Public Health Administration Practice Questions

Q: Integration of health services was first proposed by which committee?

Jungallwalla committee. The concept of **Integration of Health Services** refers to the unification of curative and preventive services under a single administrative hierarchy to eliminate fragmentation. **Why the Correct Answer is Right:** The **Jungallwalla Committee (1967)**, also known as the "Committee on Integration of Health Services," was specifically constituted to examine the problems of integrated health services. It defined integration as a "common philosophy" and recommended: * Unified cadre (Common seniority) * Equal pay for equal work * Special pay for specialized work * Abolition of private practice for government doctors **Analysis of Incorrect Options:** * **Bhore Committee (1946):** Known as the "Health Survey and Development Committee." It laid the foundation for the 3-tier health system and the concept of a "Social Physician," but it did not formally propose the administrative integration of services. * **Mudaliar Committee (1962):** Known as the "Health Survey and Planning Committee." It recommended strengthening District Hospitals and suggested that the quality of care should be improved before further expansion, but it was not the primary proposer of integration. * **Srivastava Committee (1975):** Known as the "Group on Medical Education and Support Manpower." It is famous for recommending the **ROM (Reorientation of Medical Education)** scheme and the creation of **Village Health Guides**. **High-Yield NEET-PG Pearls:** * **Chadah Committee (1963):** Recommended the "Basic Health Worker" (BHW) for Malaria vigilance. * **Kartar Singh Committee (1973):** Introduced the concept of **MPW (Multi-Purpose Worker)** and converted ANMs into Female Health Workers. * **Shrivastav Committee:** Proposed the **Referral Services Complex**. * **Mukherjee Committee (1965):** Recommended separate staff for Family Planning programs.

Q: What is the optimum unit of preventive, curative, and promotive health care?

Comprehensiveness. ### **Explanation** The concept of **Comprehensiveness** is a fundamental principle of Primary Health Care (PHC). It refers to the provision of a full range of health services—**preventive, curative, and promotive**—under one roof or through a single integrated system. **1. Why "Comprehensiveness" is Correct:** In public health administration, a health system is considered "comprehensive" when it does not merely treat diseases (curative) but also focuses on preventing them (e.g., immunization) and promoting healthy lifestyles (e.g., nutritional counseling). This holistic approach ensures that all health needs of the community are met throughout the life cycle, making it the "optimum unit" of care delivery. **2. Analysis of Incorrect Options:** * **Appropriateness:** This refers to whether the technology or service provided is scientifically sound and socially acceptable to the community. It focuses on the "suitability" of the intervention rather than the breadth of services. * **Availability:** This simply means that health services are physically present and reachable by the population. It does not guarantee that the services provided are holistic or integrated. * **Adequacy:** This refers to the quantity and quality of resources (manpower, equipment, funds) being sufficient to meet the needs of the community. **3. NEET-PG High-Yield Pearls:** * **The 5 A’s of Primary Health Care:** Remember the key principles: **A**ccessibility, **A**vailability, **A**ffordability, **A**cceptability, and **A**dequacy. * **Comprehensive Primary Health Care (CPHC):** Under the **Ayushman Bharat** scheme, Health and Wellness Centers (HWCs) are designed to deliver CPHC, expanding the package from 7 basic services to 12 essential health services. * **Alma-Ata Declaration (1978):** This was the landmark global event that identified Primary Health Care as the key to attaining "Health for All."

Q: At which level is the eligible couple register primarily maintained?

Sub center. **Explanation:** The **Sub-center** is the peripheral-most outpost of the healthcare delivery system in India, serving a population of 3,000 (hilly/tribal) to 5,000 (plain areas). It is the primary point of contact between the community and the health system. The **Eligible Couple Register (ECR)** is a vital document maintained by the Female Health Worker (ANM) at this level. 1. **Why Sub-center is correct:** The ANM is responsible for house-to-house surveys to identify "Eligible Couples" (married couples where the wife is in the reproductive age group of 15–49 years). Maintaining this register at the Sub-center level ensures proactive tracking of family planning needs, contraceptive distribution, and target-setting for the RCH (Reproductive and Child Health) program. 2. **Why other options are incorrect:** * **PHC/CHC:** While these centers supervise the work of Sub-centers and compile data for reporting to higher authorities, they do not maintain the primary, raw door-to-door registers. * **District Hospital:** This is a tertiary referral unit focused on curative care and specialized services, not grassroots-level demographic surveillance. **High-Yield Clinical Pearls for NEET-PG:** * **Eligible Couple:** A currently married couple where the woman is aged **15–49 years**. * **Target Couple:** An eligible couple who already has **2–3 living children** and requires proactive family planning intervention. * **Couple Protection Rate (CPR):** The percentage of eligible couples effectively protected against childbirth by an approved method of family planning. It is a key indicator of family planning program success. * **Register Color Coding:** In many states, the ECR is part of the RCH Register (Register No. 1).

