Panchayati Raj in Health — MCQs
Which of the following is NOT a duty of an ASHA worker?
In implementation of a health programme, best thing to do is -
All are true about Swajaldhara programme except:
Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?
How often is the Sample Registration System conducted in India?
Which of the following statements about Anganwadi workers is incorrect?
Which committee is responsible for making a plan for village health under NHM
In the context of rural healthcare delivery in India, the Panchayati Raj system plays a crucial role in implementing health programs at the grassroots level. Consider the following bodies and their involvement in village-level health initiatives: I. Gram Sabha - Village health planning and monitoring II. Gram Panchayat - Implementation of health schemes and sanitation III. Nyaya Panchayat - Health-related dispute resolution IV. Panchayat Samiti - Block-level health program coordination Which of the above bodies are present and actively involved in healthcare delivery at the village level?
All of the following are components of primary healthcare delivery system, except -
What is the population covered by an Anganwadi in a tribal area?
Panchayati Raj in Health Indian Medical PG Practice Questions and MCQs
Question 1: Which of the following is NOT a duty of an ASHA worker?
- A. Administering zero dose of DPT and OPV (Correct Answer)
- B. Assessing the success of national programs under ANM
- C. Primary screening for prevalence of non-communicable diseases
- D. All of the options
Explanation: ***Correct: Administering zero dose of DPT and OPV*** - **ASHA workers do NOT administer vaccines** - this is strictly beyond their scope of practice - According to **NRHM guidelines**, ASHAs are **facilitators and mobilizers** for immunization, not vaccine administrators - Only **ANMs and trained health workers** are authorized to administer vaccines including DPT and OPV - ASHAs role is to **identify beneficiaries, create awareness, and escort mothers/children to immunization centers** - Vaccine administration requires technical training and cold chain management that ASHAs are not equipped for *Incorrect: Assessing the success of national programs under ANM* - While this is also not a primary ASHA duty, the question asks for what is NOT a duty - Program assessment is done at district/state levels through monitoring and evaluation teams - However, between administering vaccines (strictly prohibited) vs program assessment (not their role but may provide data), vaccine administration is more clearly NOT their duty *Incorrect: Primary screening for prevalence of non-communicable diseases* - This **IS a duty** of ASHA workers under **NPCDCS** (National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke) - ASHAs conduct basic screening for hypertension, diabetes, and common cancers using simple tools - They refer suspected cases to appropriate health facilities for confirmation and management *Incorrect: All of the options* - This is incorrect because primary NCD screening IS part of ASHA duties, and administering vaccines is the most clearly defined non-duty among the options
Question 2: In implementation of a health programme, best thing to do is -
- A. Discussion with leaders in community and implement accordingly
- B. Discussion with people in community and decide according to it
- C. Discussion and decision taken by the health ministry regarding implementation
- D. Discussion with doctors in PHC and implement accordingly (Correct Answer)
Explanation: ***Discussion with doctors in PHC and implement accordingly*** - **Primary Healthcare (PHC) doctors** possess critical hands-on knowledge of common health issues, local demographics, and daily health challenges faced by the community. - Their involvement ensures the program is **practically viable** and tailored to the specific needs and resources available at the grassroots level for effective implementation. *Discussion with leaders in community and implement accordingly* - While engaging community leaders is important for acceptance and dissemination, they may lack the **medical expertise** required to design effective and clinically sound health interventions. - Relying solely on leaders might lead to programs that are **socially acceptable but not medically optimal** or comprehensive. *Discussion with people in community and decide according to it* - Involving the community is crucial for program adherence and understanding local needs, but **laypersons** may not have the necessary medical knowledge to make informed decisions about complex health interventions. - Their input is valuable for relevance and acceptance, but medical and public health expertise is required for program design and implementation to ensure **efficacy and safety**. *Discussion and decision taken by the health ministry regarding implementation* - The health ministry sets policies and provides overall strategic direction, but they often lack direct, **on-the-ground understanding** of specific local health issues and implementation challenges. - A top-down approach without involving local healthcare providers can lead to programs that are **not feasible** or effective in the local context.
Question 3: All are true about Swajaldhara programme except:
- A. Encourage water harvesting practices
- B. Provide drinking water in Rural areas
- C. State government maintain and manage all water supply (Correct Answer)
- D. Community led, participatory program
Explanation: ***State government maintain and manage all water supply*** - The **Swajaldhara programme** emphasizes a **community-driven approach**, where local communities are responsible for the operation and maintenance of the water supply systems. - This program aimed to shift away from complete government control, promoting **local ownership and sustainability**. *Encourage water harvesting practices* - The Swajaldhara scheme actively promoted and supported **water conservation methods**, including **rainwater harvesting**, to ensure the long-term availability of water resources. - This was an integral part of its strategy to enhance **water security** in rural areas. *Provide drinking water in Rural areas* - The primary objective of the Swajaldhara programme was to improve access to and the quality of **drinking water supplies** in **rural areas** of India. - It focused on providing safe and adequate drinking water to underserved rural populations. *Community led, participatory program* - Swajaldhara was designed as a **demand-driven and community-led initiative**, requiring beneficiaries to contribute to the capital cost and take responsibility for managing the water schemes. - This **participatory approach** fostered self-reliance and empowerment within the local communities.
