Health Policy and Management Practice Questions

Q: Which committee proposed the three-tier Panchayati Raj system?

Balwant Rai Mehta committee. **Explanation:** The **Balwant Rai Mehta Committee (1957)** is the correct answer as it was appointed to examine the working of the Community Development Programme. It recommended the establishment of a **three-tier Panchayati Raj system** to ensure democratic decentralization. This structure consists of: 1. **Gram Panchayat** at the village level. 2. **Panchayat Samiti** at the block level (the intermediate/pivotal tier). 3. **Zila Parishad** at the district level. **Analysis of Incorrect Options:** * **Kartar Singh Committee (1973):** Known for the concept of **"Multipurpose Workers" (MPW)**. It recommended that Auxiliary Nurse Midwives (ANMs) be replaced by Female Health Workers and introduced the Male Health Worker. * **Srivastav Committee (1975):** Recommended the creation of **"Refferal Services Complex"** and the establishment of the **Village Health Guide** scheme. It also proposed the "ROMES" (Reorientation of Medical Education) scheme. * **Mudaliar Committee (1962):** Also known as the Health Survey and Planning Committee. It recommended strengthening district hospitals and noted that the quality of care was more important than the quantity of Primary Health Centres (PHCs). **High-Yield Facts for NEET-PG:** * **Ashok Mehta Committee (1977):** Recommended a **two-tier** system (Mandal Panchayat and Zila Parishad). * **73rd Constitutional Amendment Act (1992):** Gave constitutional status to the Panchayati Raj. * **Panchayat Samiti** is the executive body responsible for the block's developmental activities and acts as the link between the Village and District levels.

Q: What is the target for case detection in the Revised National Tuberculosis Control Programme (RNTC) for tuberculosis?

90%. **Explanation:** The target for case detection in the Revised National Tuberculosis Control Programme (RNTCP)—now evolved into the **National Tuberculosis Elimination Program (NTEP)**—is **90%**. This shift reflects India’s ambitious goal to eliminate TB by 2025, five years ahead of the global Sustainable Development Goals (SDG). **1. Why 90% is correct:** Under the **National Strategic Plan (NSP) 2017-2025**, the program adopted the "90-90-90" targets: * **90% Case Detection:** Reaching 90% of all estimated TB cases (including those in the private sector). * **90% Treatment Initiation:** Ensuring 90% of diagnosed patients are started on treatment. * **90% Treatment Success:** Achieving a 90% cure rate for all initiated on therapy. **2. Analysis of Incorrect Options:** * **70% (Option D):** This was the *original* RNTCP target set during the DOTS implementation phase (70% case detection and 85% cure rate). It is now considered obsolete under the elimination framework. * **85% (Option C):** This was the historical target for *treatment success/cure rate* under the old RNTCP guidelines. * **95% (Option B):** While 95% is the target for reducing TB deaths and incidence by 2035 (End TB Strategy), it is not the specific operational case detection target for the current NSP. **High-Yield Clinical Pearls for NEET-PG:** * **Goal of NTEP:** To achieve a TB-free India by **2025**. * **Definition of TB Elimination:** Incidence of less than **1 case per million** population. * **Nikshay Poshan Yojana:** Provides ₹500/month nutritional support to all TB patients. * **Diagnostic Algorithm:** NTEP now prioritizes **NAAT (CBNAAT/Truenat)** as the initial diagnostic test rather than sputum microscopy to improve case detection.

Q: Program Evaluation (PE) and Critical Path Methods are employed in which of the following areas?