Q: Which committee proposed the establishment of a Primary Health Centre?

Bhore committee. **Explanation:** The **Bhore Committee (1946)**, also known as the Health Survey and Development Committee, is the cornerstone of public health administration in India. It proposed the concept of a **Primary Health Centre (PHC)** to provide integrated preventive and curative healthcare to rural populations. The committee famously recommended a "Short-term measure" (one PHC per 40,000 population) and a "Long-term measure" (the 3-tier system of secondary and tertiary units). **Analysis of Options:** * **Srivastava Committee (1975):** Known as the "Group on Medical Education and Support Manpower," it recommended the creation of **Village Health Guides** and the **Referral Services System**. It also led to the launch of the ROMP (Reorientation of Medical Education) scheme. * **Kartar Singh Committee (1973):** This committee introduced the concept of **"Multipurpose Workers" (MPW)**. It recommended that Auxiliary Nurse Midwives (ANMs) be replaced by Female Health Workers and that one PHC should cover a population of 50,000. * **None of the above:** Incorrect, as the Bhore Committee is the original proponent of the PHC model. **High-Yield Clinical Pearls for NEET-PG:** * **Bhore Committee (1946):** Focus on "Integration of preventive and curative services" and "Social Physicians." * **Mudaliar Committee (1962):** Recommended strengthening existing PHCs and improving the quality of care rather than just expansion. * **Chadah Committee (1963):** Recommended the "Basic Health Worker" for Malaria vigilance. * **Mukherjee Committee (1965/66):** Recommended delinking Family Planning from the Malaria maintenance phase. * **Jungalwalla Committee (1967):** Known for the "Integration of Health Services" (Equal pay for equal work).

Q: What is the period of sickness benefit given under the ESI Act?

91 days. ### Explanation The **Employees' State Insurance (ESI) Act, 1948**, is a vital piece of social security legislation in India. Under this act, **Sickness Benefit** is one of the most frequently utilized benefits, providing cash compensation to an insured person during periods of certified sickness when they are unable to attend work. **1. Why 91 days is correct:** According to the ESI Act, an insured worker is entitled to receive cash compensation for a maximum period of **91 days** in any two consecutive benefit periods (which roughly translates to one year). To qualify, the worker must have contributed for at least 78 days in the corresponding contribution period. The benefit is paid at approximately **70% of the average daily wages**. **2. Why the other options are incorrect:** * **41 days (A):** This is not a standard duration for sickness benefits under the ESI Act. * **17 days (B):** This number does not correspond to any statutory benefit period under the ESI scheme. * **101 days (D):** While the ESI Act has seen various amendments, the standard sickness benefit remains capped at 91 days. However, for specific long-term diseases (like TB or Cancer), an "Extended Sickness Benefit" can last up to 2 years. **3. High-Yield Clinical Pearls for NEET-PG:** * **Extended Sickness Benefit:** For 34 specified long-term diseases, the benefit can be extended up to **2 years** at a higher rate (80% of wages). * **Enhanced Sickness Benefit:** This is provided for undergoing sterilization (Vasectomy – 7 days; Tubectomy – 14 days) at **100% of wages**. * **Maternity Benefit:** Payable for **26 weeks** (182 days), extendable by one month on medical grounds. * **Funeral Expenses:** A lump sum of **₹15,000** is paid to the eldest surviving member of the family.

Q: In the Community Needs Assessment approach as part of the Reproductive & Child Health programme, at what level are the targets for various health activities set?

