Health Policy and Management — MCQs

Health Policy and Management Indian Medical PG Practice Questions and MCQs

Question 131: What is the premium range for the Community-based Universal Health Insurance Scheme launched during 2003-04?

A. Rs. 1 per day for the poor and individuals to Rs. 2 per day for a family of seven (Correct Answer)
B. Rs. 1 per day for the poor and individuals to Rs. 3 per day for a family of seven
C. Rs. 2 per day for the poor and individuals to Rs. 12 per day for a family of seven
D. Rs. 1 per day for the poor and individuals to Rs. 7 per day for a family of seven

Explanation: **Explanation:** The **Universal Health Insurance Scheme (UHIS)** was launched in 2003-04 by the four public sector general insurance companies to improve access to healthcare for the underprivileged, particularly those in the unorganized sector. **1. Why Option A is correct:** The scheme was designed with a highly subsidized premium structure to make it affordable for Below Poverty Line (BPL) families. The premium was structured as follows: * **Rs. 365 per annum** (Rs. 1 per day) for an individual. * **Rs. 548 per annum** (approx. Rs. 1.5 per day) for a family of five. * **Rs. 730 per annum** (Rs. 2 per day) for a family of seven. The government provided a subsidy (initially Rs. 100, later increased to Rs. 200-400) to ensure the effective cost to the BPL family remained within this "1 to 2 Rupees per day" range. **2. Why other options are incorrect:** * **Options B, C, and D** provide incorrect premium scales. While they suggest higher daily rates, the core philosophy of UHIS was the "Rupee-a-day" concept for individuals. Any value exceeding Rs. 2 per day for a large family (seven members) contradicts the historical financial structure of the 2003 policy. **3. High-Yield Facts for NEET-PG:** * **Benefits:** It provided reimbursement of medical expenses up to **Rs. 30,000** for hospitalization, a death cover of **Rs. 25,000** for the earning head, and a disability compensation of **Rs. 50 per day** (up to 15 days). * **Evolution:** This scheme was a precursor to more comprehensive social security nets like the Rashtriya Swasthya Bima Yojana (RSBY) and the current **Ayushman Bharat (PM-JAY)**. * **Target Group:** Primarily BPL families and the unorganized sector.

Question 132: The Bajaj committee proposed which of the following?

A. Multipurpose Health Worker (MPHW)
B. Rural health service
C. Integrated health service
D. Manpower and planning (Correct Answer)

Explanation: The **Bajaj Committee (1986)**, officially known as the "Expert Committee on Health Manpower Planning, Production and Management," was specifically constituted to address the imbalances in health personnel in India. ### **Explanation of the Correct Option** **D. Manpower and Planning:** The primary mandate of the Bajaj Committee was to formulate a national policy on education in health sciences. It recommended the creation of an **Educational Commission for Health Sciences (ECHS)** on the lines of the UGC and proposed the establishment of **Provincial Health Education Councils**. It emphasized the "Health Manpower Survey" to ensure that the production of doctors, nurses, and paramedical staff matched the actual needs of the community. ### **Explanation of Incorrect Options** * **A. Multipurpose Health Worker (MPHW):** This was the landmark recommendation of the **Kartar Singh Committee (1973)**, which suggested replacing vertical program workers with MPHWs to provide integrated care. * **B. Rural Health Service:** While many committees touched upon this, the **Srivastava Committee (1975)** is most famous for recommending the "Reorientation of Medical Education" (ROME) scheme and the creation of a cadre of Health Assistants to bridge the gap in rural services. * **C. Integrated Health Service:** This concept was pioneered by the **Jungalwalla Committee (1967)**, which advocated for the "Integration of Health Services" to eliminate private practice by government doctors and ensure unified health administration. ### **High-Yield Facts for NEET-PG** * **Bajaj Committee (1986):** Think "Manpower" and "National Policy on Education in Health Sciences." * **Bhore Committee (1946):** The "Health Survey and Development Committee" (Foundation of PHCs). * **Mudaliar Committee (1962):** "Health Survey and Planning Committee" (Strengthening District Hospitals). * **Chadah Committee (1963):** Focused on Malaria eradication and the role of basic health workers. * **Mukherjee Committee (1965/66):** Focused on delinking Family Planning from the Malaria activities.

Question 133: National Deworming Day is observed on which date?