Management. **Explanation:** **Why Management is Correct:** Program Evaluation and Review Technique (PERT) and Critical Path Method (CPM) are sophisticated **network analysis** tools used in **Health Management**. These techniques are designed to plan, schedule, and control complex projects. * **PERT** is a statistical tool used for projects where time estimates are uncertain (probabilistic). It focuses on reducing the time required to complete a project. * **CPM** is used for projects with predictable activities (deterministic). It identifies the "critical path"—the longest sequence of activities that determines the shortest possible project duration. Any delay in the critical path delays the entire project. **Why Other Options are Incorrect:** * **A. Community Education:** This involves behavioral change communication (BCC) and pedagogical tools, not network analysis or scheduling algorithms. * **B. Health Planning:** While PERT/CPM are used *during* the implementation phase of a plan, they are specifically categorized as **management techniques** rather than the broad conceptual framework of health planning itself. * **D. Health Survey:** Surveys are data collection tools (e.g., cross-sectional studies) used to assess the burden of disease, not project management frameworks. **High-Yield Pearls for NEET-PG:** * **PERT** is event-oriented (useful for R&D/new programs), while **CPM** is activity-oriented (useful for routine construction/maintenance). * **Work Sampling:** A management technique to analyze the time spent by personnel on various activities. * **Cost-Benefit Analysis (CBA):** Benefits are measured in **monetary terms**. * **Cost-Effectiveness Analysis (CEA):** Benefits are measured in **physical units** (e.g., lives saved, cases prevented). * **Cost-Utility Analysis (CUA):** Benefits are measured in **quality-adjusted life years (QALYs)**.

Q: The Alma Ata Conference was held in which year?

1978. **Explanation:** The **Alma-Ata Conference** is a landmark event in global public health history. Held in **1978** in Almaty (formerly Alma-Ata), Kazakhstan, it was organized by the WHO and UNICEF. The conference resulted in the "Declaration of Alma-Ata," which identified **Primary Health Care (PHC)** as the key to achieving the goal of **"Health for All by the Year 2000."** It shifted the focus from hospital-based, curative care to community-based, preventive, and promotive health services. **Analysis of Options:** * **1978 (Correct):** The year the International Conference on Primary Health Care was held and the Declaration was signed. * **1956:** This year is associated with the launch of the **National Tuberculosis Control Programme** in India (though the pilot started earlier, the formal program evolved later) and is not related to Alma-Ata. * **1977:** In this year, the 30th World Health Assembly launched the global target of **"Health for All,"** which set the stage for the Alma-Ata conference the following year. * **1948:** This marks the establishment of the **World Health Organization (WHO)** and the year the **Bhore Committee** report (1946) began influencing post-independence Indian health planning. **High-Yield NEET-PG Pearls:** * **Primary Health Care (PHC) Elements:** Remember the acronym **ELEMENTS** (Education, Local endemic diseases, Expanded program on immunization, Maternal & Child health, Essential drugs, Nutrition, Treatment of common ailments, Sanitation & Water). * **Health for All (HFA):** The target was set in 1977; the strategy (PHC) was defined in 1978. * **Millennium Development Goals (MDGs):** Established in 2000 (target 2015). * **Sustainable Development Goals (SDGs):** Established in 2015 (target 2030); **SDG 3** focuses on Health.

Q: Which committee recommended establishing a health center to serve a population of 10,000 to 20,000?

Bhore committee. **Explanation** The **Bhore Committee (1946)**, also known as the Health Survey and Development Committee, is the cornerstone of public health planning in India. It recommended a comprehensive "Integrated National Health Service." **Why the Bhore Committee is correct:** The committee proposed a long-term plan involving a three-tier system. A key recommendation was the establishment of **Primary Health Units** to serve a population of **10,000 to 20,000**. It also famously introduced the concept of the "Social Physician" and recommended the integration of preventive and curative services at all levels. **Analysis of Incorrect Options:** * **Shrivastav Committee (1975):** Known for the "Reorientation of Medical Education" (ROME) scheme and the creation of the Village Health Guide (VHG) cadre. * **Mudaliar Committee (1962):** Also known as the Health Survey and Planning Committee. It found the Bhore Committee's targets too ambitious and recommended that a Primary Health Centre (PHC) should serve a population of **40,000**, focusing on strengthening existing district hospitals. * **Kartar Singh Committee (1973):** Famous for introducing the concept of the **"Multipurpose Worker" (MPW)** and recommending one Female Health Worker (ANM) per 5,000 population. **High-Yield NEET-PG Pearls:** * **Bhore Committee (1946):** 3-million plan, Social Physician, 10k-20k population per health center. * **Chadah Committee (1963):** Recommended Vigilance Operations for Malaria (NMEP maintenance phase). * **Mukherjee Committee (1965):** Recommended separate staff for Family Planning. * **Jungalwalla Committee (1967):** Focused on "Integration of Health Services" (Equal pay for equal work). * **Current Norms:** Today, a PHC serves 30,000 (Plains) and 20,000 (Hilly/Tribal areas).

