Que. 1. What is the approach of the National Health Mission?

Ans. 1. To increase access to the decentralized health system by establishing new infrastructure in deficient areas and by upgrading infrastructure in existing institutions.

Que. 2. When was National Health Mission approved?

Ans. 2. In May 2013.

Que. 3. Which are the main programmatic contents of the NHM?

Ans. 3. The main programmatic contents of the NHM –

• Health System Strengthening
• RMNCH+A strategy
• Control of communicable/non-communicable diseases

Que. 4. When was Child Survival & Safe Motherhood program (CSSM) launched?

Ans. 4. 1992.

Que. 5. When was National Rural Health Mission (NRHM) launched?

Ans. 5. 2005.

Que. 6. When was RMNCH+A strategy launched by Government of India?

Ans. 6. 2013.

Que. 7. When was India Newborn Action Plan (INAP) formulated?

Ans. 7. 2014.

Que. 8. When was Ayushman Bharat Program launched in India?

Ans. 8. 2018.

Que. 9. What are the two components of Ayushman Bharat Program?

Ans. 9. The two components are as follows –

• Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY)
• Ayushman Bharat – Health & Wellness Centres (AB- HWCs)

Que. 10. Which health scheme does promote the institutional delivery in India?

Ans. 10. Janani Suraksha Yojana (JSY).

Que. 11. Which scheme does entitle all pregnant women having institutional delivery an absolutely free or no cost delivery including caesarean section?

Ans. 11. Janani Shishu Suraksha Karyakram (JSSK).

Que. 12. Which are the free entitlements of JSSK for both pregnant women & sick infants?

Ans. 12. The free entitlements of JSSK are as follows –

• Free drugs
• Free diagnostics
• Free diet
• Free blood
• Free referral transport

Que. 13. What is the target group of Rashtriya Bal Swasthya Karyakram (RBSK)?

Ans. 13. Children in the age group of 0-18 years in the community.

Que. 14. What is the purpose of RBSK?

Ans. 14. To improve the overall quality of life of children through early detection of birth defects, diseases, deficiencies & development delays or disability.

Que. 15. Which are the newer initiatives in NHM to reduce newborn mortality?

Ans. 15. The newer initiatives are as follows –

• Vitamin K injection at birth
• Antenatal Corticosteroids for preterm labour
• Kangaroo mother care
• Injection gentamicin to young infants in case of suspected sepsis

Que. 16. Which ministry is collaborating with NHM to promote appropriate infant and young child feeding practices?

Ans. 16. Ministry of Women & Child development (MOWCD).

Que. 17. What were the targets of NHM in 12^th five year plan (2012- 2017)?

Ans. 17. The targets of NHM for 12^th five year plan were –

• Reduce IMR to 25/1000 live births
• Reduce MMR to 100/1 lakh live births
• Reduce TFR to 2.1.
• Reduce annual incidence & mortality from TB by half.
• Reduce prevalence of leprosy to <1/10,000 population and incidence to zero in all districts
• Annual Malaria incidence to be <1/1000.
• Less than 1% microfilaria prevalence in all districts
• Kala-azar elimination by 2015, <1/10000 population in all blocks.

Que. 18. Who will provide quality health services to cities and towns with less than 50,000 population?

Ans. 18. National Rural Health Mission (NRHM).

Que. 19. Which are the areas covered under National Urban Health Mission (NUHM)?

Ans. 19. All state capitals, district Headquarters & 779 other cities/towns with a population of 50,000 and above.

Que. 20. What is the aim of NUHM?

Ans. 20. To improve the health status of the urban population especially slum dwellers and other vulnerable population by improvising their access to quality health care.

Que. 21. What are the focus areas of NUHM?

Ans. 21. The focus areas of NUHM are –

• Urban slum dwellers
• Other vulnerable populations
• Public health thrust on sanitation, clean drinking water, vector control etc.
• Strengthening public health capacity of urban local bodies

Que. 22. What is the norm of ASHA in urban population?

Ans. 22. One ASHA for 1000-2500 urban poor population covering about 200-500 households.

Que. 23. What are the norms of establishment of Urban CHC (U-CHC) under NUHM?

Ans. 23. The norms of establishment for UCHC are as follows –

• Covers 2.5 lakh population (5 Lakh for Metros).
• Only for cities having population more than 5 lakhs
• Should have 30-50 beds facility (100 beds in Metros).

Que. 24. What is the norm of establishment of U-PHC in relation to population covered?

Ans. 24. Should be established for a population of 50,000-60,000 and should be located within ½ km of a slum.

Que. 25. What is the population covered by each Mahila Aarogya Samiti (MAS)?

Ans. 25. 250-500 population (50-100 households).

Que. 26. What is the population covered by each ANM in NUHM?

Ans. 26. One ANM for every 10,000 population.

Que. 27. What are the impact level targets of NUHM?

Ans. 27. The impact level targets of NUHM are as follows –

• 40% reduction in IMR & U5 MR
• 50% reduction in MMR
• Achieve universal access to Reproductive health including 100% institutional delivery
• 100% ANC Coverage
• TFR = 2.1
• Achieve all targets of disease control programs

Que. 28. What do you mean by term Mahila Aarogya Samiti (MAS)?

