COMMUNITY HEALTH MOCK QUESTIONS - MAY 2015 ---

from CURRENT SOURCE

1. What is qualitative sampling? Give four advantages and disadvantages of qualitative

sampling. (10 marks)

Qualitative sampling – is the type of sampling done in a research that is aimed at

deepening the understanding of a scientific topic by targeting a specific group, event or
process.

Qualitative sampling is the selection of individual or group of people from a known

population to better understand them by means of interviews and further exploration of
their personal experiences, life stories, perceptions, motivations, intentions and
behaviours.

Advantages:
i) Provides depth and detail – on attitude, feelings and behaviour
ii) Creates openness – as the sample are encouraged to expand on their responses
iii) Simulates people’s individual experiences
iv) Attempts to avoid pre-judgement

Disadvantages:

i) Data collection is time-consuming

ii) Tends to be impossible to generalize research findings since the sample size is
usually small
iii) Data collection largely depends on the skills of the researcher e.g. in contacting
interviews
iv) Difficulty in making systematic comparisons – due to the varying and highly
subjective responses of people interviewed

2. Define CHPS. Give three (3) scenarios of CHPS in action. (10 marks)
 CHPS – stands for Community-Based Health Planning and Services and it is a health
strategy to deliver essential health services to communities --- objectives are to
improve access to health services; improve efficiency and responsiveness to client
needs & develop effective inter-sector collaboration

Scenarios of CHPS in action:

1. Urban Centre settings – Assigning staff to defined communities – geographically

or social-cultural groupings
2. Medium to large communities – Placing more than one staff but still using CHPS
approach
3. Small communities - One staff responsible for more than one community.

3. List 5 sources of demographic data (5 marks)

Traditional Sources

i. Census
ii. Vital registration system
iii. Sample surverys

Non-Traditional Sources
I) Immigration office registers
II) School registers
III) Parish registers
IV) Maternity clinics
V) Social security files

4. Describe the following: (20 marks)

a. Purposive sampling – is a non-probability sample that is selected based on specific
CHARACTERICS of the population and the OBJECTIVE of the study. It is also known
as judgmental, selective or subjective sampling.
 b. Placebo – is a medication that doesn’t contain an active agent, and as such has no
pharmacological effect, but is given to a patient who supposes it to be medicine.

c. Informed consent – is permission granted in full knowledge of the possible

consequences when one is about to undertaking an action or get a particular
treatment.

d. Sample size – refers to the individual pieces of data collected in a survey or the
subset of a population under study that is included in a research.

e. Institution review board – also known as the Independent Ethics Committee or

Research Ethics board – is a type of committee used to approve, monitor and
review behavioral and biomedical research involving humans, and it ensures that
appropriate steps are taken to protect the rights and welfare of humans
participating as subjects in a research study.

5. Measures to reduce maternal mortality in your district (10 marks).

Use primary, secondary and tertiary prevention ideas as a guide

Primary (Education, Antenatal care, Skilled delivery)

Secondary (Training health workers on early identification and high-risk pregnancies)

Tertiary (Prompt management of complications in pregnancy; Stabilizing patients before

referral to near and higher facilities for care)

Primordial: Good nutrition, education.

6. Define maternal mortality. What are the MDGS associated with maternal mortality?
Importance of maternal mortality in public health. (10 marks)

Maternal mortality - the number of female deaths per 100,000 live births from any cause
related to or aggravated by pregnancy, delivery or management within 42 days of giving
birth, excluding accidental or incidental causes, in a year.

MDGs associated with maternal mortality – Millennium Development Goal 5

 IMPORTANCE OF MATERNAL MORTALITY IN PUBLIC HEALTH – (effects of maternal
deaths?)
*Increases risk of neonatal morbidity and mortality – due to breastfeeding issues,
less neonatal bonding, risk of hypothermia and adverse effects on the general well-being
of the newborn
*Single parenthood and increasing numbers of orphans – challenges in the up-
bringing of children whose mothers are dead; associated issues including psychological,
emotional and social health challenges

