Public Health Administration Practice Questions

Q: Which of the following is a key focus of the National Programme for Control of Blindness?

Cataract removal. ***Cataract removal*** - The **National Programme for Control of Blindness and Visual Impairment (NPCB-VI)**, launched in India in 1976, primarily focuses on reducing the backlog of blindness through surgical interventions for **cataract**. - **Cataract** accounts for approximately **62-82% of avoidable blindness** in India, making its surgical management the **cornerstone strategy** of the program. - The program aims to increase cataract surgical coverage and improve quality of services through high-volume, high-quality cataract surgeries. *Prevention of communicable eye diseases* - While the NPCB does address corneal blindness and trachoma, this is not the **primary focus** of the program. - Communicable eye diseases contribute significantly less to the overall **burden of blindness** compared to cataracts in India. - These are addressed as secondary objectives within the comprehensive eye care framework. *Correction of refractive errors* - This became an important component through the **School Eye Screening Programme**, but it is not the **central pillar** of NPCB. - Refractive errors cause **visual impairment** rather than **blindness**, which is the primary focus of the program. - While important for reducing visual disability, uncorrected refractive errors contribute less to the blindness burden compared to cataracts. *Screening for glaucoma* - Glaucoma prevention and control is a component of NPCB but not its **primary focus**. - Glaucoma accounts for approximately **5-12% of blindness** in India, significantly less than cataracts. - The program does include glaucoma screening in tertiary centers, but cataract surgery remains the main intervention strategy.

Q: As part of the Anemia Mukt Bharat Programme, a district health officer reviews data showing a slight decrease in anemia prevalence but significant improvements in iron-folic acid (IFA) distribution and dietary counseling coverage. What should the next step be?

Target interventions to address compliance and follow-up.. ***Target interventions to address compliance and follow-up.*** - While **IFA distribution** and **dietary counseling coverage** are good, a "slight decrease" in anemia prevalence suggests that uptake and adherence to these interventions might be suboptimal. - Addressing **compliance** (e.g., ensuring individuals actually take the IFA tablets) and improving **follow-up** (e.g., monitoring their progress and addressing side effects) are crucial to translate coverage into significant health outcomes. *Increase the dosage of IFA supplementation.* - Increasing the dosage could lead to more **side effects** (e.g., **gastric irritation, constipation**), which might further reduce compliance, especially if the current issue is not about insufficient iron intake but poor adherence. - There is no indication that the current IFA dosage is inadequate for the population; the problem seems to be with the *consumption* of the distributed supplements. *Discontinue the program due to lack of effectiveness.* - A "slight decrease" in anemia prevalence, despite improvements in distribution and counseling, indicates that the program is having *some* effect, albeit not as robust as desired. - Discontinuing it would be premature and detrimental, as it would reverse any gains and neglect the potential for greater impact by refining current strategies. *Shift focus entirely to deworming interventions.* - While **deworming** is an important component of anemia control, particularly in areas endemic for **soil-transmitted helminths**, shifting *entirely* away from **IFA supplementation** and **dietary counseling** would be ill-advised. - The problem described specifically highlights an issue with the implementation of IFA and dietary counseling; these are primary interventions for nutritional anemia that still need optimization.

Q: What is the target population for a Secondary Service Center as per the Vision 2020 initiative in India?

5 lac. ***5 lac*** - As per the **Vision 2020 initiative** (National Programme for Control of Blindness) in India, Secondary Service Centers are designed to cater to a target population of **500,000 (5 lac) individuals**. - This population size allows for efficient resource allocation and ensures comprehensive secondary-level eye care services, including cataract surgery and other specialist ophthalmological procedures, are accessible to a significant segment of the population. - Secondary Centers serve as referral units between Primary Centers and tertiary-level District Centers. *10000* - A target population of 10,000 is typically served by **Primary Vision Centers** or sub-centers, which provide basic eye screening and first-contact eye care. - Secondary Service Centers offer a broader range of specialized services that require a larger catchment area to be economically viable and effectively utilized. *50000* - A population of 50,000 is too small for a Secondary Service Center under the Vision 2020 framework. - This population size might be appropriate for enhanced Primary Care facilities, but Secondary Centers require a much larger demographic base to justify the specialized infrastructure and trained ophthalmologists necessary for comprehensive secondary eye care. *1 lac* - While 100,000 (1 lac) represents a substantial population, it is still **smaller than the intended target** for a Secondary Service Center under Vision 2020. - The centers are designed to serve **5 times this population** (5 lac), acting as major hubs for secondary eye care with surgical facilities and specialist services for multiple primary centers.