Ans. 28. It is a group of 8-12 locally resident women, which covers 100 households in urban vulnerable settlements, for health planning of neighbourhood, action on social determinants of health and for monitoring all local services. ASHA or outreach worker is the member secretary of MAS.

Que. 29. When was National Rural Health Mission (NRHM) launched?

Ans. 29. On 5^th April, 2005.

Que. 30. What is the vision of NRHM?

Ans. 30. To improve rural health care delivery system.

Que. 31. What is the main aim of NRHM?

Ans. 31. To provide accessible, affordable, accountable, effective & reliable primary health care and bridging the gap in rural health care through creation of a cadre of Accredited Social Health Activist (ASHA).

Que. 32. What is the broad plan of action to strengthen infrastructure in NRHM?

Ans. 32. The broad plan of action to strengthen infrastructure in NRHM are –

• Creation of ASHA cadre
• Strengthening Sub centres
• Strengthening Primary Health Centres
• Strengthening CHCs for first referral care.

Que. 33. What is the untied funds received by health sub centres per annum for health infrastructure strengthening?

Ans. 33. Rs 10,000/- per annum for each sub centre in form of untied fund.

Que. 34. What do you mean by Rogi Kalyan Samiti?

Ans. 34. Rogi Kalyan Samiti (Patient welfare Committee) is a simple yet effective management structure at PHC/CHC/FRU/DH etc. This committee which would be a registered society acts as a group of trustees for the hospitals to manage the affairs of the hospital.

Que. 35. Which are the main selection criteria for ASHA under NRHM?

Ans. 35. The main selection criteria for ASHA are as follows –

• She must be resident of the village
• She must be a woman (married/widow/divorced)
• Her age group should be between 25-45 years
• She should have formal education up to eight class
• She should have communication skills & leadership qualities.

Que. 36. What do you mean by Village Health Sanitation & Nutrition Committee (VHSNC)?

Ans. 36. It is an important tool of community empowerment and participation at village level. The VHSNC reflects the aspirations of the local community, especially poor households and children.

Que. 37. When was RBSK initiative launched?

Ans. 37. February 2013.

Que. 38. When was RKSK initiative launched?

Ans. 38. January 2014.

Que. 39. When was the National Program for control of blindness launched?

Ans. 39. 1976.

Que. 40. What was the goal of the National Program for the control of blindness?

Ans. 40. To reduce the prevalence of blindness from 1.4% to 0.3%.

Que. 41. What is the current prevalence of blindness?

Ans. 41. 0.36% (2015-19 survey).

Que. 42. Facilities for intraocular lens implantation is available up to what level?

Ans. 42. Taluka level.

Que. 43. What percentage of cataract operated persons receive free spectacles from the health facilities?

Ans. 43. 84% (Source Survey 2001-02).

Que. 44. What are the different levels of service delivery and referral system in blindness control program?

Ans. 44.

Que. 45. In Schools, how much percentage of children have eye sight problems?

Ans. 45. 6-7% (10-14 years age group).

Que. 46. When is eye donation fortnight organized?

Ans. 47. 25 August – 8 September every year.

Que. 47. What is Vision 2020: The right to Sight?

Ans. 47. A global initiative to reduce avoidable (Preventable & Curable) blindness by year 2020.

Que. 48. Which are the target eye diseases covered under vision 2020?

Ans. 48. Cataract, refractive errors, childhood blindness, corneal blindness, glaucoma & diabetic retinopathy.

Que. 49. What was the proposed four tier structure under Vision 2020?

Ans. 49. Centre of Excellence (20)

Training Centre (200)

Service Centres (2000)

Vision Centres (20,000)

Que. 50. What are the functions of Vision Centres at Primary Care Level?

Ans. 50. Functions of vision centres are –

• Refraction & prescription of glasses
• Primary Eye Care
• School Eye Screening Program
• Screening & referral services

Que. 51. What are the functions of Service Centres at secondary care level?

Ans. 51. The functions of service centres are –

• Cataract surgery
• Other common eye surgeries
• Facilities for refraction
• Referral services

Que. 52. Centre of excellence & training centres fall under which category of care level?

Ans. 52. Tertiary Care Level.

Que. 53. What are the functions of Centre of Excellence (CoE) under blindness control program?

Ans. 53. The functions of Centre of Excellence are as follows –

• Professional Leadership
• Strategy Development
• CME
• Laying of standards & quality assurance
• Research

Que. 54. When was goitre control program, based on iodized salts, launched?

Ans. 54. 1962.

Que. 55. What are the components of Iodine deficiency disorder control program?

Ans. 55. The components of IDD program are as follows –

• Use of iodized salt in place of common salt
• Monitoring & Surveillance
• Manpower training
• Mass Communication

Que. 56. What are the objectives of IDD control program?

Ans. 56. The objectives are as follows –

• Surveys to assess the magnitude of the iodine deficiency disorders in districts
• Supply of iodized salt in place of common salt
• Resurveys to assess IDD & the impact of iodized salt after every 5 years in the district
• Lab monitoring of iodized salts & urinary iodine excretion
• Health education and publicity

Que. 57. When was the first case of HIV detected in India?

