Maternal and Child Health Practice Questions

Q: Which one of the following is an indicator for evaluation of impact of family planning?

Family size. ***Family size*** - This is a true **impact indicator** that measures the long-term effect of family planning programs on demographic outcomes. - A reduction in **average family size** over time directly reflects the program's effectiveness in helping individuals and couples achieve their desired number of children and birth spacing. - Impact indicators measure the ultimate goal of a program, and family size is one of the most important metrics alongside birth rate, fertility rate, and population growth rate. *Community needs assessment* - This is a **planning tool** used to **identify health needs and priorities** of a community, typically conducted *before* implementing a program. - It serves as a baseline for program design rather than an indicator of the *impact* of an already implemented family planning program. - This is part of the initial assessment phase, not an evaluation metric. *Number of postpartum services availed* - This is an **output/utilization indicator** that measures **service delivery** rather than program impact. - While important for monitoring service uptake, it does not directly evaluate the overall impact or effectiveness of family planning on birth rates or family size decisions. - Output indicators measure what was done, not the effect achieved. *Change in behaviour of people* - While behavioral changes (e.g., increased contraceptive use) are important, this option is too **broad and vague** to serve as a specific measurable indicator. - This could be considered a **process or intermediate outcome indicator** but is not a direct measure of program impact. - Changes in family size are a more concrete and quantifiable outcome reflecting the combined effect of behavioral changes.

Q: How many postnatal visits should be made by the ANM to the house of a low birth weight baby?

4. ***4*** - For a **low birth weight (LBW) baby**, as per traditional guidelines, an **Auxiliary Nurse Midwife (ANM)** makes postnatal home visits on **day 1, day 3, day 7, and day 14** after birth = **4 visits**. - This represents the **minimum essential visits** during the critical first two weeks for monitoring growth, feeding, and identifying complications. - **Note**: Current HBNC guidelines recommend at least 6 visits (adding day 28 and 42) for all newborns, with more intensive follow-up for LBW babies. *8* - Eight visits are **not the standard recommendation** for a low birth weight baby's postnatal care by an ANM. - While more frequent follow-ups may be clinically indicated in some complex cases, it is not the general guideline for all LBW babies. *2* - Two postnatal visits are **insufficient** for proper monitoring of a **low birth weight baby**, who is at higher risk for health issues. - This number of visits would miss critical periods for identifying complications or providing essential care. *6* - Six postnatal visits represent the **current HBNC (Home Based Newborn Care) guideline** for all newborns (days 1, 3, 7, 14, 28, 42). - However, the answer key for this UPSC-CMS 2018 question indicates **4 visits** as the expected answer, likely reflecting guidelines at that time.

Q: Manual Vacuum Aspiration (MVA) that has been introduced in primary health centres helps in reducing which of the following indices?

Maternal mortality. ***Maternal mortality*** - **Manual Vacuum Aspiration (MVA)** is a safe and effective method for managing **incomplete abortion** and **early pregnancy loss**, which are significant causes of **maternal mortality**, especially when performed in primary healthcare settings. - By providing timely and accessible care for these complications, MVA helps prevent severe complications like hemorrhage and sepsis that can lead to a mother's death. *Preterm mortality* - Preterm mortality is primarily related to **preterm birth** and its associated complications, such as respiratory distress syndrome and infection. - MVA is a procedure for managing early pregnancy loss or incomplete abortion and does not directly impact the incidence or outcomes of preterm births. *Neonatal mortality* - Neonatal mortality refers to deaths of infants within the first 28 days of life, often due to issues like **birth asphyxia**, **prematurity**, and **neonatal infections**. - MVA addresses complications of pregnancy for the mother and does not directly relate to the common causes of death in newborns. *Infant mortality* - Infant mortality encompasses deaths from birth up to one year of age, including causes such as **sudden infant death syndrome (SIDS)**, congenital anomalies, and infections occurring after the neonatal period. - While improved maternal health can indirectly benefit infant survival, MVA directly tackles maternal health crises rather than primary causes of infant death.