7. List 4 fat soluble and 4 water soluble vitamins and explain why they are important (10
marks).
FAT SOLUBLE VITAMINS – A D E K // K A D E
WATER SOLUBLE VITAMINS – B1(Thiamine), B2(Riboflavin), B3(Niacin), Pantothenic acid,
Folate, B6, B12, Biotin, Vitamin C

8. Health implications of festivals (10 marks)

i. Alcohol abuse
ii. Unprotected sex
iii. Noise pollution
iv. Rowdiness & Hooliganism
v. Smoking & illicit drug use
vi. RTAs
vii. Increased theft cases
viii. Littering
ix. Spread of infections
x. STIs

9. Comment on the following (10 marks)

a. Control – disease control is a reduction in the INCIDENCE, PREVALENCE,
MORBIDITY and MORTALITY of an infectious disease to a locally acceptable level
b. Elimination – is the reduction TO ZERO of the INCIDENCE of disease or infection in a
defined geographical area
c. Eradication – is the PERMANENT reduction to ZERO of the worldwide incidence of
an infection e.g. small pox
 d. Extinction – the specific infectious agent no longer exists in nature or in the
laboratory

10. What is sample size? Give two types of sampling techniques (5 marks).
SAMPLE SIZE - refers to the individual pieces of data collected in a survey or the
subset of a population under study that is included in a research.

TYPES OF SAMPLING TECHNIQUES/METHODS:

a. Probability sampling – Simple random, Systematic, Stratified, Multiphasic,

Cluster
b. Non probability sampling – Purposive, Convenience and Quota
SECTION A

1. Ghana is ranked among the top 65 countries with high maternal and neonatal mortalities.
a. List direct causes of neonatal deaths
i. Low birth weight & prematurity
ii. Congenital anomalies
iii. Birth Asphyxia
iv. Birth Injuries
v. Neonatal Sepsis

b. Give and briefly write about 6 interventions put in place to curb the deaths which
can even be used in resource lacking areas.

Low birth weight & prematurity Antenatal care

Congenital anomalies Health Promotion (Education) on pre-

conception care and against teratogenic
agents in women expecting to get pregnant
Birth Asphyxia Antenatal care and delivery by skilled
health personnel
Birth Injuries Antenatal care and delivery by skilled
health personnel
Neonatal Sepsis Health workers in the neonatal unit should
practise regular hand-washing

Over-crowding is to be avoided in the unit

since this increases the risk of infections

2. State MDGs 4, 5 and 6. Target 6a of MDG 6 is to halt and begin to reverse the spread of
HIV/AIDS. Ghana is on course to achieve MDG 6. What strategies are being put in place to
achieve this target by 2015.

1. Eradicate extreme hunger and poverty

2. Achieve universal primary education
3. Promote gender equality and women empowerment
4. Reduce child mortality
5. Improve maternal health
 6. Combat HIV/AIDS, Malaria and other diseases
7. Ensure Environmental Sustainability
8. Develop Global partnerships for development

Combact HIV/AIDS in Ghana:… achieving targets by 2015

SECTION B

1. List three (3) occupational hazards that would be associated with a tomato farmer in Tono,
Upper East Region.
i. Snake bite
ii. Trauma/Injury from a farm/working tools e.g. cut by a cutlass
iii. Pesticide (chemical)poisoning
iv. Low back pain (from continual bending to work)
v. Hernia (from working activities that increase intraabdominal pressure)
vi. Helminth infection (hookworm)
vii. Accidental gunshot injuries

2. List three components of a health system and briefly describe two them

Hospitals/Health facilities – the institutions in which healthcare is given

Patients/People – individuals who are ill and are seeking healthcare and wellness

Health workers – Professionals who regulate the provision of healthcare to appropriate

patients based on their needs

3. The Kwahu North district in Ghana had a projected population of 149,734 in 2007 with an
growth rate of 1.4%
a. Project the population for 2015
i. Population in 2007 (P2007) = Po = 149,734
Rate of population growth = R = 1.4 % = 1.4/100

Population in 2015 = Pr;