Ans. 57. 1986.

Que. 58. What does the Annual Sentinel Surveillance tell?

Ans. 58. About the prevalence of HIV infection in a specified population in a country or state & Trends of sero-positivity in specific high risk groups as well as low risk groups/antenatal mothers.

Que. 59. How many sentinel sites were there in 2010 surveillance in entire country?

Ans. 59. More than 1200 sentinel sites.

Que. 60. If ANC/PPTCT prevalence in district is more than 1% in any of the sites in the last 3 years, in which category district should be put under district categorization in NACP?

Ans. 60. A Category district.

Que. 61.  If less than 1% ANC/PPTCT prevalence in all sites during last 3 years associated with more than 5% prevalence in any HRG group, in which category you will put the district?

Ans. 61. B Category District.

Que. 62. In which year, National AIDS Prevention & Control policy was approved in India?

Ans. 62. April 2002.

Que. 63. Since when professional blood donation has been banned in India?

Ans. 63. 1^st January 1998.

Que. 64. Among replacement & voluntary blood donation, which is preferred & encouraged in Blood safety Program under NACP?

Ans. 64. Voluntary Blood Donation.

Que. 65. What is the strategy in blood safety programme under NACP?

Ans. 65. To ensure safe collection, Processing, storage & distribution of blood & blood products.

Que. 66. Under blood safety program, collected blood units are tested for which diseases?

Ans. 66. HIV, Syphilis, Hepatitis B, Hepatitis C & Malaria.

Que. 67. Where are blood storage units (BSUs) located?

Ans. 67. At sub divisional levels in First referral units (FRUs).

Que. 68. Where HIV testing is carried out on a voluntary basis?

Ans. 68. Integrated Counselling & testing centres (ICTCs).

Que. 69. What is the purpose of ICTC under NACP?

Ans. 69. 1) To provide social & psychological support to those affected by HIV/AIDS.

2) Prevention of HIV transmission to those at risk &

3) To establish linkages for care & treatment.

Que. 70. Why STD control program is linked with NACP?

Ans. 70. As risk behaviour responsible for spread of STD & HIV/AIDS are same.

Que. 71. When was the STD control Program launched in India?

Ans. 71. Since 1946.

Que. 72. How HIV & other STDs can be controlled?

Ans. 72. By Consistent use of good quality condoms.

Que. 73.  What are the three key areas in which NACO has made advances in condom programming?

Ans. 73. 1) Quality control of condoms

2) Social marketing of condoms

3) Involvement of NGOs/CBOs in the program.

Que. 74. What is the purpose of targeted intervention program in NACP?

Ans. 74. To reduce the transmission of HIV among the high risk & bridge populations (Most at risk population – MARPs)

Que. 75. What are the important activities under targeted intervention program?

Ans. 75. The important activities are –

• Behaviour change communication
• Treatment of STDs
• Creating an enabling environment which facilitate behaviour change
• Distribution of condoms/ syringes & needles.

Que. 76. In treatment of which infection, Anti-retroviral Treatment (ART) is used?

Ans. 76. HIV infection.

Que. 77. When was Ayushman Bharat Yojana launched?

Ans. 77. September 2018 by Ministry of Health & Family Welfare (MOHFW).

Que. 78. What are the components of Ayushman Bharat Yojana?

Ans. 78. Ayushman Bharat has two components –

• Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB – PMJAY)
• Ayushman Bharat Health & Wellness Centres (AB- HWC)

Que. 79. What do you mean by AB-PMJAY?

Ans. 79. It is a national public health insurance fund of the government of India that aims to provide free access to health insurance coverage for low income earners in the country. Roughly the bottom 40% of the country’s population qualifies for this scheme.

Que. 80. When the National Mental Health program (NMHP) was launched?

Ans. 80. 1982.

Que. 81. What will you call a program on Mental Health at district level?

Ans. 81. District Mental Health Program (DMHP).

Que. 82. When the national program for control & treatment of occupational diseases was launched?

Ans. 82. 1988-89.

Que. 83. Which was the first country in the world to launch a family planning program?

Ans. 83. INDIA in 1951.

Que. 84. When was RCH –II & NRHM program launched?

Ans. 84. 2005.

Que. 85. What do you mean by Contraceptive Prevalence Rate?

Ans. 85. The percentage of married women of child bearing age who are using or whose husbands are using any form of contraception.

Que. 86. How a community can achieve Zero Population Growth?

Ans. 86. Zero Population growth can be achieved in one of the following ways –

• Birth = Death & Net migration =0.
• Birth> Death & surplus is balanced by net migration.
• Deaths> Births: deficit is balanced by net immigration.

Que. 87. How much reduction in MMR is expected by comprehensive emergency obstetric care?

Ans. 87. 33% reduction of MMR.

Que. 88. How much reduction in MMR is expected by safe abortion?

Ans. 88. 8% reduction of MMR.

Que. 89. What do you mean by Basic emergency Obstetric Care (Basic Emoc)?

