherein any obstetrician, maternity home, nursing home, MBBS doctor can provide safe motherhood services

Answer

The enrolled doctors must provide iron and folic acid tablets out of their pocket free to the beneficiaries

Answer

The TT injections are provided by the District Medical Officers to the enrolled doctors for free administration to the beneficiaries

Answer

To join the Vandemataram Scheme, the facility must have resources for caesarean section

Question 5

Which of the following are the principal causes of infant mortality in India?

1. Acute respiratory infections
2. Congenital anomalies
3. Childhood cancers
4. Diarrhoeal diseases

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Question 6

Which of the following services are provided to pregnant women under the Integrated Child Development Scheme (ICDS)?

Accepted Answer

Supplementary nutrition

Answer

Health check-up

Answer

Nutrition and health education

Answer

Immunization against tetanus

Question 7

Amongst the following, the Pearl Index is highest with

Accepted Answer

calendar rhythm method

Answer

combined oral contraceptives

Answer

barrier contraceptives

Answer

intrauterine contraceptive devices

Question 8

ICDS Scheme does not include

Accepted Answer

Primary school children

Answer

Pregnant women

Answer

Children in the age group of 0-6 years

Answer

Lactating women

Question 9

Among the causes of maternal mortality, which of the following is correct in descending order of maternal deaths in India ?

Accepted Answer

Haemorrhage, sepsis, abortion, obstructed labour

Answer

Obstructed labour, haemorrhage, abortion, sepsis

Answer

Haemorrhage, obstructed labour, abortion, sepsis

Answer

Sepsis, obstructed labour, abortion, haemorrhage

Question 10

Failure rate of contraceptive method is determined by:

Accepted Answer

Pearl index

Answer

Total fertility rate

Answer

Age specific fertility rate

Answer

Half life index

Maternal and Child Health — MCQs

Maternal and Child Health — MCQs

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