Q: Consider the following in respect of Navjyot Shishu Suraksha Karyakram (NSSK): 1. It is a programme aimed to train health personnel in basic newborn care and resuscitation 2. It addresses care at birth issues (i.e. prevention of hypothermia, prevention of infection, early initiation of breastfeeding and basic newborn resuscitation) 3. The objective is to have a trained health person in basic newborn care and resuscitation at every delivery point Which of the statements given above are correct?

1, 2 and 3. ***1, 2 and 3*** - The **Navjyot Shishu Suraksha Karyakram (NSSK)** focuses on training healthcare personnel in **basic newborn care and resuscitation** to reduce neonatal mortality. - It addresses critical **care at birth issues**, including preventing **hypothermia**, preventing **infections**, promoting **early breastfeeding initiation**, and providing **basic newborn resuscitation**. The overarching objective is to ensure that a trained health person is available at **every delivery point** to provide essential newborn care. *1 and 2 only* - This option incorrectly excludes the third statement regarding the objective of having a trained health person at every delivery point. - The target of ensuring trained personnel at every birth is a core component and objective of the NSSK. *2 and 3 only* - This option incorrectly excludes the first statement, which details the primary function of training health personnel. - The NSSK is fundamentally a training program designed to equip healthcare providers with the necessary skills. *1 and 3 only* - This option incorrectly excludes the second statement, which outlines the specific care at birth issues addressed by the program. - The identified issues such as preventing hypothermia, infection, and promoting breastfeeding are central to the effectiveness of the NSSK.

Q: Which of the following schemes is primarily aimed at promoting safe motherhood and reducing maternal mortality in India?

Janani Suraksha Scheme. ***Janani Suraksha Yojana (JSY)*** - This is the **flagship national scheme** launched in 2005 under the National Rural Health Mission (now National Health Mission). - It provides **cash incentives** to pregnant women for choosing to deliver in health facilities and to ASHA workers for promoting institutional deliveries. - Its primary objective is to reduce **maternal and neonatal mortality** by increasing institutional deliveries and ensuring access to essential obstetric care. *Ayushman Bharat Scheme* - This is a national health protection scheme (Pradhan Mantri Jan Arogya Yojana) that provides **health insurance coverage** up to ₹5 lakhs per family for secondary and tertiary care hospitalization. - While it contributes to overall health including maternal health, its primary focus is **broader healthcare access** rather than specifically promoting safe motherhood or reducing maternal mortality through institutional delivery incentives. *Mamta Scheme* - While several state-level maternal and child health programs exist under similar names (e.g., Bihar's MAMTA scheme), there is no widely recognized **national scheme** called "Mamta Scheme" that serves as the primary program for safe motherhood. - The **Janani Suraksha Yojana** remains the principal national initiative for this objective. *Vande Mataram Scheme* - This refers to voluntary initiatives encouraging private practitioners to provide maternal health services. - While supportive of safe motherhood, it is **not the primary comprehensive national scheme** with structured financial incentives and widespread implementation for reducing maternal mortality like JSY.

Q: After male sterilization, additional contraceptive protection is

needed for 2 to 3 months. ***needed for 2 to 3 months*** - After **vasectomy**, residual **sperm** distal to the ligation site can remain in the ejaculatory ducts and vas deferens. - It takes approximately **20 ejaculations** or **2 to 3 months** for these sperm to be cleared from the reproductive tract, requiring additional contraception until **azoospermia** is confirmed. *not needed* - This option is incorrect because the male reproductive tract is not immediately sterile after a vasectomy due to the presence of **pre-existing sperm**. - Without additional contraception, there is a risk of **unintended pregnancy** until sterility is confirmed by follow-up testing. *needed for 1 to 2 months* - While closer, a duration of **1 to 2 months** may not be sufficient for all residual sperm to be cleared from the system. - The standard recommendation often extends to **3 months** or a specific number of ejaculations to ensure complete sterility. *needed for 1 month* - This duration is generally too short to ensure the complete clearance of **viable sperm** from the ejaculatory ducts after a vasectomy. - Relying on this period alone would carry a higher risk of **contraceptive failure**.