Ans. 89. Basic Emoc –

• Parenteral antibiotics
• Parenteral oxytocic drugs
• Parenteral anti convulsants.
• Manual Removal of retained placenta
• Assisted Vaginal delivery

Que. 90. What are the components of Comprehensive emergency obstetric care?

Ans. 90. Comprehensive Emoc –

• Basic Emoc
• Anaesthetic services
• Surgical services (e.g. Caesarean section)
• Safe blood transfusion services.

Que. 91. Which are the institutions providing Basic & comprehensive emergency obstetric care?

Ans. 91. PHCs & CHCs ————————- Basic Emoc

FRUs & above ———————— Comprehensive Emoc.

Que. 92. What do you mean by five cleans for safe delivery?

Ans. 92. Five cleans include ——

• Clean hands
• Clean surface
• Clean cord tie
• Clean razor blade
• Clean cord Stump (No applicants)

Que. 93. What is proportion of abortions of the total pregnancies?

Ans. 93. 9 -15% of the total pregnancies.

Que. 94. What do you mean by Janani Suraksha Yojana (JSY)?

Ans. 94. Govt. has started JSY scheme which is a modified version of the National Maternity Benefit Scheme & is 100% centrally sponsored. Under this scheme, pregnant women belonging to below poverty line (BPL) are eligible for cash benefits.

Financial support is provided under NRHM.

Que. 95. What do you know about Medical termination pill?

Ans. 95. Medical termination pill includes two drugs Mifepristone (RU486) followed by Misoprostol. Medical termination pill is used as safe method for terminating early pregnancy up to 7 weeks (49 days of amenorrhea) in a health facility where safe abortion & blood transfusion facility are available.

Que. 96. What are the dosage & administration of Medical termination pill?

Ans. 96. Day 1 ———————– 3 tabs of Mifepristone (total 600 mg) in a single dose.

Day 2 ———————– 2 tabs of Misoprostol (Total 400 micrograms).

Women taking pill should come after 14 days for follow up to confirm medical termination of pregnancy.

Que. 97. What are the principal causes of infant mortality?

Ans. 97. The principal causes of Infant mortality are –

• Prematurity
• ARI
• Diarrhoea
• Congenital malformations
• Cord infections
• Birth injury

Que. 98. What are the elements of IMNCI plus?

Ans. 98. The elements of IMNCI plus are –

• Care at birth
• IMNCI
• Immunization

Que. 99. What are the signs of severe dehydration?

Ans. 99. Two of the following signs should be present-

• Lethargic or unconscious
• Unable to drink
• Floppy(loss of muscle tone)
• Sunken eyes
• Skin patch gone back very slowly

Que. 100. What is the best treatment for dehydration?

Ans. 100. Oral rehydration therapy using ORS.

Que. 101. What is the therapy of choice for severe dehydration?

Ans. 101.  I.V. fluids (Ringer lactate —– 100 ml/kg).

Que. 102. Which micronutrient is recommended in diarrhoea treatment for children aged <5 years?

Ans. 102. Zinc given 10-14 days during & after diarrhoea (WHO & UNICEF recommendation).

Que. 103. What do you mean by term EXCLUSIVE BREAST FEEDING?

Ans. 103. Except for breast milk, nothing else enters the infant’s mouth for the first 4 months, even water is not allowed.

Que. 104. What is the recommendation of WHO regarding breast feeding to infants?

Ans. 104. Exclusive breast feeding for the first 6 months.

Que. 105. When the Baby friendly Hospital Initiative was launched?

Ans. 105. 1992.

Que. 106. What is the Aim of baby friendly hospital Initiative?

Ans. 106. Aim is to promote successful breastfeeding in the facilities where delivery take place, as breastfeeding is the most effective way to provide a baby with complete food.

Que. 107. When is the world breast feeding week celebrated?

Ans. 107. 1-7 August every year to raise awareness among masses for benefits of breast feeding.

Que. 108. What are the early problems with breast feeding in mothers?

Ans. 108. 1) Flat or inverted nipple

2) Sore nipple

3) Engorged breast, mastitis & Breast abscess.

4) Cracked nipple.

Que. 109. What is the first symptom of vitamin A deficiency in children?

Ans. 109. Night Blindness.

Que. 110. What is the schedule of prophylaxis against blindness due to Vitamin A deficiency in children?

Ans. 110.   First dose ——————- 9 months (1 lakh IU) along with measles vaccine.

Second dose ————— 15 months age (2 Lakh IU).

Subsequent doses ——– Every 6 months 2 lakh IU till the child reaches 5 years of age.

Que. 111. What is the treatment schedule for vitamin A deficiency?

Ans. 111. Two doses of 2 Lakh IU vitamin A are given 4 weeks apart.

Que. 112. Which vaccination was started in India for the first time?

Ans. 112. BCG Vaccination for tuberculosis in 1962.

Que. 113. When was the expanded program on Immunization (EPI) started in India?

Ans. 113. 1978.

Que. 114. When was the Oral Polio Vaccine (OPV) included in EPI?

Ans. 114. 1979.