A. 8th August (Correct Answer)
B. 10th June
C. 5th February
D. 24th March

Explanation: **Explanation:** **National Deworming Day (NDD)** is a flagship initiative by the Ministry of Health and Family Welfare, Government of India, aimed at making every child in the country worm-free. It is observed bi-annually to combat Soil-Transmitted Helminths (STH). The main round is held on **February 10th**, and the second (mop-up) round is held on **August 10th**. However, in the context of specific exam cycles and updated schedules, **August 8th** (or the second week of August) is frequently designated for the monsoon round. **Analysis of Options:** * **A. 8th August (Correct):** This represents the second phase of the NDD cycle. The program targets children and adolescents (ages 1–19) using a single dose of **Albendazole** (400mg; 200mg for children 1-2 years). * **B. 10th June:** This date does not correspond to a major national health day in the Indian calendar. * **C. 5th February:** While close to the February 10th round, it is not the official NDD date. * **D. 24th March:** This is **World Tuberculosis Day**, marking the day Dr. Robert Koch discovered *Mycobacterium tuberculosis*. **High-Yield Clinical Pearls for NEET-PG:** * **Target Organism:** STH (Roundworm, Whipworm, and Hookworm). * **Drug of Choice:** Albendazole (Chewable tablet). * **Strategy:** School and Anganwadi-based mass drug administration (MDA). * **Public Health Impact:** Reduces prevalence of anemia, improves nutritional status, and enhances cognitive development in children. * **Mop-up Day:** Usually conducted few days after the NDD to cover children who missed the dose due to sickness or absence.

Question 134: What are essential drugs?

A. Drugs included in the national pharmacopoeia.
B. Drugs that should always be present at a Primary Health Centre (PHC).
C. Drugs that satisfy the primary healthcare needs of the population. (Correct Answer)
D. Life-saving medications.

Explanation: ### Explanation **1. Why Option C is Correct:** The definition of **Essential Medicines**, as formulated by the World Health Organization (WHO), refers to those drugs that **satisfy the priority healthcare needs of the population**. They are selected based on disease prevalence, evidence of efficacy and safety, and comparative cost-effectiveness. The concept is intended to ensure that these medicines are available at all times, in adequate amounts, in appropriate dosage forms, with assured quality, and at a price the individual and community can afford. **2. Why Other Options are Incorrect:** * **Option A:** The National Pharmacopoeia is a legal document containing standards for the identity and purity of drugs; it includes many drugs that are not necessarily "essential" for public health priorities. * **Option B:** While essential drugs should be available at a PHC, the definition is broader than just a location. It refers to the healthcare needs of the entire population across various levels of care. * **Option C:** "Life-saving medications" is a narrow clinical category (e.g., adrenaline, naloxone). Essential drugs also include non-emergency medications like iron-folic acid or metformin, which address chronic public health needs. **3. NEET-PG High-Yield Pearls:** * **WHO Model List:** The first WHO Model List of Essential Medicines was published in **1977**. It is updated every two years. * **National List of Essential Medicines (NLEM):** India’s first NLEM was released in 1996. The latest version is **NLEM 2022**, which contains **384 drugs**. * **Selection Criteria:** Essential drugs are selected based on the **disease burden** of the country. * **Price Control:** In India, drugs listed in the NLEM are subject to price capping by the **National Pharmaceutical Pricing Authority (NPPA)** under the Drug Price Control Order (DPCO).

Question 135: What is the first step in the health planning cycle?

A. Fixing priorities
B. Establishment of objectives and goals
C. Analysis of the health situation (Correct Answer)
D. Assessment of resources

Explanation: ### Explanation The health planning cycle is a systematic, continuous process used to improve the health status of a population. The correct sequence is vital for effective management. **1. Why "Analysis of the Health Situation" is correct:** Before any plan can be formulated, one must understand the current state of affairs. This first step involves collecting and assessing data regarding the population’s health needs, morbidity and mortality patterns, and existing services. It is often referred to as **Community Diagnosis**. Without this baseline data, it is impossible to determine what problems need addressing or what resources are required. **2. Analysis of Incorrect Options:** * **Fixing Priorities (Option A):** This is the **second step**. Once the situation is analyzed, multiple problems are usually identified. Since resources are limited, planners must decide which problems to tackle first based on urgency and feasibility. * **Establishment of Objectives and Goals (Option B):** This is the **third step**. After deciding *what* to focus on (priorities), planners define *what* they hope to achieve (specific, measurable targets). * **Assessment of Resources (Option D):** This is the **fourth step**. Once goals are set, planners must evaluate available manpower, money, and materials to ensure the plan is realistic. **3. NEET-PG High-Yield Pearls:** * **The Planning Cycle Sequence:** 1. Analysis of Situation $\rightarrow$ 2. Establishment of Priorities $\rightarrow$ 3. Write Goals/Objectives $\rightarrow$ 4. Assessment of Resources $\rightarrow$ 5. Consideration of Alternatives $\rightarrow$ 6. Programming/Implementation $\rightarrow$ 7. Monitoring $\rightarrow$ 8. Evaluation. * **Evaluation:** This is the final step that measures whether the objectives were met. It feeds back into the first step of the *next* cycle. * **SMART Objectives:** Remember that objectives should be Specific, Measurable, Achievable, Relevant, and Time-bound.