Q: What is the last administrative level at which the Reproductive and Child Health Programme is implemented?

Primary Health Centre. ***Primary Health Centre*** - The **Primary Health Centre (PHC)** is the **last administrative level** at which the **Reproductive and Child Health (RCH) Programme** is implemented in India. - PHCs serve as the **operational headquarters at the block level** and directly implement RCH services including antenatal care, immunization, family planning, and postnatal care. - The **Medical Officer in-charge** of the PHC is responsible for supervising sub-centers and ensuring RCH program implementation in the catchment area. - PHCs maintain records, conduct outreach activities, and provide referral services for maternal and child health. *Community Health Centre* - **Community Health Centres (CHCs)** serve as referral centers for PHCs and provide specialized services. - CHCs are primarily **secondary care facilities** rather than administrative implementation units for RCH programs. - They support PHCs but are not the administrative level where RCH programs are coordinated and implemented. *District Health Office* - The **District Health Office** provides **administrative oversight, monitoring, and supervision** of RCH programs across the district. - It is a **coordinating and planning authority** rather than a direct implementation level. - District officials monitor performance, allocate resources, and provide technical support to PHCs and CHCs. *State Health Department* - The **State Health Department** operates at the **policy and planning level**, formulating guidelines and allocating resources. - It is far removed from ground-level implementation of RCH services. - State authorities monitor district-level performance but do not directly implement programs.

Q: Which of the following conditions must be fulfilled for a PHC to become a First Referral Unit (FRU)?

Emergency obstetric care. ***Emergency obstetric care*** - A primary healthcare center (PHC) cannot function as a **First Referral Unit (FRU)** without the capability to provide comprehensive **emergency obstetric care**, which includes conducting deliveries and managing obstetric complications. - FRUs are designed to handle obstetric and neonatal emergencies, ensuring that pregnant women and newborns receive timely and appropriate interventions, which is a core feature of their referral capacity. *4-6 beds* - While adequate bed capacity is important for a PHC, simply having 4-6 beds does not alone qualify it as an FRU. - An FRU requires a broader range of services and infrastructure, beyond just beds, particularly for specialized care like emergency obstetrics. *15 workers* - The number of healthcare workers is crucial for staffing and service delivery but does not solely define an FRU. - The specific skills and types of healthcare professionals, such as obstetricians and anesthetists, are more important for FRU status than just a total count of workers. *Basic laboratory services* - **Basic laboratory services** are a standard requirement for most healthcare facilities, including PHCs. - Although important for diagnosis, they are not the distinguishing factor that elevates a PHC to an **FRU**, which requires specialized emergency care capabilities.

Q: National Health Mission (NHM) in India is primarily aimed at:

Strengthening healthcare delivery through NRHM and NUHM. ***Strengthening healthcare delivery through NRHM and NUHM*** - The National Health Mission is primarily aimed at **strengthening primary, secondary, and tertiary healthcare services** across India. - NHM encompasses both the **National Rural Health Mission (NRHM)** and the **National Urban Health Mission (NUHM)**. - Key focus areas include maternal and child health, communicable and non-communicable diseases, and health system strengthening. - Provides accessible, affordable, and quality healthcare to all, particularly in rural and underserved urban areas. *Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana* - This is a **separate scheme** launched in 2018 focusing on providing **health insurance coverage** to economically vulnerable populations. - Provides coverage up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. - While complementary to NHM, it is not what NHM is primarily aimed at. *National AIDS Control Programme* - This is a **vertical disease-specific program** targeting the prevention and control of HIV/AIDS. - Operates as a separate program under the Ministry of Health and Family Welfare. - Not the primary aim of the broader National Health Mission. *National Vector Borne Disease Control Programme* - This is another **vertical disease-specific program** focusing on malaria, dengue, chikungunya, and other vector-borne diseases. - While important for public health, it is a specialized program, not the overarching aim of NHM. - NHM may support NVBDCP activities but is not primarily aimed at it.