Q: Steroidal contraceptives available in the basket of contraceptive choice from Ministry of Health & Family Welfare, Government of India are

Monophasic. ***Monophasic*** - **Monophasic oral contraceptive pills** are the formulation type available in India's National Family Planning Programme basket of contraceptive choices. - The Ministry of Health & Family Welfare provides **Mala-N** (Levonorgestrel 0.15mg + Ethinyl estradiol 0.03mg) and **Mala-D** (Desogestrel + Ethinyl estradiol) - both are monophasic formulations. - Monophasic pills contain a **fixed dose of estrogen and progestin** throughout the 21 active pill cycle, making them simpler to use and ensuring better compliance. *Biphasic* - **Biphasic pills** contain two different doses of hormones during the active pill cycle. - These are **not included** in the Government of India's national family planning programme basket of contraceptive choices. - Less commonly used compared to monophasic formulations. *Estrogen only pills* - **Estrogen-only pills** are not used as contraceptives due to the risk of **endometrial hyperplasia** and cancer if not balanced with progestin. - These are used for hormone replacement therapy or specific medical conditions, **not for contraception**. *Triphasic* - **Triphasic pills** contain three different dosages of hormones throughout the active pill cycle to mimic the natural menstrual cycle. - These are **not included** in the Government of India's national family planning programme basket. - Their varied dosing schedule is more complex and not preferred for widespread public health distribution.

Q: Which of the following are correct regarding failure rate of contraceptive methods? 1. Depot medroxyprogesterone acetate 0 to 1 per HWY 2. Norplant 0.1 per HWY 3. LNG-IUS 0.02 per HWY 4. Levonorgestrel-only pills 3 per HWY

1, 2 and 3. ***1, 2 and 3*** - **Depot medroxyprogesterone acetate (DMPA)**, **Norplant** (levonorgestrel implants), and **Levonorgestrel-releasing intrauterine system (LNG-IUS)** are highly effective contraceptive methods with very low failure rates, typically below 1 pregnancy per 100 women-years (HWY) for typical use. - The quoted failure rates of 0 to 1 per HWY for DMPA, 0.1 per HWY for Norplant, and 0.02 per HWY for LNG-IUS are consistent with their known efficacy as **long-acting reversible contraceptives (LARCs)** and hormonal methods. *1, 3 and 4* - This option incorrectly includes the failure rate for **levonorgestrel-only pills (minipills)**. While minipills are effective, their typical use failure rate is generally higher than 3 per HWY, often closer to 7-10 pregnancies per 100 women-years due to the strict adherence required for daily dosing. - The failure rates for DMPA and LNG-IUS are accurate, but the inclusion of incorrectly low typical failure rate for levonorgestrel-only pills makes this option incorrect. *1, 2 and 4* - This option is incorrect because the typical failure rate of **levonorgestrel-only pills** is much higher than 3 per HWY in real-world use, often due to missed doses or delayed administration. - While DMPA and Norplant have low failure rates, the inaccuracy for levonorgestrel-only pills makes this choice invalid. *2, 3 and 4* - This option inaccurately suggests that the failure rate for **levonorgestrel-only pills** is 3 per HWY, which is generally lower than their actual typical use failure rates (closer to 7-10 pregnancies per 100 women-years). - The failure rates for Norplant and LNG-IUS are correct, but the error regarding levonorgestrel-only pills renders this option incorrect.

Q: A screening programme for school children was undertaken with the following results: 1. 30% boys and 60% girls were found to be anemic 2. 50% children had history of passing worms in stool 3. 10% children had poor vision 4. 5% children had enlarged tonsils In this context, which of the following is not an appropriate follow up activity?