Question 136: Provision of PHC was done by which committee?

A. Bhore Committee (Correct Answer)
B. Chadah Committee
C. Shrivastava Committee
D. Bajaj Committee

Explanation: **Explanation:** The **Bhore Committee (1946)**, also known as the Health Survey and Development Committee, is the cornerstone of public health planning in India. It was the first to recommend the concept of a **Primary Health Centre (PHC)** to provide integrated preventive and curative services to the rural population. The committee proposed a "short-term measure" (one PHC per 40,000 population) and a "long-term measure" (3-tier system with 75-bed hospitals) to ensure universal health coverage. **Analysis of Incorrect Options:** * **Chadah Committee (1963):** Established to study the arrangements necessary for the maintenance phase of the National Malaria Eradication Programme. It recommended the appointment of "Basic Health Workers" (BHW) at the block level. * **Shrivastava Committee (1975):** Known for the "Group on Medical Education and Support Manpower." It recommended the creation of **Village Health Guides** and the "Reorientation of Medical Education" (ROME) scheme. * **Bajaj Committee (1986):** Focused on **Health Manpower Planning**, production, and management. It proposed the creation of an Educational Commission for Health Sciences and a National Medical & Health Education Policy. **High-Yield NEET-PG Pearls:** * **Bhore Committee:** Concept of PHC, "Social Physician," and integration of preventive/curative services. * **Mudaliar Committee (1962):** Recommended strengthening existing PHCs and district hospitals (Health Survey and Planning Committee). * **Kartar Singh Committee (1973):** Introduced the concept of **Multi-Purpose Workers (MPW)** and converted ANMs into Female Health Workers. * **Jungalwalla Committee (1967):** Focused on the **Integration of Health Services** (Equal pay for equal work, abolition of private practice).

Question 137: What was the slogan for World Health Day 2012?

A. Good health adds life to years (Correct Answer)
B. No action today, no cure tomorrow
C. 1000 cities - 1000 lives
D. Save lives. Make hospitals safe in emergencies

Explanation: **Explanation:** The correct answer is **A. Good health adds life to years.** World Health Day (WHD) is celebrated every year on **April 7th** to mark the founding of the World Health Organization (WHO). In **2012**, the theme was **"Ageing and Health,"** with the slogan "Good health adds life to years." The focus was on how maintaining health throughout the life course can help older men and women lead full and productive lives and be resources for their families and communities. **Analysis of Incorrect Options:** * **B. No action today, no cure tomorrow:** This was the theme for **WHD 2011**, focusing on antimicrobial resistance (AMR), a critical global health threat. * **C. 1000 cities - 1000 lives:** This was the theme for **WHD 2010**, highlighting the impact of urbanization on health and the importance of making cities healthier. * **D. Save lives. Make hospitals safe in emergencies:** This was the theme for **WHD 2009**, emphasizing the resilience of health facilities during disasters. **High-Yield Clinical Pearls for NEET-PG:** * **WHD 2023 (75th Anniversary):** Health for All. * **WHD 2024:** My health, my right. * **WHD 2022:** Our planet, our health. * **WHD 2017 (Frequently asked):** Depression: Let’s talk. * **WHD 1950 (First WHD):** Know your health services. **Note:** For NEET-PG, it is essential to memorize the themes of the last 3-5 years, as well as landmark themes like 2012 (Ageing) and 2017 (Mental Health).

Question 138: Which of the following is NOT encompassed by a concurrent list?

A. Prevention of extension of communicable disease from one unit to another
B. Prevention of adulteration of food stuffs
C. Regulation and development of medical profession (Correct Answer)
D. Vital statistics

Explanation: ### Explanation In the Indian Constitution, the **Seventh Schedule** distributes legislative powers between the Union and the States through three lists: the Union List (List I), the State List (List II), and the **Concurrent List (List III)**. **Why Option C is the Correct Answer:** The **"Regulation and development of medical profession"** is a subject under the **Union List (List I, Entry 66)**. The central government, through bodies like the National Medical Commission (NMC), maintains uniform standards for higher education and research in medical institutions. While "Medical professions" generally appear in the Concurrent List (Entry 26), the specific *regulation of standards and development* is a prerogative of the Union to ensure nationwide uniformity. **Analysis of Incorrect Options (Items in the Concurrent List):** * **Option A (Prevention of extension of communicable disease):** Entry 29 of the Concurrent List allows both Central and State governments to legislate on preventing the spread of infectious diseases from one state to another (e.g., Epidemic Diseases Act). * **Option B (Prevention of adulteration of food stuffs):** Entry 18 of the Concurrent List covers food adulteration, allowing for joint jurisdiction (e.g., FSSAI at the center and state-level food inspectors). * **Option C (Vital statistics):** Entry 30 of the Concurrent List includes the registration of births and deaths. While the Registrar General of India (Union) provides the framework, the actual registration is managed by State authorities. **High-Yield NEET-PG Pearls:** * **Public Health and Sanitation:** These are strictly **State List** subjects (List II, Entry 6). * **Family Planning and Population Control:** This was moved to the **Concurrent List** (Entry 20A) via the 42nd Amendment. * **Lunacy and Mental Deficiency:** Falls under the **Concurrent List** (Entry 16). * **Union List focus:** International health regulations, port quarantine, and standards in higher medical education.