District. ### Explanation The **Community Needs Assessment Approach (CNAA)**, introduced in 1996, marked a paradigm shift in India’s health planning by replacing the old "top-down" target-setting system with a **"bottom-up" approach**. **Why District is the Correct Answer:** Under the Reproductive and Child Health (RCH) programme, the planning process begins at the grassroots level. The ANM (at the Sub-centre) identifies local needs in consultation with the community. these plans are aggregated at the PHC level and finally consolidated at the **District level**. The District is the administrative unit where the final targets for various health activities are officially set and integrated into the **District Health Plan**. This ensures that targets are realistic and based on actual local requirements rather than centrally imposed quotas. **Analysis of Incorrect Options:** * **A. Community:** While the community is consulted to identify needs, it lacks the administrative infrastructure to set formal programmatic targets. * **B. Sub-centre:** This is the level where the primary data collection and "bottom-up" planning begin, but it is not the level where final targets are finalized. * **C. Primary Health Centre (PHC):** The PHC acts as a supervisory and intermediary level that compiles data from various sub-centres, but the ultimate target-setting authority lies with the District. **High-Yield Pearls for NEET-PG:** * **Target-Free Approach (TFA):** CNAA was formerly known as the Target-Free Approach (introduced April 1, 1996). * **Key Objective:** To improve the quality of care and client satisfaction by moving away from rigid contraceptive targets. * **Planning Unit:** The **Sub-centre** is the basic unit for *planning*, but the **District** is the unit for *target setting and implementation*. * **RCH Phase I** was launched in 1997; **RCH Phase II** in 2005.

Q: Which medication is typically provided in Kit B at a subcentre?

Paracetamol. **Explanation:** In the Indian healthcare system, Sub-centres are provided with two types of drug kits: **Kit A** and **Kit B**. Understanding the contents of these kits is high-yield for NEET-PG. **1. Why Paracetamol is Correct:** **Kit B** is primarily designed to contain drugs for the management of common ailments and emergency stabilization. **Paracetamol** (tablets and syrup) is a core component of Kit B, used as an antipyretic and analgesic for symptomatic relief in both adults and children. Other items in Kit B include Methylergometrine tablets (for PPH), Dicyclomine (antispasmodic), and various ointments/dressings. **2. Why the Other Options are Incorrect:** * **Option A (Vitamin A) and Option D (Iron):** These are nutritional supplements. They are categorized under **Kit A**, which is specifically designed for the management of nutritional deficiencies and basic maternal/child health prophylaxis. Kit A also contains Folic Acid and Oral Contraceptive Pills. * **Option B (ORS):** Oral Rehydration Solution is also a component of **Kit A**, intended for the early management of diarrhea to prevent dehydration at the community level. **High-Yield Clinical Pearls for NEET-PG:** * **Kit A (Nutritional/Prophylactic):** Think "Prevention & Nutrition." Contains Vitamin A, Iron-Folic Acid (IFA), ORS, Zinc, and Cotrimoxazole. * **Kit B (Curative/Emergency):** Think "Treatment & First-aid." Contains Paracetamol, Methylergometrine, Dicyclomine, Mebendazole, and Chloramphenicol eye ointment. * **ASHA Kit:** Contains basic items like Paracetamol, ORS, IFA (blue/pink), and pregnancy test kits (Nishchay). * **Sub-centre Coverage:** One sub-centre covers a population of 5,000 (Plain areas) or 3,000 (Hilly/Tribal areas).

Q: What is the primary function of a female health worker?

To train dais. **Explanation:** The **Female Health Worker (FHW)**, also known as the Auxiliary Nurse Midwife (ANM), is the frontline health functionary at the Sub-centre level. Her primary role in maternal health is to reduce maternal and neonatal mortality by improving the quality of birth practices at the community level. **Why "To train dais" is correct:** One of the most critical functions of the FHW is the **training and supervision of Traditional Birth Attendants (Dais)**. Since many rural deliveries are still attended by local dais, the FHW is responsible for training them in "Safe Delivery" practices (the 5 Cleans), identifying high-risk pregnancies, and ensuring timely referrals. This acts as a bridge between traditional practices and the formal healthcare system. **Analysis of Incorrect Options:** * **A. To perform 50% of deliveries:** There is no specific percentage mandate for the FHW to conduct deliveries. While she conducts deliveries at the Sub-centre or home, her role is more focused on antenatal care (ANC) and supervision. * **C. To enlist dais of the subcentre:** While she does maintain a list of dais, this is a clerical task. Her *primary functional objective* is the actual capacity building (training) of these workers. * **D. To perform chlorination of water:** This is primarily the responsibility of the **Male Health Worker (MPW-M)** or the Village Health Sanitation and Nutrition Committee (VHSNC). **High-Yield Facts for NEET-PG:** * **Population Norms:** One FHW/ANM is posted at a Sub-centre covering 5,000 population (3,000 in hilly/tribal areas). * **Supervision:** The FHW is supervised by the **Lady Health Visitor (LHV)** or Health Assistant (Female). * **Key Tasks:** Immunization, ANC/PNC checkups, family planning counseling, and maintaining the **Eligible Couple Register**.