Referring those children with enlarged tonsils for surgery. ***Referring those children with enlarged tonsils for surgery*** - Only **5%** of children had enlarged tonsils, and many cases of enlarged tonsils are **asymptomatic** and do not require surgery. - **Tonsillectomy** is a surgical procedure with risks and is typically reserved for recurrent infections or significant airway obstruction, which is not indicated by simple enlargement. *Providing iron supplementation to all children* - A significant proportion of children (30% boys, 60% girls) were found to be **anemic**, making universal iron supplementation a reasonable public health intervention to address widespread nutritional deficiency. - Iron deficiency is common in school-aged children and can impact **cognitive development** and physical performance. *Administering mass deworming medication to all children* - **50%** of children had a history of passing worms in stool, indicating a high prevalence of **intestinal helminthiasis** in the school population. - **Mass deworming** is a cost-effective public health strategy in areas with high prevalence to reduce the burden of worm infections and improve child health outcomes. *Prescribing corrective spectacles to children with poor vision* - **10%** of children had poor vision, a significant percentage that warrants intervention. - Providing **corrective spectacles** is an appropriate and effective follow-up to address refractive errors, which are a common cause of poor vision in children and can impact academic performance.

Question 1

Which one of the following is an indicator for evaluation of impact of family planning?

Accepted Answer

Family size

Answer

Community needs assessment

Answer

Number of postpartum services availed

Answer

Change in behaviour of people

Question 2

How many postnatal visits should be made by the ANM to the house of a low birth weight baby?

Accepted Answer

4

Answer

8

Answer

2

Answer

6

Question 3

Manual Vacuum Aspiration (MVA) that has been introduced in primary health centres helps in reducing which of the following indices?

Accepted Answer

Maternal mortality

Answer

Preterm mortality

Answer

Neonatal mortality

Answer

Infant mortality

Question 4

Consider the following in respect of Navjyot Shishu Suraksha Karyakram (NSSK):

1. It is a programme aimed to train health personnel in basic newborn care and resuscitation
2. It addresses care at birth issues (i.e. prevention of hypothermia, prevention of infection, early initiation of breastfeeding and basic newborn resuscitation)
3. The objective is to have a trained health person in basic newborn care and resuscitation at every delivery point

Which of the statements given above are correct?

Accepted Answer

1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Question 5

Which one of the following statements regarding the growth chart is NOT true?

Accepted Answer

It is used as a tool for action against the Anganwadi worker

Answer

It is used as a tool for growth monitoring and diagnosis

Answer

It is used for planning and policy making

Answer

It is used as a tool for teaching and evaluation of effectiveness of programme

Question 6

Which of the following schemes is primarily aimed at promoting safe motherhood and reducing maternal mortality in India?

Accepted Answer

Janani Suraksha Scheme

Answer

Ayushman Bharat Scheme

Answer

Mamta Scheme

Answer

Vande Mataram Scheme

Question 7

After male sterilization, additional contraceptive protection is

Accepted Answer

needed for 2 to 3 months

Answer

not needed

Answer

needed for 1 to 2 months

Answer

needed for 1 month

Question 8

Steroidal contraceptives available in the basket of contraceptive choice from Ministry of Health & Family Welfare, Government of India are

Accepted Answer

Monophasic

Answer

Biphasic

Answer

Estrogen only pills

Answer

Triphasic

Question 9

Which of the following are correct regarding failure rate of contraceptive methods?

1. Depot medroxyprogesterone acetate 0 to 1 per HWY
2. Norplant 0.1 per HWY
3. LNG-IUS 0.02 per HWY
4. Levonorgestrel-only pills 3 per HWY

Accepted Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

1, 2 and 4

Answer

2, 3 and 4

Question 10

A screening programme for school children was undertaken with the following results:

1. 30% boys and 60% girls were found to be anemic
2. 50% children had history of passing worms in stool
3. 10% children had poor vision
4. 5% children had enlarged tonsils

In this context, which of the following is not an appropriate follow up activity?

Accepted Answer

Referring those children with enlarged tonsils for surgery

Answer

Providing iron supplementation to all children

Answer

Administering mass deworming medication to all children

Answer

Prescribing corrective spectacles to children with poor vision

Maternal and Child Health — MCQs

Maternal and Child Health — MCQs

On this page

Practice by Chapter

Want unlimited practice?