Time (T) is 8 years from 2007

Pt = Po x eRT = 167,479.4
 (NB: e is log inverse)
b. How many years will it take for the population to double
i. Population Doubling time (Tpd) ,3
¿2
Rate
Tpd = of = 49.5105129 years
Population growth

c. Briefly describe the expected population structure of this district

A population that is expected to double in 49.51 years…

4. Industrial emissions and products threaten the global environment more recently, concern
about climatic change has emerged since the combustion of fossil fuels which account for
nearly 90% of the world’s commercial energy production, is the largest source of the so
called green house gases. Write short notes on the following
a. Global warming
b. Green house gases
c. Ozone layer depletion
d. Acid rain

Global warming Global warming refers to the general increase in the ambient temperature
of the environment which has mainly been attributed to the Greenhouse
gas emissions. This is manifested by the Melting of ice, Flooding of low lying
areas and the Heat stroke.
Greenhouse gases Greenhouse gases are gases produced from fossil fuel combustion which
absorbs and emits radiation within the thermal (infra-red) range &
prevents heat loss from the earth’s surface. Eg: Carbondioxide, Methane,
Water vapour, Nitrous Oxide
Ozone layer This simply refers to the loss of the ozone layer that has been attributed to
depletion Chlorofluorocarbons in foams, old fridges and aerosol which get into the
earth’s atmosphere. The Ozone layer protects the earth from harmful
solar radiation and as such it’s depletion is of much global concern
Acid rain Acid rain is the type of rain that is produced from the reaction of water
molecules in the atmosphere with acidic gases such as Nitrous Oxide and
 Sulphur Dioxide. Acid rain leads to the destruction of land, forest,
buildings and has been associated with airway disease

5. Respiratory rate of 3500 children under one year was measured at the CWC with the
following results: mean = 55cpm, SD = 10cpm. If the respiratory rate has a normal
distribution, determine
a. 95% and

Confidence Interval (95%) =

?? Point estimate (x) +/- Reliability Co-efficient x Standard error

CI95%= Mean +/- 1.96*(SEM)

Mean = 55, SD = 10, n = 3500

Standard error of the mean (SEM) = SD/sqrt(n) = 10/ sqrt (3500) = 10/ 59.2 = 0.17

CI95%= Mean +/- 1.96*(SEM)

= 55 +/- 1.96 * 0.17

= 55 +/- 0.33

Upper confidence limit = 55. 3

Lower confidence limit = 54.7

b. 99% confidence interval.

CI99%= Mean +/- 2.576*(SEM)

6. A mother with 6 months old infant requires advice on complementary feeding, briefly
describe how you would handle such an encounter.

 continue frequent, on-demand breastfeeding until 2 years of age or beyond;

  practise responsive feeding (for example, feed infants directly and assist older children. Feed
slowly and patiently, encourage them to eat but do not force them, talk to the child and
maintain eye contact);
 practise good hygiene and proper food handling;
 start at 6 months with small amounts of food and increase gradually as the child gets older;
 gradually increase food consistency and variety;
 increase the number of times that the child is fed: 2–3 meals per day for infants 6–8 months
of age and 3–4 meals per day for infants 9–23 months of age, with 1–2 additional snacks as
required;
 use fortified complementary foods or vitamin-mineral supplements as needed; and
 during illness, increase fluid intake including more breastfeeding, and offer soft, favourite
foods

…Exclusive breastfeeding is advised…

7. List three epidemiological methods. Cite one advantage and one disadvantage of each
method listed.

DAE

Descriptive Cheap ?Can’t do analysis

Results may change over time
Analytical Economical Time-consuming e.g. Cohort
studies
Experimental Very accurate & with reliable Laborious & Expensive
results

8. Describe the information about growth and body composition that the following indices give
with reference to the nutritional status of children under 5
a. Height for age

STUNTED – determinant of chronic malnutrition – that measures the height of a

child of a particular age and sex, and compares it with the height of other children
of the same age and sex

b. Weight for height

WASTED (a form of acute malnutrition) – that is based on the weight of a child of a

particular height and sex as compared to other children of the same age and
 sex….calculated in Standard Deviations – a SD below -2 signifies moderate
malnutrition & below -3 signifies severe malnutrition. Normal: -2 to 2

c. Weight for age

UNDERWEIGHT (a form of acute malnutrition) – that is based on the weight of a

child of a particular age and sex as compared to other children of the same age
and sex….calculated in standard deviations – a SD below -2 signifies moderate… &
below -3 signifies severe