Q: Which committee suggested a 3-year graduate MBBS programme?

Expert Level Committee on Universal Health Coverage. The **High-Level Expert Group (HLEG) on Universal Health Coverage (UHC)**, chaired by **K. Srinath Reddy** in 2011, proposed a radical shift in medical education to address the shortage of rural healthcare providers. They suggested the introduction of a **3-year Bachelor of Rural Health Care (BRHC)** or a shortened MBBS-equivalent program to train a cadre of mid-level healthcare providers specifically for rural postings. ### Analysis of Options: * **Expert Level Committee on UHC (Correct):** This committee emphasized "task-shifting" and recommended a shortened medical degree to ensure that rural sub-centers and PHCs are manned by trained professionals who are more likely to remain in rural areas compared to traditional MBBS graduates. * **Srivastava Committee (1975):** Known for recommending the **"Reorientation of Medical Education" (ROME)** scheme and the creation of the **Multi-Purpose Worker (MPW)** cadre. It did not suggest shortening the MBBS duration. * **Sundar Committee (2001):** Focused primarily on **Health Management and Medical Education** reforms but did not propose a 3-year graduate program. * **Krishnan Committee:** This is often a distractor in NEET-PG; while there was a Bajaj Committee (1986) for health manpower, the Krishnan Committee is not associated with major MBBS curriculum duration changes. ### High-Yield NEET-PG Pearls: * **Srivastava Committee:** Key for the **Village Health Guide** scheme and the 3-tier health system. * **Kartar Singh Committee:** Famous for the concept of **"Multi-Purpose Workers"**. * **Jungalwalla Committee:** Known for the **"Integration of Health Services"** (Elimination of private practice). * **Bhore Committee (1946):** The foundation of India's health planning; recommended the **"Social Physician"** concept and the 3-million plan.

Question 1

Integration of health services was first proposed by which committee?

Accepted Answer

Jungallwalla committee

Answer

Bhore committee

Answer

Mudaliar committee

Answer

Srivastava committee

Question 2

What is the optimum unit of preventive, curative, and promotive health care?

Accepted Answer

Comprehensiveness

Answer

Appropriateness

Answer

Availability

Answer

Adequacy

Question 3

At which level is the eligible couple register primarily maintained?

Accepted Answer

Sub center

Answer

Primary Health Centre (PHC)

Answer

District hospital

Answer

Community hospital

Question 4

Which committee proposed the establishment of a Primary Health Centre?

Accepted Answer

Bhore committee

Answer

Srivastava committee

Answer

Kartar Singh committee

Answer

None of the above

Question 5

What is the period of sickness benefit given under the ESI Act?

Accepted Answer

91 days

Answer

41 days

Answer

17 days

Answer

101 days

Question 6

In the Community Needs Assessment approach as part of the Reproductive & Child Health programme, at what level are the targets for various health activities set?

Accepted Answer

District

Answer

Community

Answer

Sub-centre

Answer

Primary health-centre

Question 7

What is meant by clinical audit?

Accepted Answer

Measuring current patient care against explicit criteria

Answer

Measuring hospital records

Answer

Measuring input-output analysis

Answer

Measuring the shortest time needed to complete a task

Question 8

Which medication is typically provided in Kit B at a subcentre?

Accepted Answer

Paracetamol

Answer

Vitamin A

Answer

Oral Rehydration Solution (ORS)

Answer

Iron

Question 9

What is the primary function of a female health worker?

Accepted Answer

To train dais

Answer

To perform 50% of deliveries

Answer

To enlist dais of the subcentre

Answer

To perform chlorination of water

Question 10

Which committee suggested a 3-year graduate MBBS programme?

Accepted Answer

Expert Level Committee on Universal Health Coverage

Answer

Sundar Committee

Answer

Srivastava Committee

Answer

Krishnan Committee

Public Health Administration — MCQs

Public Health Administration — MCQs

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