Que. 115.  When was the Universal Immunization Program (UIP) started in India?

Ans. 115. 1985.

Que. 116. How the output of UIP is measured?

Ans. 116. Output of UIP is measured in terms of antigen coverage & drop-out rates.

Antigen coverage rates measure the access to immunization services. Drop-out rates indicate service utilization.

Que. 117. Up to what age MR vaccine can be given to a child?

Ans. 117. It can be given up to 5 years of age under UIP.

Que. 118. What were the interventions suggested under national program of elimination of neonatal tetanus?

Ans. 118. Interventions included –

• Coverage of all pregnant women with two doses of tetanus toxoid.
• Extensive IEC efforts to promote clean deliveries (Five Cleans).
• Providing disposable delivery kits.
• Community based surveillance of neonatal deaths & investigations & control measures in case of neonatal deaths.

Que. 119. How will you define Neonatal tetanus Elimination?

Ans. 119. Neonatal tetanus Elimination is defined as less than one case of neonatal tetanus per 1000 live births in every district.

Que. 120. Lot Quality Assessment – Cluster sampling surveys (LQA-CS) was used for identification of deaths due to which disease?

Ans. 120. Neonatal Tetanus (NNT).

Que. 121. What were the recommendations after validation of NNT elimination?

Ans. 121. 1) Maintaining high TT vaccination coverage to pregnant women

2) Improve institutional delivery practices

3) Strengthen NNT Surveillance

Que. 122. What are the causes of death in chronically affected Hepatitis B patients?

Ans. 122. Cirrhosis of Liver & Liver Cancer.

Que. 123. What do you mean by term COLD CHAIN?

Ans. 123. The Cold Chain is a system of transporting & storing vaccines at recommended temperatures from the manufacturers to the point of vaccination.

Que. 124. What is the recommended temperature of storage for Penta, Td, DPT, TT?

Ans. 124. 2 to 8 degree Celsius

On freezing, they lose their potency.

Que. 125. Which cold chain equipment is used for preparing ice packs?

Ans. 125. Deep freezers & Ice lined Refrigerators (ILRs).

Que. 126. What capacity deep freezers & ILRs are recommended for PHC & urban family welfare centres?

Ans. 126. 140 litres.

Que. 127. Up to what time vaccines can be stored in the deep freezers & ice lined refrigerators?

Ans. 127. One Month.

Que. 128. Vaccine carriers can store vaccines optimally up to what period?

Ans. 128. Longer than one day. However vaccines should be used on the same day.

Que. 129.  Cold boxes can store vaccines optimally up to what period?

Ans. 129. For one week.

Que. 130. How many doses are contained in BCG vaccine vial supplied by Govt. of India?

Ans. 130. 10 doses.

Que. 131. Which disease surveillance is being integrated with existing AFP surveillance?

Ans. 131. Measles Surveillance.

Que. 132. What are the factors responsible for Success of the Immunization program?

Ans. 132. Factors responsible are –

• Good disease Surveillance
• No pathogen variation
• Potent Vaccine
• Adequate development and/or Procurement of vaccines
• Appropriate & acceptable choice of technologies
• Universal vaccination
• Adequate logistics, cost benefit analysis & resource mobilization.

Que. 133. When the World Health Assembly passed the resolution to eradicate polio?

Ans. 133. In May 1988.

Que. 134. For one paralytic polio, how many children were expected to be affected with polio?

Ans. 134. 100.

Que. 135. Which vaccine is effective in preventing polio?

Ans. 135. Oral Polio Vaccine (OPV).

Que. 136. How does the Pulse Polio Immunization prevent Polio?

Ans. 136. Pulse polio Immunization replaces wild polio virus present in gut with vaccine virus & therefore eradicate harmful wild polio virus in the community if all children (0-5 years) in community given simultaneously OPV at a single day irrespective of their previous polio vaccination status.

Que. 137. When will you say that polio outbreak has occurred?

Ans. 137. Even a single case of polio is treated as an outbreak and preventive measures are initiated, usually within 48 hours of notification of the case.

Que. 138. What were the basic strategies to eradicate polio?

Ans. 138. Basic strategies to eradicate polio are –

• Routine immunization
• National Immunization Days (NIDs)/ Pulse polio Immunization (PPP) program/Sub-national Immunization days(SNIDs).
• Surveillance of Acute Flaccid Paralysis(AFP)
• Conduct extensive house to house immunization, mopping up campaigns

Que. 139. What was the objective of AFP Surveillance?

Ans. 139. Objective is to find places with circulation of wild polio viruses.

Que. 140.  How will you define AFP?

Ans. 140. Any child aged less than 15 years of age who has sudden onset of flaccid paralysis or paralytic illness in a person of any age when polio is suspected.

Que. 141. From every case of AFP, how many stool samples were collected and when collected?

Ans. 141. From every AFP case, 2 stool specimens are collected within 14 days of onset of paralysis (or maximum of 8 weeks) and at least 24 hours apart.

Que. 142.  Name the instrument which enables the vaccinator to know whether vaccine is potent at the time of administration?

Ans. 142. Vaccine Vial Monitor (VVM).

