Public Health Administration — MCQs

Public Health Administration Indian Medical PG Practice Questions and MCQs

Question 241: Health functionary at PHC level is:

A. Anganwadi Worker
B. Health Worker (Female)
C. ASHA
D. Health Assistant (Female) (Correct Answer)

Explanation: ***Health Assistant (Female)*** - The **Health Assistant (Female)**, also known as the Block Extension Educator or Lady Health Visitor, supervises the work of multiple **Health Workers (Female)** and is primarily stationed at the **Primary Health Centre (PHC)** level in India. - Their role involves providing administrative and technical support, training, and supervision to grassroots health functionaries, making them a key health functionary at the PHC level. *Anganwadi Worker* - An **Anganwadi Worker** operates at the village level, typically managing an Anganwadi centre, which is primarily focused on children's health, nutrition, and early childhood education. - While they are important community health volunteers, they are not considered a primary health functionary at the PHC level, but rather work under the Integrated Child Development Services (ICDS) scheme. *Health Worker (Female)* - A **Health Worker (Female)**, also known as an Auxiliary Nurse Midwife (ANM), is a grassroots-level functionary, usually based at the **Sub-Centre (SC)**, which is below the PHC level. - They provide direct primary healthcare services to a defined population within a cluster of villages, and are supervised by the Health Assistant (Female) at the PHC. *ASHA* - An **ASHA (Accredited Social Health Activist)** is a community health volunteer who acts as a crucial link between the community and the public health system. - They operate at the village level, working primarily as a mobilizer, health educator, and facilitator for accessing health services, rather than a health functionary stationed at the PHC.

Question 242: Which among the following is/are the examples of primordial prevention ? 1. Adopting healthy lifestyles from childhood 2. Immunization of infants 3. Screening of cervical cancer Select the correct answer using the code given below:

A. 1, 2 and 3
B. 1 and 3 only
C. 1 and 2 only
D. 1 only (Correct Answer)

Explanation: ***1 only*** - **Primordial prevention** aims to prevent the emergence of risk factors in the population, typically through establishing conditions that minimize hazards to health. **Adopting healthy lifestyles from childhood** (such as healthy eating habits, regular physical activity, avoiding smoking and alcohol) prevents the development of risk factors for chronic diseases like obesity, hypertension, and diabetes later in life. - This is the classic example of primordial prevention - intervening before risk factors even develop. *1 and 2 only* - While adopting healthy lifestyles is primordial prevention, **immunization of infants** is actually **primary prevention**, not primordial prevention. - **Primary prevention** prevents disease occurrence in susceptible individuals by interventions like immunization, which protects against specific diseases but does not prevent the emergence of risk factors themselves. - The disease agents already exist in the environment; vaccination simply prevents their effect on the individual. *1, 2 and 3* - **Immunization** is **primary prevention** (not primordial), and **screening for cervical cancer** is **secondary prevention** (early detection and treatment of existing disease). - This option incorrectly classifies both immunization and screening as primordial prevention. *1 and 3 only* - **Screening for cervical cancer** is a form of **secondary prevention** as it aims for early detection and prompt treatment of an existing disease or pre-cancerous condition, not the prevention of risk factors. - This option incorrectly includes secondary prevention and excludes statement 2, which while also incorrect as primordial, makes this combination wrong.

Question 243: The benefits of ESI Act include the following except:

A. Medical benefit
B. Nutritional allowance (Correct Answer)
C. Rehabilitation allowance
D. Sickness benefit

Explanation: ***Nutritional allowance*** - The **Employees' State Insurance (ESI) Act** primarily provides benefits related to health, disability, maternity, and unemployment, but it does not directly offer a "nutritional allowance." - While it covers health issues that might impact nutrition, a specific allowance for nutrition is not a statutory benefit under the ESI Act. *Medical benefit* - The ESI Act provides comprehensive **medical care** for the insured person and their family, including hospitalization, outpatient care, specialist consultation, and medicines. - This is a fundamental and direct benefit ensuring access to healthcare services. *Rehabilitation allowance* - The ESI Act includes provisions for **rehabilitation benefits** for insured persons who suffer from disablement due to employment injury or occupational disease. - This benefit aims to help injured workers regain their functional capacity and re-enter the workforce. *Sickness benefit* - **Sickness benefit** is a cash payment provided to insured persons during periods of certified sickness, compensating for loss of wages. - This benefit ensures income security when an employee is unable to work due to illness.