Question 4: Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?
- A. Cataract surgery
- B. Pan retinal photocoagulation for diabetic retinopathy
- C. Syringing and probing of the nasolacrimal duct (Correct Answer)
- D. Trabeculectomy surgery
Explanation: ***Syringing and probing of the nasolacrimal duct*** - While important for lacrimal drainage issues, procedures like **syringing and probing** are generally considered minor and less vision-restoring compared to the major surgeries targeted by the **NPCB**. - The **NPCB** focuses on interventions for leading causes of blindness, primarily **cataract** and other significant vision-threatening conditions, which this procedure typically isn't. *Cataract surgery* - **Cataract surgery** is a cornerstone of the **NPCB's** efforts, as cataracts are the leading cause of reversible blindness. - Reimbursement for **cataract surgery** is a primary objective to improve access and reduce the burden of blindness. *Pan retinal photocoagulation for diabetic retinopathy* - **Diabetic retinopathy** is a major cause of preventable blindness, and **pan retinal photocoagulation (PRP)** is a key intervention to preserve vision. - The **NPCB** includes procedures for **diabetic retinopathy** management due to its significant public health impact. *Trabeculectomy surgery* - **Trabeculectomy** is a surgical procedure for **glaucoma**, which is another significant cause of irreversible blindness. - The **NPCB** includes interventions for **glaucoma** given its severe vision-threatening nature and the need for surgical management in many cases.
Question 5: How often is the Sample Registration System conducted in India?
- A. 2 years
- B. 5 years
- C. 6 months
- D. 1 year (Correct Answer)
Explanation: ***1 year*** - The **Sample Registration System (SRS)** in India is a large-scale demographic survey conducted **annually** to provide reliable estimates of birth rates, death rates, and other fertility and mortality indicators. - Its annual nature allows for regular monitoring of demographic changes and health trends across different states and regions. *6 months* - While some surveys or data collections might occur semi-annually, the comprehensive SRS is not conducted every six months. - Conducting a system as extensive as the SRS twice a year would be logistically challenging and resource-intensive. *2 years* - A biennial (every two years) frequency would mean less up-to-date data for tracking rapid demographic shifts or evaluating the immediate impact of health interventions. - The need for current statistics on vital events necessitates a more frequent survey than every two years. *5 years* - A quinquennial (every five years) frequency would provide very infrequent data, which is insufficient for effective public health planning and policy formulation. - Key demographic indicators are needed more regularly than every five years to respond to evolving health and population needs.
Question 6: Which of the following statements about Anganwadi workers is incorrect?
- A. Training for 40 days
- B. Under ICDS scheme
- C. Mostly female
- D. Covers a population of 2000 (Correct Answer)
Explanation: ***Covers a population of 2000*** - An **Anganwadi center** typically covers a population of **1000** in rural and urban areas, and **700** in tribal areas, not 2000. - This statement is incorrect because the specified population coverage is double the standard norm for an Anganwadi center. *Mostly female* - The vast majority of **Anganwadi workers** are **women** from the local community. - This is a correct statement, reflecting the gender composition of the Anganwadi workforce. *Training for 40 days* - **Anganwadi workers** undergo an initial **training program of 40 days**. - This statement is correct, outlining the standard duration of their foundational training. *Under ICDS scheme* - **Anganwadi centers** are a crucial part of the **Integrated Child Development Services (ICDS) scheme**. - This statement is correct, as the ICDS scheme established and oversees Anganwadi centers to provide health, nutrition, and early childhood education services.
Question 7: Which committee is responsible for making a plan for village health under NHM
- A. Village Health Sanitation and Nutrition Committee (Correct Answer)
- B. Village Health planning and management committee
- C. Rogi kalyan samiti
- D. Panchayat Health Committee
Explanation: ***Village health sanitation and Nutrition committee*** - The **Village Health, Sanitation and Nutrition Committee (VHSNC)** is the designated body under the National Health Mission (NHM) responsible for local health planning and resource management at the village level. - Its primary role is to promote community participation, address **local health needs**, and facilitate the implementation of health and nutrition programs. *Village Health planning and management committee* - This is not the officially recognized or structured committee name under the **National Health Mission (NHM)** for village-level health planning. - While reflecting similar functions, the specific nomenclature and mandate belong to the **VHSNC**. *Panchayat Health Committee.* - While panchayats play a crucial role in local governance and health initiatives, the dedicated committee for health planning under NHM is the **VHSNC**, not a general "Panchayat Health Committee." - The **VHSNC** is specifically constituted for health, sanitation, and nutrition, often with broader representation than just the panchayat members. *Rogi kalyan samiti* - **Rogi Kalyan Samitis** (Patient Welfare Committees) primarily operate at the **facility level** (e.g., district hospitals, Community Health Centers) to improve basic amenities and services for patients. - They are not responsible for comprehensive **village-level health planning** as described in the question.