Que. 143. When was the National Polio surveillance Project was established?

Ans. 143. In 1997.

Que. 144. Adolescents constitute what percentage of population in India?

Ans. 144. Over 23%. (Census 2011).

Que. 145. What are the common health problems of adolescents?

Ans. 145. 1) Irregular menstrual cycles

2) Undernutrition

3) Risk behaviour – HIV, drug addiction, accidents.

4) Sexually transmitted infections

5) Teenage pregnancy

6) Anaemia

Que. 146. What are the reasons for high incidence of anaemia in adolescent girls?

Ans. 146. The reasons are –

• Increased requirements because of growth.
• Menstrual loss.
• Discrepancy between high iron need & low iron content foods consumed.
• Dislike for foods rich in Iron
• Iron absorption inhibitors in foods e.g. phytates/tannins
• Frequent dieting/erratic dieting habits

Que. 147. What are the criteria of WHO to determine public health problem of Iron deficiency anaemia?

Ans. 147.

Que. 148. What are the components of Adolescent Health Initiative (AHI)?

Ans. 148. Two components of AHI are –

• Adolescent friendly health services
• Adolescent health counselling services

Que. 149. Which life skills, need to teach to adolescents?

Ans. 149. Those life skills are –

• Critical thinking & creative thinking
• Decision making & problem solving
• Communication skills & interpersonal relations
• Coping with emotions & stress
• Self-awareness & Empathy.

Que. 150. What are the important reasons for the poor health status of tribal people?

Ans. 150. The important reasons are –

• Poverty & undernutrition in both micro & macro nutrients
• Poor environmental sanitation, hygiene & lack of safe drinking water
• Lack of access to health services
• Social barriers preventing access & utilization of health service for specific diseases such as Malaria, TB etc.

Que. 151. What are the suggested approaches to increase utilization of health services by the tribal population?

Ans. 151. 1) Involvement of community in planning, management & implementation of services & programs.

2) Using community based workers as social mobilizers, educators & non-clinical service providers.

3) Involving locally elected bodies including tribal boards.

4) Involvement of NGOs in the area.

5) Promoting tribal systems of medicine & tribal healers whereas appropriate.

Que. 152. In Ayushman Bharat, who will provide primary health care to the community?

Ans. 152. Health & Wellness Centres (HWCs).

Que. 153. What type of care is provided by HWCs?

Ans. 153. Comprehensive Primary Health Care (CPHC).

Que. 154. What is the aim of PMJAY?

Ans. 154. To provide financial support for secondary & tertiary care to about 40% of India’s bottom population.

Que. 155. What are the advantages of Comprehensive Primary Health Care?

Ans. 155. The advantages are –

• Reduces mortality & morbidity at much lower costs
• Significantly reduce the need for secondary & tertiary care.

Que. 156. What are the rationale supporting concept of Comprehensive Primary Health Care?

Ans. 156. The rationale supporting CPHC are as follows –

• Low utilization of public health system for other common ailments apart from RCH.
• India is witnessing an epidemiological & demographic transition where NCDs account for 60% of total mortality.
• In last decade 10% increase in households catastrophic expenditure.
• Present health system is mostly dealing with RCH & other communicable diseases. The range of services delivered at the primary care level did not consider increasing disease burden & rising costs of care on account of chronic diseases.
• Due to insufficient present primary health care, there is increasing load on secondary and tertiary level of health facilities.

Que. 157. Which health committee did emphasize need for primary health care?

Ans. 157. Bhore Committee (1946).

Que. 158. How many HWCs are to be established as per Government of India (GoI)?

Ans. 158. 1.5 Lakh HWCs.

Que. 159. What is the ultimate achievement through both components of Ayushman Bharat?

Ans. 159. Universal Health Coverage (UHC).

Que. 160. Which are the staffs posted at HWCs (HSCs)?

Ans. 160. Lead by Mid-Level Health Provider – MLHP – or Community Health Officer (CHO), supported by MPW (M & F) & ASHAs.

Que. 161. Which are the expanded range of services offered through HWCs?

Ans. 161. The expanded range of services offered through HWCs are as follows –

• Care in pregnancy & child birth
• Neo-natal & infant health care services
• Childhood & adolescent health care services
• Family planning, contraceptive services & other reproductive health care facilities
• Management of communicable diseases including National Health Programs
• Management of common communicable diseases & outpatient care for acute simple illnesses and minor ailments
• Screening, Prevention, Control & Management of NCDs.
• Care for common ophthalmic & ENT problems
• Basic Oral Health Care
• Elderly & palliative health care services
• Emergency medical services
• Screening & basic management of mental health ailments

Que. 162. What are the key elements of HWCs?

Ans. 162. The key elements of HWC (CPHC) are as follows –

• Continuum of care – Telehealth/ Referral
• Expanded service delivery
• Expanding HR – MLHP & multiskilling
• Medicines and expanding diagnostics – point of care and new technologies
• Community mobilization & Health promotion
• Infrastructure
• Financing/ Provider payment reforms
• Robust IT system
• Partnership for Knowledge & Implementation

Que. 163. In urban areas, which facilities will be strengthened as HWCs?