Q: Which of the following has responsibility of data collection for active malaria surveillance at PHC level ?

MPW [Multipurpose worker]. ***MPW [Multipurpose Worker]*** - The **Multipurpose Worker (MPW)** is the primary field-level health worker responsible for **active malaria surveillance and data collection** at the PHC level. - MPWs conduct **house-to-house surveys**, identify suspected malaria cases, collect blood smears for testing, maintain surveillance registers, and report data to the MO-PHC. - Under the **National Vector Borne Disease Control Programme (NVBDCP)**, MPWs are specifically designated for active case detection and surveillance activities in their assigned areas. *MO-PHC [Medical Officer-PHC]* - The **Medical Officer-PHC** has **supervisory and administrative responsibility** for malaria control programs at the PHC. - While they oversee surveillance activities, review data, and ensure reporting, they do not perform the actual **field-level data collection** for active surveillance. - The MO-PHC coordinates the program and provides technical guidance to MPWs. *DHO [District Health Officer]* - The **District Health Officer (DHO)** is responsible for health administration at the **district level**, which is a higher administrative tier. - They monitor overall district health outcomes and compile reports from multiple PHCs but are not involved in direct data collection at individual PHCs. *DMO [District Medical Officer]* - The **District Medical Officer (DMO)** is also a senior administrative position at the **district level**. - Their role focuses on district-wide health management, policy implementation, and resource allocation, not direct field-level surveillance data collection.

Q: What is the first step in health program planning?

Quantitative. ***Quantitative*** - While **quantitative assessment** (measuring prevalence, incidence, burden of disease) is crucial in the **needs assessment phase**, it is not the singular first step in isolation. - Health program planning begins with **needs assessment**, which typically uses **both qualitative and quantitative methods** to comprehensively identify and understand health problems. - Quantitative data helps establish baseline prevalence and magnitude, but alone does not constitute the complete first step. *Based on behavioral science* - **Behavioral science principles** are applied during intervention design and implementation, not as the initial step. - These principles help understand health behaviors and design effective interventions after the health problem has been identified. *Qualitative* - **Qualitative methods** (interviews, focus groups, observations) are essential for understanding context, perceptions, and barriers during needs assessment. - Many frameworks emphasize starting with qualitative exploration to understand the problem before quantifying it. - However, like quantitative methods, qualitative approaches are part of needs assessment rather than a standalone first step. *None of the options* - This option would be correct if we consider that the actual first step is **"Needs Assessment"** (which uses both qualitative and quantitative methods). - However, given the context of the question and standard teaching, **quantitative assessment** is conventionally emphasized as initiating the systematic data collection process in program planning. - Therefore, among the given options, quantitative is the most appropriate answer, though needs assessment would be the most precise term.

Q: The number of Anganwadi workers supervised by a Mukhyasevika is:

25. ***Correct: 25*** - A **Mukhyasevika (Lady Supervisor)** in the ICDS program supervises **20-25 Anganwadi Workers (AWWs)** in a designated cluster. - This supervisory ratio ensures effective monitoring, program implementation support, and quality oversight. - The Mukhyasevika coordinates activities, provides training, and ensures proper delivery of ICDS services. *Incorrect: 10* - This number is too low for the supervisory role of a Mukhyasevika. - Supervising only 10 AWWs would be inefficient utilization of supervisory resources and expertise. *Incorrect: 15* - While closer, 15 is still below the standard supervisory cluster size. - The typical ratio of 20-25 is designed to balance effective supervision with comprehensive program coverage. *Incorrect: 30* - Supervising 30 AWWs would exceed the recommended ratio and compromise quality of supervision. - The standard ratio ensures the Mukhyasevika can provide adequate support and monitoring to each Anganwadi center.