Question 8: In the context of rural healthcare delivery in India, the Panchayati Raj system plays a crucial role in implementing health programs at the grassroots level. Consider the following bodies and their involvement in village-level health initiatives: I. Gram Sabha - Village health planning and monitoring II. Gram Panchayat - Implementation of health schemes and sanitation III. Nyaya Panchayat - Health-related dispute resolution IV. Panchayat Samiti - Block-level health program coordination Which of the above bodies are present and actively involved in healthcare delivery at the village level?
- A. I, II and III
- B. III and IV only
- C. II, III and IV
- D. I and II only (Correct Answer)
Explanation: ***I and II only*** - The **Gram Sabha** is responsible for **village health planning** and monitoring, ensuring community participation in health initiatives. - The **Gram Panchayat** undertakes the **implementation of health schemes** and plays a vital role in sanitation and environmental health at the village level. *I, II and III* - While I and II are correct, the **Nyaya Panchayat** is primarily involved in **justice delivery and dispute resolution**, not active healthcare delivery. - Its role in healthcare is indirect, often related to settling disputes arising from health-related issues, rather than direct program implementation. *III and IV only* - **Nyaya Panchayat** (III) is not directly involved in healthcare delivery at the village level. - **Panchayat Samiti** (IV) operates at the **block level**, not the village level, though it coordinates health programs that impact villages. *II, III and IV* - The **Nyaya Panchayat** (III) does not have a direct role in healthcare delivery. - The **Panchayat Samiti** (IV) functions at the **block level**, not the village level.
Question 9: All of the following are components of primary healthcare delivery system, except -
- A. Primary Health Centre (PHC)
- B. Community Health Centre (CHC)
- C. District Collector Office (Correct Answer)
- D. Sub-Centre
Explanation: ***District Collector Office*** ✓ - The **District Collector Office** is an administrative body responsible for revenue collection, law and order, and overall district administration. - It is **NOT a component of the primary healthcare delivery system** itself, making it the correct answer to this EXCEPT question. - While it may coordinate certain public health initiatives at the district level, it does not provide direct healthcare services. *Primary Health Centre (PHC)* - **Primary Health Centres (PHCs)** are essential facilities at the first level of contact between the community and a medical officer in the healthcare system. - They offer basic medical care, maternal and child health services, family planning, immunization, and public health programs. - PHCs are a core component of primary healthcare delivery. *Community Health Centre (CHC)* - **Community Health Centres (CHCs)** serve as referral centers for PHCs and provide secondary-level care with specialist services. - They offer extended medical services including specialist consultations, emergency obstetric care, and 24x7 services. - CHCs are an integral part of the three-tier primary healthcare system. *Sub-Centre* - **Sub-Centres** are the most peripheral and first point of contact between the primary healthcare system and the community. - Typically staffed by one Auxiliary Nurse Midwife (ANM) and one Male Health Worker, they serve a population of 3,000-5,000. - They provide basic health services including maternal and child health care, immunization, family planning, treatment of minor ailments, and health education.
Question 10: What is the population covered by an Anganwadi in a tribal area?
- A. 700 (Correct Answer)
- B. 100
- C. 400
- D. 1000
Explanation: ### Explanation **Concept Overview:** The Anganwadi Center (AWC) is the focal point of the **Integrated Child Development Services (ICDS)** scheme. It provides a package of six services, including supplementary nutrition and immunization. The population norms for setting up an Anganwadi are strictly defined based on the geographical terrain to ensure accessibility in difficult areas. **Why Option A is Correct:** According to the revised ICDS norms, the population coverage for an Anganwadi in **Tribal/Riverine/Desert/Hilly/Difficult areas** is: * **1 Anganwadi Center:** 300 – 800 population. * **Mini-Anganwadi:** 150 – 300 population. In the context of the given options, **700** falls within the standard 300–800 range for a full Anganwadi in a tribal area. **Why Other Options are Incorrect:** * **Option B (100):** This is below the minimum threshold for even a Mini-Anganwadi (which starts at 150 in tribal areas). * **Option C (400):** While 400 is technically within the 300–800 range, in standard NEET-PG patterns, 700–800 is often cited as the upper limit/standard for a full center, whereas 400 is more commonly associated with the lower limit for plain areas. * **Option D (1000):** This is the upper limit for an Anganwadi in **Plain areas** (Norm: 400 – 800 per AWC; 800 – 1600 for 2 AWCs; 1600 – 2400 for 3 AWCs). **High-Yield Clinical Pearls for NEET-PG:** * **Anganwadi Worker (AWW):** One AWW is typically allocated for every 1,000 population in plains and 700 in tribal areas. * **Supervision:** One **Mukhya Sevika** (Lady Supervisor) supervises 25 Anganwadi workers. * **ICDS Services:** Includes Supplementary Nutrition, Pre-school non-formal education, Nutrition & Health education, Immunization, Health check-up, and Referral services. * **Beneficiaries:** Children (0-6 years), pregnant women, and lactating mothers.
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