9. Explain the following terms

a. De facto census – (in fact, whether by right or not) – is the type of census in which
there is the ENUMERATION of all persons present in a household at the time of
census, including all who are not usual residents of the household.

b. Total fertility rate – the average number of children that would be born to a
woman over her lifetime if:

i. she were to experience the exact current age-specific fertility rates through
her lifetime and,
ii. she were to survive from birth through the end of her reproductive life

The age-specific fertility rates is:

Number of live births in a year per 1000 women in each of the 7 age groups (15 – 49)
at 5 year intervals: ie 15 – 19, 20 – 24, 25 – 29, 30 – 34, 35 – 39, 40 – 44, 45 – 49)
B x∗1000
ASFR (fi) =
Wx
Bx is number of live births in X(a particular age group)
Wx is number of women in age group

c. Demographic transition – refers to the transition from high birth and death rates
TO lower birth and death rates as a country or region develops from a pre-
industrial to an industrialized economic system
 d. De jure census – (by right) means the ENUMERATION of all individuals who usually
live in a household whether they are present or not.

e. Measures of central tendency – refers three (3) main measures: the mode, median
and mean (arithmetic and geometric mean). All of these measures describe a
different indication of the typical or central value of a distribution.

f. Measures of dispersion – dispersion is also called variability, scatter or spread –

describe the extent to which a distribution is stretched (broadened) or squeezed
(narrowed). The measures of dispersion include the variance, standard deviation,
range and the interquartile range.

10. Screening is the best tool…………………………………………

a. List the different types of screening
1. Mass screening (of the whole population)
2. High risk/Selective (of groups with specific exposure OR high risk
groups on the basis of epidemiologic research)
3. Targeted screening
4. Multiphasic screening (application of two or more screening tests
to a population at one time)
5. Opportunistic or case-finding screening (done when a patient
consults a health practitioner for some other purpose)

b. List the components of screening test

c. Three examples of diseases for which screening tests are undertaken

Tuberculosis, Hepatitis B, Diabetes Mellitus, Hypertension, Breast cancer,
Cervical cancer, prostate cancer, COVID-19, HIV

11. What are the key duties of port health?

Enforce Maritime and International Health regulations
Ensuring good hygiene at the ports
Food safety by sample testing
 Disinfection and de-infestation of the ports and arriving ships
Vaccination of crews and prospective travelers

Interpret the following

a. QL flag – signifies that a vessel is infected i.e. there has been a case of an infectious
disease for less than 5 days on board.

b. QQ flag – signifies that a vessel is suspected to have an infection on-board i.e.

there has been a case or cases of an infectious disease for more than 5 days or there
has been unusual death of rodents on board

12. What are the major direct causes of neonatal mortality in Ghana?
Low birth weight and prematurity
Severe Congenital Malformations
Birth asphyxia
Birth injuries
Neonatal infections/ Neonatal sepsis/ Neonatal tetanus

List any 4 of the interventions documented to contribute to newborn survival during labour,
delivery and first 2 hours of life
1. Delivery by skilled personnel
2. Active Management of the Third Stage of labour – Oxytocin
injection and controlled cord traction to deliver the placenta
3. Breastfeeding within the first 30 minutes after delivery
4. APGAR score of the newborn, prompt resuscitation and transfer to
the mother-baby unit

13. List members of DHMT and give a brief account of the functions of the team.
-district health officer
-public health nurse
-hospital administrator
-nutritionist
-environmental health officer.
14. Health care seeking behavior. Short notes on
a. Sickness and where Ghanaians seek treatment
Sickness refers to the alteration of physical, mental, psychological, emotional &
social well-being.

Ghanaians seek healing from mainstream health facilities, herbal healing and
spiritual healing centres. This health seeking behaviour is influenced by a number
of factors including availability, accessibility, acceptability, affordability and
appropriateness…

b. Sick role concept – This refers to the social aspect of falling ill and includes the
privileges and obligations accompanying it. For example a sick person is
considered as a sanctioned deviant & a non-productive member of the society. As
such they are given care and assistance by close relations. They are also exempted
from some customary rites. They are however expected to seek intervention from
health professionals.