Q: Which analysis is done for expenditure of a large proportion for a small number and vice versa?

ABC analysis. ### Explanation **Correct Answer: A. ABC Analysis** **ABC Analysis** (Always Better Control) is an inventory management technique based on **Pareto’s Principle** (the 80/20 rule). It categorizes items based on their annual consumption value (cost × quantity): * **Category A:** Represents a **small number of items** (approx. 10%) that account for a **large proportion of expenditure** (approx. 70%). These require stringent control. * **Category B:** Intermediate items (approx. 20%) accounting for moderate expenditure (approx. 20%). * **Category C:** Represents a **large number of items** (approx. 70%) that account for a **small proportion of expenditure** (approx. 10%). These require loose control. --- ### Why the other options are incorrect: * **B. SUS Analysis:** This stands for **Scarce, Urgent, and Soft**. It is based on the **availability** and supply chain lead time of items in the market, rather than cost. * **C. HML Analysis:** This stands for **High, Medium, and Low**. It classifies items based on the **unit price** (cost per item) rather than the total annual consumption value. * **D. VED Analysis:** This stands for **Vital, Essential, and Desirable**. It is based on the **criticality/utility** of the item for patient care. Vital items (e.g., Oxygen, Adrenaline) must always be in stock, regardless of cost. --- ### High-Yield Pearls for NEET-PG: * **ABC Analysis** is based on **Cost/Expenditure**. * **VED Analysis** is based on **Criticality/Utility**. * **Matrix Analysis (ABC + VED):** In hospital management, these are often combined. The most critical items to monitor are **Category AV** (Costly and Vital). * **FSN Analysis:** Based on consumption rate (**Fast, Slow, and Non-moving**). * **SDE Analysis:** Based on procurement difficulty (**Scarce, Difficult, and Easy** to acquire).

Q: What are the minimum and maximum values established for the calculation of the Life Expectancy index in the Human Development Index (HDI)?

25 years and 85 years. **Explanation:** The **Human Development Index (HDI)** is a composite statistic used to rank countries based on three dimensions: health, education, and standard of living. The health dimension is assessed by **Life Expectancy at Birth**. To transform these raw indicators into a dimension index ranging from 0 to 1, the UNDP establishes specific **goalposts** (minimum and maximum values): 1. **Why Option D is Correct:** For the Life Expectancy Index, the **minimum value is 20 years** (revised from 25 in older reports, but 20-25 remains the standard academic benchmark for exams) and the **maximum value is 85 years**. The value of 20-25 years is chosen as a "natural zero," representing the minimum life expectancy required for a society to survive, while 85 years is an observed aspirational ceiling. 2. **Why Options A, B, and C are Incorrect:** * **0 years** is not used as a minimum because no human population has ever functioned with a life expectancy of zero. * **65 or 100 years** are not used as maximums because 65 is too low (many countries exceed this) and 100 is currently unrealistic as a national average. **High-Yield Facts for NEET-PG:** * **HDI Components:** 1. Life Expectancy Index (Health), 2. Education Index (Mean years and Expected years of schooling), 3. GNI per capita (Standard of Living). * **Calculation:** HDI is the **Geometric Mean** of these three dimension indices. * **India’s Status:** India typically falls in the **"Medium Human Development"** category. * **PQLI vs. HDI:** Do not confuse HDI with the Physical Quality of Life Index (PQLI). PQLI includes Infant Mortality Rate, Life Expectancy at age 1, and Literacy, but *excludes* income.

Q: Which of the following is NOT an element of primary health care?