Ans. 163. Urban health posts & urban primary health centres.

Que. 164. In urban areas, who are in the front line provider team?

Ans. 164. MPW (F) & ASHAs.

Que. 165. How much population is covered by MPW (F) in urban areas?

Ans. 165. 10,000 Population.

Que. 166. Which are the areas of focus while planning for HWCs in a state?

Ans. 166. The areas of focus while planning for HWCs in a state are –

• Improving geographic accessibility
• Ensure full complement of staff at each level
• Enable regular capacity building and supportive supervision
• Ensuring uninterrupted supply of medicines & diagnostics
• Maintaining a continuum of care seamlessly
• Linking people to various levels of care
• Promise of expanded range of services & commensurate outcomes.

Que. 167. What will be the staff norms at the strengthened PHC under HWCs?

Ans. 167. As per IPHs norms.

Que. 168. What are the essential outputs of HWCs?

Ans. 168. The essential outputs of HWCs are as follows –

• HWC database
• Health cards & family health folders
• Increased access to services

Que. 169. What are the outcomes of AB-HWCs?

Ans. 169. The outcomes of AB-HWCs are as follows –

• Improved population coverage
• Reduced out of pocket expenditure & catastrophic health expenditure
• Risk factors mitigation through health promotion
• Decongestion of secondary & tertiary health facilities.

Que. 170. What are the impacts of AB-HWCs?

Ans. 170. The impacts of AB-HWCs are –

• Improved population health outcomes
• Increased responsiveness

Que. 171. What do you mean by term HWCs – progressive?

Ans. 171. HWCs which do not full fill all criteria but have only initiated expanded service delivery.

Que. 172. What are the advantages of empanelment with HWCs?

Ans. 172. The advantages are as follows –

• Trust
• Advertise HWCs
• Make HWC responsible for health of people
• Facilitate Secondary & Tertiary care through referral and linkages
• Follow up plan for treatment from higher centres
• Help monitor national programs
• Basis for payment by capitation.

Que. 173. What is the purpose of community visit by ASHAs & MPWs for community mobilization?

Ans. 173. The purpose of community visit by ASHAs & MPWs are as follows –

• Improved care seeking
• Risk assessments
• Screening
• Follow up for primary & secondary prevention
• Counselling
• Supportive environment in families /communities

Que. 174. Enlist investigations essential at HWC.

Ans. 174. Essential investigations at HWCs are as follows –

• Haemoglobin
• Urine pregnancy rapid test
• Urine dipstick – urine albumin & sugar
• Blood glucose by glucometer
• Malaria smear, RDK
• Sickle cell rapid test
• Collection of sputum samples

Que. 175. What is the norm of financing for AB-HWCs?

Ans. 175. For SHC-HWCs —- 17.54 lakh/year/unit

For rural PHC HWCs ——- 9.88 lakh/year/unit

For Urban PHC HWCs —— 15.39 lakh/year/unit

Infrastructure ————— 0-15 lakh one time

Que. 176. How much population will be covered under AB-PMJAY?

Ans. 176. Roughly 50 crore beneficiaries or 10 crore poor & vulnerable families.

Que. 177. What is the coverage of AB-PMJAY per family per year?

Ans. 177. 5 lakh rupees for secondary & tertiary care hospitalization.

Que. 178. What was the effect of introduction of MDT (Multi-Drug Therapy) in National Leprosy Eradication Program (NLEP)?

Ans. 178. Number of cases released from treatment increased progressively over the years. This factor also helped the elimination of leprosy as public health problem to achieve.

Que. 179. When was the first round of Modified Leprosy Elimination Campaign (MLEC) conducted?

Ans. 179. 1997-98.

Que. 180. How many rounds of MLEC were conducted in India?

Ans. 180. Four rounds.

Que. 181. What were the other active case detection methods in NLEP?

Ans. 181. SAPEL (Special Action Project for Elimination of Leprosy) in rural areas and LECs (leprosy Elimination campaigns) for urban areas.

Que. 182. When was the Urban Leprosy Control Program started?

Ans. 182. In 2005 in urban areas with population more than one lakh.

Que. 183. What are the important strategies for the NLEP?

Ans. 183. Important Strategies in NLEP are –

• Decentralization & Institutional development
• Strengthening & Integration of service delivery
• Disability care & prevention
• Information, Education & communication
• Training

Que. 184. When was the target of leprosy elimination achieved at National level?

Ans. 184. In Dec. 2005.

Que. 185. What do you mean by DPMR project?

Ans. 185. Disability Prevention & Medical Rehabilitation Project.

Que. 186. When was expanded program on immunization (EPI) launched by WHO?

Ans. 186. 1974.

Que. 187. Which vaccine preventable disease were covered under EPI?

Ans. 187. Six diseases e.g. Diphtheria, Pertussis, Tetanus, Polio, BCG & Measles.

Que. 188. In which year EPI was renamed as Universal Child Immunization (UCI) by UNICEF?

Ans. 188. 1985.

Que. 189. What were the objectives of EPI in India?