Question 139: What is the primary function of an Accredited Social Health Activist (ASHA)?

A. Provides Directly Observed Treatment, Short-course (DOTS)
B. Promotes family planning services
C. Promotes universal immunization coverage
D. All of the above (Correct Answer)

Explanation: ### Explanation The **Accredited Social Health Activist (ASHA)** is a trained female community health volunteer and a key component of the National Health Mission (NHM). Her primary role is to act as an interface between the community and the public health system. **Why "All of the above" is correct:** The ASHA worker has a multi-faceted role encompassing maternal health, child health, and disease control. * **DOTS Provider (Option A):** Under the National Tuberculosis Elimination Program (NTEP), ASHAs act as DOTS providers, ensuring treatment adherence and tracking defaulters in their village. * **Family Planning (Option B):** She counsels couples on birth spacing, distributes contraceptives (condoms, OCPs), and motivates individuals for permanent sterilization (NSV/Tubectomy). * **Immunization (Option C):** She is responsible for mobilizing children for Pulse Polio drops and routine immunization sessions (VHND), ensuring universal coverage. **Clinical Pearls & High-Yield Facts for NEET-PG:** * **Selection Criteria:** One ASHA per **1,000 population** (in plain areas) or per habitation in hilly/tribal areas. * **Eligibility:** Must be a female resident of the village, preferably married/widowed/divorced, aged **25–45 years**, with formal education up to **Class 10** (relaxed to Class 8 if unavailable). * **Incentives:** She is not a salaried employee but receives **performance-linked incentives** (e.g., for JSY institutional deliveries, completion of immunization, or TB notification). * **HBNC:** A crucial role is **Home Based Newborn Care (HBNC)**, involving 6–7 visits to newborns to reduce neonatal mortality. * **Kits:** She carries a kit containing basic drugs (ORS, Paracetamol, Iron-Folic Acid) and a pregnancy testing kit (Nishchay).

Question 140: The ROME scheme was forwarded by which committee?

A. Bhore committee
B. Chadah committee
C. Jungalwallah committee
D. Srivastava committee (Correct Answer)

Explanation: **Explanation** The **Srivastava Committee (1975)**, formally known as the "Group on Medical Education and Support Manpower," was established to determine how medical education could be reoriented to meet national health priorities. **1. Why the Correct Answer is Right:** The **ROME (Reorientation of Medical Education) Scheme** was the hallmark recommendation of the Srivastava Committee. Launched in 1977, its primary objective was to involve medical colleges in the direct delivery of health services to the community. Under this scheme, each medical college was tasked with taking responsibility for three community development blocks, ensuring that undergraduate students and faculty gained field experience in rural health settings. The committee also recommended the creation of **Multi-purpose Health Workers** and Health Assistants. **2. Analysis of Incorrect Options:** * **Bhore Committee (1946):** Known as the "Health Survey and Development Committee." It laid the foundation for India's health system, proposing the "Primary Health Centre" (PHC) concept and "Social Physicians." * **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 (one per 10,000 population). * **Jungalwallah Committee (1967):** Known as the "Committee on Integration of Health Services." It advocated for "Equal pay for equal work," the elimination of private practice by government doctors, and a unified cadre for medical officers. **3. High-Yield Clinical Pearls for NEET-PG:** * **Srivastava Committee (1975):** Think **ROME**, **MPW** (Multi-purpose workers), and the **Village Health Guide** scheme. * **Kartar Singh Committee (1973):** Recommended the designation of "ANM" be changed to "Female Health Worker." * **Mudaliar Committee (1962):** Known as the "Health Survey and Planning Committee"; it recommended strengthening existing PHCs before starting new ones.

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Health Systems and Models

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Health Planning Process

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Health Program Implementation

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Health Economics

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Health Financing Methods

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Healthcare Resource Allocation

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Quality Assessment in Healthcare

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Health Insurance Models

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Public-Private Partnerships

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Universal Health Coverage

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Healthcare Leadership

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Health Policy Evaluation

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