Q: Under National Cancer Control Programme, oncology wings were sanctioned to -

Medical College Hospitals. ***Medical College Hospitals*** - Under the **National Cancer Control Programme (NCCP)**, oncology wings were sanctioned to **Medical College Hospitals** to strengthen cancer care infrastructure at a more accessible level. - This initiative aimed to decentralize cancer treatment services beyond specialized regional institutes, making care available in major teaching hospitals across different regions. *Regional Cancer Institutes* - **Regional Cancer Institutes (RCIs)** are already specialized centers for cancer treatment and research. - The sanctioning of oncology wings was primarily to *expand* access to cancer care, not to facilities that were already dedicated to it. *District Hospitals* - While district hospitals are crucial for primary and secondary healthcare, the initial phase of establishing comprehensive oncology wings with specialized equipment and personnel was typically targeted at **tertiary care centers** like Medical College Hospitals due to resource intensity. - District hospitals often receive support for early detection and basic follow-up but not full-fledged oncology wings. *Voluntary Agencies treating cancer patients* - Voluntary agencies often play a supportive role in cancer care, such as providing **palliative care**, awareness, or financial assistance. - However, direct governmental sanctioning of full oncology wings, which involve significant infrastructure and specialized staffing, is usually directed towards *governmental or semi-governmental healthcare institutions*.

Question 1

Which of the following is a key focus of the National Programme for Control of Blindness?

Accepted Answer

Cataract removal

Answer

Prevention of communicable eye diseases

Answer

Correction of refractive errors

Answer

Screening for glaucoma

Question 2

As part of the Anemia Mukt Bharat Programme, a district health officer reviews data showing a slight decrease in anemia prevalence but significant improvements in iron-folic acid (IFA) distribution and dietary counseling coverage. What should the next step be?

Accepted Answer

Target interventions to address compliance and follow-up.

Answer

Increase the dosage of IFA supplementation.

Answer

Discontinue the program due to lack of effectiveness.

Answer

Shift focus entirely to deworming interventions.

Question 3

What is the target population for a Secondary Service Center as per the Vision 2020 initiative in India?

Accepted Answer

5 lac

Answer

10000

Answer

50000

Answer

1 lac

Question 4

What is the last administrative level at which the Reproductive and Child Health Programme is implemented?

Accepted Answer

Primary Health Centre

Answer

District Health Office

Answer

Community Health Centre

Answer

State Health Department

Question 5

Which of the following conditions must be fulfilled for a PHC to become a First Referral Unit (FRU)?

Accepted Answer

Emergency obstetric care

Answer

4-6 beds

Answer

15 workers

Answer

Basic laboratory services

Question 6

National Health Mission (NHM) in India is primarily aimed at:

Accepted Answer

Strengthening healthcare delivery through NRHM and NUHM

Answer

Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana

Answer

National AIDS Control Programme

Answer

National Vector Borne Disease Control Programme

Question 7

Which of the following has responsibility of data collection for active malaria surveillance at PHC level ?

Accepted Answer

MPW [Multipurpose worker]

Answer

DHO [District Health Officer]

Answer

MO-PHC [Medical Officer-PHC]

Answer

DMO [District Medical Officer]

Question 8

What is the first step in health program planning?

Accepted Answer

Quantitative

Answer

Based on behavioral science

Answer

Qualitative

Answer

None of the options

Question 9

The number of Anganwadi workers supervised by a Mukhyasevika is:

Accepted Answer

25

Answer

30

Answer

15

Answer

10

Question 10

Under National Cancer Control Programme, oncology wings were sanctioned to -

Accepted Answer

Medical College Hospitals

Answer

Regional Cancer Institutes

Answer

District Hospitals

Answer

Voluntary Agencies treating cancer patients

Public Health Administration — MCQs

Public Health Administration — MCQs

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