Sound referral system. **Explanation:** The concept of **Primary Health Care (PHC)** was defined during the Alma-Ata Declaration in 1978. It is based on eight essential elements (often remembered by the acronym **ELEMENTS**). **Why "Sound referral system" is the correct answer:** While a referral system is a crucial component of the overall health care delivery system (linking primary, secondary, and tertiary levels), it is **not** listed as one of the eight core elements defined by the Alma-Ata Declaration. Referral systems are considered a *supportive functional requirement* rather than a foundational element of PHC itself. **Analysis of Incorrect Options:** * **A. Safe water and sanitation:** This is a core element. Environmental health is fundamental to preventing communicable diseases at the community level. * **B. Providing essential drugs:** This is a core element. PHC ensures that basic, life-saving medications are available and accessible to all. * **D. Health education:** This is the first and most important element of PHC, focusing on educating the public about prevailing health problems and methods of preventing and controlling them. **High-Yield Facts for NEET-PG:** The **8 Essential Elements of PHC** (Alma-Ata, 1978) are: 1. **E**ducation concerning prevailing health problems. 2. **L**ocal endemic disease prevention and control. 3. **E**xpanded programme on Immunization. 4. **M**aternal and Child health care, including family planning. 5. **E**ssential drugs provision. 6. **N**utrition and promotion of food supply. 7. **T**reatment of common diseases and injuries. 8. **S**afe water and basic sanitation. *Note:* In the Indian context, the **National Health Policy** sometimes adds "Mental Health" and "Control of Non-communicable diseases" as additional dimensions, but the classic Alma-Ata list remains the standard for exams.

Question 1

Which committee proposed the three-tier Panchayati Raj system?

Accepted Answer

Balwant Rai Mehta committee

Answer

Kartar Singh committee

Answer

Srivastav committee

Answer

Mudaliar committee

Question 2

What is the target for case detection in the Revised National Tuberculosis Control Programme (RNTC) for tuberculosis?

Accepted Answer

90%

Answer

95%

Answer

85%

Answer

70%

Question 3

Which of the following is NOT included in the 90:90:90 targets of the National Health Policy 2017?

Accepted Answer

90% of all people living with HIV and TB know their HIV status

Answer

90% of all people living with HIV know their HIV status

Answer

90% of all people diagnosed with HIV received antiretroviral therapy

Answer

90% of all people receiving antiretroviral therapy will have effective viral suppression

Question 4

Program Evaluation (PE) and Critical Path Methods are employed in which of the following areas?

Accepted Answer

Management

Answer

Community education

Answer

Health planning

Answer

Health survey

Question 5

The Alma Ata Conference was held in which year?

Accepted Answer

1978

Answer

1956

Answer

1977

Answer

1948

Question 6

What is true about the national program for prevention and control of cancer, diabetes, cardiovascular diseases, and stroke?

Accepted Answer

Community Health Centers (CHCs) have facilities for the diagnosis and treatment of cardiovascular diseases and diabetes.

Answer

Home-based care is not provided.

Answer

Implementation is in 5 states over 10 districts.

Answer

There is a separate center for stroke and diabetes mellitus.

Question 7

Which committee recommended establishing a health center to serve a population of 10,000 to 20,000?

Accepted Answer

Bhore committee

Answer

Shrivastav committee

Answer

Mudhaliar committee

Answer

Kaar Singh committee

Question 8

Which analysis is done for expenditure of a large proportion for a small number and vice versa?

Accepted Answer

ABC analysis

Answer

SUS analysis

Answer

HML analysis

Answer

VED analysis

Question 9

What are the minimum and maximum values established for the calculation of the Life Expectancy index in the Human Development Index (HDI)?

Accepted Answer

25 years and 85 years

Answer

0 years and 65 years

Answer

0 years and 85 years

Answer

0 years and 100 years

Question 10

Which of the following is NOT an element of primary health care?

Accepted Answer

Sound referral system

Answer

Adequate supply of safe water and basic sanitation

Answer

Providing essential drugs

Answer

Health education

Health Policy and Management — MCQs

Health Policy and Management — MCQs

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