Question 244: Marriage between two heterozygous individuals for the same disorder is prevented by:

A. Mass health education
B. Retrospective genetic counselling
C. Prospective genetic counselling (Correct Answer)
D. Legislation

Explanation: ***Prospective genetic counselling*** - This approach identifies individuals at risk **before** they marry or have children, allowing them to make informed decisions and prevent the union of two carriers for the same disorder. - It focuses on **prevention** by providing information about genetic risks and reproductive options. *Mass health education* - While it raises general awareness, it lacks the **personalized risk assessment** and specific guidance needed to prevent a particular high-risk marriage. - It is a broad approach and may not effectively reach or influence individuals specifically at risk of carrying the same genetic disorder. *Retrospective genetic counselling* - This type of counselling occurs **after** a child with a genetic disorder has been born, aiming to inform parents about recurrence risks for future pregnancies. - It does not prevent the marriage itself but rather addresses risks for future offspring once a genetic condition has already manifested within the family. *Legislation* - Implementing laws to prevent specific marriages based on genetic carrier status would be an extreme measure, raising significant **ethical and human rights concerns**. - Such laws could be seen as discriminatory and are generally not a practical or acceptable approach for preventing marriages between carriers.

Question 245: The difference between Type A and Type B sub centre as per Indian Public Health standards is in terms of:

A. Labour room or delivery facility (Correct Answer)
B. Staffing pattern
C. Location
D. Availability of drugs

Explanation: ***Labour room or delivery facility*** - A **Type A Sub-centre** is defined as one where **deliveries are not conducted**, focusing primarily on basic health services, antenatal and postnatal care, and health promotion. - A **Type B Sub-centre** is distinguished by the **provision of delivery services**, requiring specific infrastructure like a labour room and trained personnel to conduct safe deliveries. *Staffing pattern* - While there are specific staffing norms for both types of sub-centres, the fundamental difference between Type A and Type B is not solely based on the general staffing pattern. - The staffing complement in Type B sub-centres is specifically augmented to include personnel capable of assisting with deliveries, which is a consequence of the delivery facility rather than the primary differentiating factor itself. *Location* - The location of a sub-centre (either Type A or Type B) is determined by population norms and geographical accessibility, aiming to serve a defined rural population. - Location itself does not differentiate between Type A and Type B; rather, the services offered at these locations define their type. *Availability of drugs* - Both Type A and Type B sub-centres are expected to maintain a basic stock of essential drugs to provide primary healthcare services to their target population. - The range of drugs might expand in a Type B sub-centre to support delivery services, but the core distinction isn't merely the general availability of drugs.

Question 246: What constitutes the denominator in ‘Total Dependency Ratio’?

A. Mid year population
B. Population 15–45 years of age
C. Population 15–64 years of age (Correct Answer)
D. Population less than 14 and more than 65 years of age

Explanation: ***Population 15–64 years of age*** - The **total dependency ratio** is calculated by dividing the sum of the dependent population (ages 0-14 and 65+) by the **working-age population** (15-64 years). - This age group traditionally represents the population that is generally considered to be economically productive and supporting the dependent populations. *Mid year population* - The **mid-year population** is the total population count at the midpoint of a year, used as the denominator for many public health rates, but not specifically for the dependency ratio. - While it's the base for many demographic calculations, it does not specifically represent the **working-age group** for dependency calculations. *Population 15–45 years of age* - This age range defines a **subset of the working-age population** but is too narrow, as it excludes economically productive individuals between 46 and 64 years old. - Using this range would artificially **inflate the dependency ratio** by undercounting the contributing working population. *Population less than 14 and more than 65 years of age* - This age group represents the **dependent population** (young children and retirees) and forms the numerator of the total dependency ratio. - Including them in the denominator would be incorrect as they are the very groups whose **reliance on the working-age population** is being measured.

Question 247: Which one of the following statements regarding the growth chart is NOT true?

A. It is used as a tool for growth monitoring and diagnosis
B. It is used for planning and policy making
C. It is used as a tool for action against the Anganwadi worker (Correct Answer)
D. It is used as a tool for teaching and evaluation of effectiveness of programme

Explanation: ***It is used as a tool for action against the Anganwadi worker*** - The primary purpose of a growth chart is to **monitor child growth**, provide insights into health status, and evaluate interventions, not to penalize workers. - Using it as a punitive tool goes against its intended use for **health promotion** and programmatic improvement. *It is used as a tool for growth monitoring and diagnosis* - Growth charts are essential for **tracking a child's physical development** over time, allowing for early detection of growth faltering or excessive weight gain. - They aid in the **diagnosis of malnutrition** (underweight, stunting, wasting) or overweight/obesity by comparing individual measurements to population standards. *It is used for planning and policy making* - Data aggregated from growth charts can inform **public health planning** by identifying areas with high prevalence of malnutrition and allocating resources effectively. - They provide crucial evidence for **policy formulation** aimed at improving child health and nutrition outcomes at local, regional, and national levels. *It is used as a tool for teaching and evaluation of effectiveness of programme* - Growth charts serve as an excellent **educational tool** for parents, healthcare workers, and community health volunteers to understand healthy growth patterns and nutritional needs. - They are vital for **evaluating the impact of health and nutrition programs** by demonstrating changes in growth trends and nutritional status over time.

Question 248: Which one of the following management techniques helps in standardising the methods of performing jobs ?

