Maternal and Child Health Practice Questions

Q: Which of the following are beneficiaries of services provided under the Integrated Child Development Scheme (ICDS) ? 1. Adolescent boys 2. Adolescent girls 3. Pregnant women 4. Children less than 6 years of age Select the correct answer using the code given below :

2, 3 and 4. ***2, 3 and 4*** - The **Integrated Child Development Services (ICDS)** scheme specifically targets **adolescent girls (11-14 years)**, **pregnant women**, and **children under 6 years of age** as primary beneficiaries. - Services include **supplementary nutrition**, **immunization**, **health check-ups**, **referral services**, **nutrition and health education**, and **pre-school education**. - Adolescent girls were included through the **Scheme for Adolescent Girls (SAG)** to address their nutritional and health needs during the critical growth phase. *1, 2 and 3* - Incorrectly includes **adolescent boys**, who are not primary beneficiaries of ICDS. - The scheme focuses on vulnerable groups with specific nutritional and reproductive health needs. *1, 3 and 4* - Incorrectly includes **adolescent boys** while excluding **adolescent girls**. - Omits **pregnant women**, who are a core beneficiary group receiving antenatal care and nutritional support. *1, 2 and 4* - Incorrectly includes **adolescent boys**. - Omits **pregnant women**, who receive crucial services including antenatal care, nutritional supplementation, and health education through ICDS.

Q: The expected outcome of Government of India's initiative 'SUMAN' is :

Zero preventable maternal and newborn deaths. ***Zero preventable maternal and newborn deaths*** - The **SUMAN (Surakshit Matritva Aashwasan)** initiative aims to provide assured, dignified, and quality healthcare at no cost to every woman and newborn visiting a public health facility. - The ultimate goal of this comprehensive program is to eradicate all **preventable maternal and newborn deaths**, ensuring healthy outcomes for both mother and child. *Limit preventable maternal and newborn deaths to between 1 - 2%* - This percentage represents a reduction target, but not the ultimate aspirational goal of the SUMAN initiative. - The initiative's design emphasizes achieving a state where no preventable deaths occur, rather than settling for a small percentage. *Limit preventable maternal and newborn deaths to between 2 - 5%* - This range of preventable deaths is too high to be considered the desired outcome of such a comprehensive maternal and child health program. - The SUMAN initiative strives for maximum safety and care, making even 2% to 5% an unacceptable target for preventable deaths. *Limit preventable maternal and newborn deaths to between 0.5 - 1%* - While a very low percentage, this still implies that some preventable deaths would be acceptable, which contradicts the core principle of the SUMAN initiative. - The program's foundational premise is that all preventable deaths should be eliminated through quality care and intervention.

Q: The most common cause of maternal mortality in India is

obstetric haemorrhage. ***Obstetric haemorrhage*** - **Postpartum hemorrhage (PPH)** remains the leading **direct cause** of maternal mortality in India and globally - Most commonly results from **uterine atony** (inadequate uterine contraction after delivery), accounting for approximately 70% of PPH cases - Other causes include retained placental tissue, genital tract trauma, and coagulation disorders - Contributes to approximately **30-35%** of maternal deaths in India according to recent SRS data *Unsafe abortion* - Significant contributor to maternal mortality, particularly in regions with limited access to safe abortion services - Complications include **sepsis, hemorrhage, and uterine perforation** - Ranks as the second or third leading cause depending on the data source, but not the most common overall *Toxaemia of pregnancy* - Also known as **pre-eclampsia and eclampsia**, this is an important cause of maternal mortality - Complications include **eclamptic seizures, stroke, HELLP syndrome, and multi-organ failure** - Ranks third to fourth among direct causes of maternal death in India *Obstructed labour* - Can lead to serious complications including **uterine rupture, postpartum hemorrhage, and sepsis** - With improved access to cesarean sections, the contribution to maternal mortality has decreased - Now contributes less to overall maternal mortality compared to hemorrhage

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**.

Question 1

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

1. Adolescent boys 
2. Adolescent girls 
3. Pregnant women 
4. Children less than 6 years of age

Select the correct answer using the code given below :

Accepted Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

1, 2 and 4

Question 2

The expected outcome of Government of India's initiative 'SUMAN' is :

Accepted Answer

Zero preventable maternal and newborn deaths

Answer

Limit preventable maternal and newborn deaths to between 1 - 2%

Answer

Limit preventable maternal and newborn deaths to between 2 - 5%

Answer

Limit preventable maternal and newborn deaths to between 0.5 - 1%

Question 3

The most common cause of maternal mortality in India is

Accepted Answer

obstetric haemorrhage

Answer

unsafe abortion

Answer

toxaemia of pregnancy

Answer

obstructed labour

Question 4

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 5

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 6

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 7

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 8

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 9

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 10

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

Maternal and Child Health — MCQs

Maternal and Child Health — MCQs

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