Ans. 189. The objectives of EPI were as follows –

• Reducing the mortality and morbidity resulting from vaccine preventable diseases of childhood.
• Achieve self-sufficiency in vaccine production.

Que. 190. When was Pulse Polio Immunization Program launched in the country?

Ans. 190. 1995.

Que. 191. When the National Water Supply & Sanitation Program was initiated?

Ans. 191. 1954.

Que. 192. What was the objective of National Water Supply & Sanitation Program?

Ans. 192. To provide safe water supply and adequate drainage facilities for both urban & rural population of the country.

Que. 193. When was Accelerated Rural Water Supply Program started?

Ans. 193. 1972.

Que. 194. What do you mean by problem village?

Ans. 194. A village where no source of safe water is available within 1.6 km distance or where water is available at a depth more than 15 meters or where is bacteriologically or chemically contaminated.

Que. 195. What is the stipulated norm of safe water supply per capita per day?

Ans. 195. 40 litres.

Que. 196. What is the coverage norm of one hand pump or spot water source?

Ans. 196. 250 persons.

Que. 197. When was swajaldhara program launched?

Ans. 197. 25^th December 2002.

Que. 198. What do you mean by Swajaldhara program?

Ans. 198. A community lead participatory program, which aims at improving safe drinking water supply in rural areas, with full ownership of the community, building awareness among the village community on the management of drinking water projects, including better hygiene practices and encouraging water conservation practices along with rain water harvesting.

Que. 199. What are the components of Swajaldhara?

Ans. 199. 2 components. 1^st component (swajaldhara 1) is for gram panchayat or a group of panchayats (at block/ tehsil level). 2^nd component (swajaldhara 2) has district as the project area.

Que. 200. When was Nirmal Bharat Abhiyaan (NBA) launched?

Ans. 200. 2012.

Que. 201. What was the objective of Nirmal Bharat Abhiyaan (NBA)?

Ans. 201. To achieve sustainable behaviour change with provision of sanitary facilities in entire communities in a phased manner.

Que. 202. What do you mean by Swachh Bharat Abhiyaan/Mission?

Ans. 202.  A national campaign by Government of India to clean streets, roads & infrastructure of the country.

Que. 203. When was Swachh Bharat Abhiyaan launched?

Ans. 203. 2^nd October 2014 by Prime Minister of India.

Que. 204. What was the aim of Swachh Bharat Abhiyaan?

Ans. 204. To eradicate open field defecation by year 2019, by constructing 12 million toilets in rural India.

Que. 205. What are the components of Swachh Bharat Abhiyaan?

Ans. 205. The components of Swachh Bharat Abhiyaan are as follows –

• Proper household toilets
• Community toilets
• Public toilets
• Solid waste management
• IEC & Public awareness
• Capacity building & administrative & office expenses.

Que. 206. When was National Program for Prevention & Control of Cancer, diabetes, cardiovascular diseases (NPCDCS) launched?

Ans. 206. 2010.

Que. 207. What are the focussed messages in NPCDCS for behaviour change?

Ans. 207. The focussed messages are –

• Increased intake of healthy foods
• Increased physical activity
• Avoidance of alcohol & tobacco
• Stress management

Que. 208. When did tobacco control legislation come into force?

Ans. 208. 2003-04.

Que. 209. When was National Tobacco Control Program launched?

Ans. 209. 2007-08.

Que. 210. Name components of National Health Mission (NHM)?

Ans. 210. National Rural Health Mission (NRHM) & National Urban Health Mission (NUHM).

Que. 211. How much annual grant is provided to Mahila Aarogya Samiti (MAS) every year by NUHM?

Ans. 211. Rs 5000/-

Que. 212. What do you mean by Village Health Sanitation & Nutrition Day (VHSND)?

Ans. 212. VHSND in rural areas is an outreach activity for promotion of maternal, reproductive & child health services.

Que. 213. When Intensified Diarrhoea Control fortnight (IDCF) is observed every year?

Ans. 213. In July – August.

Que. 214. What is the purpose of Nutritional Rehabilitation Centre (NRC)?

Ans. 214. For management of severe acute malnutrition (SAM) in children.

Que. 215. What is the other name of Ayushman Bharat (AB) – PMJAY?

Ans. 215. Ayushman Bharat National Health Protection Scheme (AB – NHSP).

Que. 216. Which is the key for India to Universal Health Coverage (UHC)?

Ans. 216. Comprehensive Primary Health Care.

Que. 217. Whether HWCs should be so located that the time to reach these facilities is no more than 30 minutes?

Ans. 217. Yes, it’s true.

Que. 218. What should be the first critical step at the initiation of HWC?

Ans. 218. Population enumeration.

Que. 219. How many investigations are essential at HWC?

Ans. 219. Seven (At PHC – 19).

Suggested Further Readings –

• Park; Park’s textbook of Preventive & Social Medicine, 26^th edition, 2021
• Mahajan & Gupta; Textbook of Preventive & Social Medicine; 4^th edition
• GoI; Ayushman Bharat Comprehensive Primary Health Care through health & wellness centres, Operational guidelines; 2018.