A. Work Sampling
B. Personnel Management
C. Systems Analysis (Correct Answer)
D. Decision Making

Explanation: ***Systems Analysis*** - **Systems analysis** is a management technique that systematically examines processes, workflows, and organizational systems to identify inefficiencies and standardize operations. - It helps in **standardizing methods of performing jobs** by breaking down complex tasks into components, analyzing each step, and establishing uniform procedures and protocols. - In public health administration, systems analysis is used to create **standard operating procedures (SOPs)** and ensure consistency in service delivery. - This is the **best answer** among the given options for standardizing job methods. *Work Sampling* - **Work sampling** is a work measurement technique that uses random observations to determine the proportion of time workers spend on various activities. - Its primary purpose is **data collection and time measurement**, not the standardization of how tasks should be performed. - It helps identify *what* workers do, but not *how* to standardize the methods. *Personnel Management* - **Personnel management** deals with human resource functions including recruitment, training, performance appraisal, and employee welfare. - While training may involve teaching standardized methods, personnel management itself is **not a technique for standardizing job methods**. - It focuses on managing people, not on analyzing and standardizing work processes. *Decision Making* - **Decision making** is a cognitive and managerial process of choosing between alternatives to achieve organizational goals. - It is a **general management function**, not a specific technique for analyzing and standardizing how jobs are performed. - While decisions may lead to standardization, decision making itself is not the technique that accomplishes it.

Question 249: Consider the following staff: 1. Medical Officer 2. Pharmacist 3. Anaesthetist 4. Health Educator Of them, who are routinely posted to a PHC ?

A. 1, 2 and 4 (Correct Answer)
B. 2, 3 and 4
C. 1, 2 and 3
D. 1, 3 and 4

Explanation: ***1, 2 and 4*** - According to **IPHS (Indian Public Health Standards)** for PHC staffing, a **Medical Officer** is the essential physician providing primary medical care, and a **Pharmacist** is mandatory for dispensing medications and managing the drug store. - While a designated "Health Educator" post may not be uniformly established at all PHCs, **health education activities** are a core PHC function, often performed by staff nurses, ANMs, or health workers as part of their routine duties under the supervision of the Medical Officer. - In the context of this question and official guidelines, these three roles represent the personnel involved in **medical care, pharmaceutical services, and health education functions** at PHC level. *2, 3 and 4* - An **Anaesthetist** is NOT routinely posted at PHC level as PHCs do not perform surgical procedures requiring anaesthesia. - Anaesthetists are stationed at **CHCs (Community Health Centres)** with operation theatre facilities or higher-level hospitals. - This option incorrectly includes anaesthetist while omitting the essential Medical Officer. *1, 2 and 3* - While **Medical Officer** and **Pharmacist** are definitely routine PHC staff, an **Anaesthetist** is not posted at PHC level. - PHCs provide basic primary healthcare services, not surgical interventions requiring anaesthesia services. - Anaesthetists are found at CHC level and above. *1, 3 and 4* - This option incorrectly includes an **Anaesthetist** who is not a PHC-level staff member. - Additionally, it omits the **Pharmacist**, who is a mandatory and essential staff member at every PHC for medication dispensing and drug store management. - Without a pharmacist, the PHC cannot function effectively in providing essential medicines.

Question 250: Which of the following indicators stand consolidated in Physical Quality of Life Index (PQLI)? 1. Infant mortality 2. Life expectancy at age one 3. Per capita income 4. Literacy

A. 1, 2 and 4 (Correct Answer)
B. 1, 2 and 3
C. 2, 3 and 4
D. 1, 3 and 4

Explanation: ***1, 2 and 4*** - The **Physical Quality of Life Index (PQLI)** is a composite index that measures the quality of life based on three specific indicators: infant mortality, life expectancy at age one, and literacy. - These indicators were chosen to reflect basic human needs and achievements independent of economic production. *1, 2 and 3* - This option incorrectly includes **per capita income** as an indicator. The PQLI was developed as an alternative to economic measures like GDP or per capita income. - **Per capita income** is an economic indicator, whereas PQLI focuses on social indicators of well-being. *2, 3 and 4* - This option incorrectly includes **per capita income** and excludes **infant mortality**, which is a core component of the PQLI reflecting the health status of a population. - The PQLI specifically aims to capture non-economic aspects of development. *1, 3 and 4* - This option incorrectly includes **per capita income** and excludes **life expectancy at age one**, which is a critical health indicator in the PQLI. - PQLI specifically includes **life expectancy at age one** instead of other age groups to reflect achievements in reducing early childhood mortality and improving health.

Practice by Chapter

Health Administration Structures

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National Health Programs

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District Health System

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Community Health Centers

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Primary Health Centers

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Sub-Centers

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Public Health Legislation

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Health Information Systems

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Health Management Information System

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Health Workforce Planning

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Public Health Ethics

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Intersectoral Coordination

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