The sick role involves four elements: two (2) are Rights and the other two (2) are
obligations.
The rights of the sick role:
Exemption from normal social obligations such as attending work or fully
engaged in family activities
The sick person should not be blamed because he/she can nothing about the sick
role (it absolves the person from any blame)

Obligations of the sick role:

The sick person must accept that their current situation is undesirable and should
seek to get well as soon as possible
The sick person must seek professional help and cooperate with the
medical profession to get better

15. Distinguish between the following

 a. Current cross-sectional studies - it is a DESCRIPTIVE study that examines the
relationship between a disease (or other health related state) & other variables of
interest
As they exist in a DEFINED POPULATION at a SINGLE POINT in TIME or over a
period

b. Case control study – it is an ANALYTICAL study in which there are cases (individuals
with a disease) and controls (individuals without a disease) WITH the goal of
investigating the POSSIBLE EXISTENCE of an ASSOCIATION between exposure to
risk factors and the disease of interest

c. Before and after study – a study in which outcomes are measured before an
intervention is implemented and compared with outcomes measured afterwards

d. Cohort study – it is an ANALYTICAL study

In which a group or groups of individuals to be studied share a common attribute
They are followed up to determine disease occurrence
And information on disease occurrence is related to exposure status

e. Here and there study.

f. Prevalence study

16. What is the most essential tool for health service planning?

Briefly describe the basic steps in planning process.

1. Situation analysis,
2. prioritization of needs,
3. setting objectives,
4. formulating strategies
5. Choosing strategies,
6. developing an action plan,
7. Budgeting
 8. Implementation,
9. Monitoring
10. Evaluation

17. List the stages involved in the treatment of water for an urban place such as Kumasi
metropolis –
1)IMPOUNDING 2.SCREENING 3.AERATION i, 4)COAGULTION 5. FLOCCULATION 6.
SEDIMENTATION, 7) FILTRATION, 8) DISINFECTION, 9) STORGE 10. LAB ANALYSIS 11.
TRANSMISSION 12. WATER QUALITY SULPHONATION

If asked to write short notes…

IMPOUNDING—When water is dammed to get enough for the year

SCREENING—Sieving water to remove large particles from it

ABSTRACTION: pumping of water to the treatment site

Aeration - involves the removal of excess gases to cure the oxygen deficiency.
Improve taste by removing Hydrogen Sulfide (H2S) and the volatile taste and odour
producing waste from algae

COAGULATION: polymer or aluminium sulphate (alum) is incorperated into the

water to bind all minute particles together to produce flocs

Sedimentation & Flocculation: the driving unit of the dividing chamber pulls flocs
from the walls and pulls them together allowing them to come together by aglomenition,
and the sediments released into the troughs.

Filtration - getting rid of flocculated material can be by Rapid Sand Filtration (0.45
to 1m thickness at a rate of over 5m/h under gravity and pressure/EXPENSIVE) or Slow
Sand Filtration (0.6 to 0.9m thickness at the rate of over 0.2m/h - simple, easily set up and
cheap)

Disinfection (& Breakpoint chlorination) - involves the addition of Chloride or lime

as a disinfectant & kills pathogenic organisms in water and improves taste
 Sulphonation – this refers to the addition of sulphur dioxide to remove excess Chloride.
Weekly samples of tap water are also tested for Chloride levels. Not always done
LAB ANALYSIS: three min analysis re done—physical, chemical, and bacteriological according
to the who standard

18. Define the following terms

a. Maternal mortality rate – number of maternal deaths during a given year per
100,000 women of reproductive age
b. Maternal mortality ratio – number of maternal deaths during a given year per
100,000 live births during the same period

c. Life expectancy – the average number of years that a person can expect to live in
specific region

d. Neonatal mortality – the number of deaths during the first 28 days of life per 1000
live births in a year.

19. Components of reproductive health under the Ghana Health Service

Safe motherhood
Family planning
P & M of unsafe abortion and post-abortion care

P & M of Reproductive Tract Infections including STIs

P & M of Infertility
P & M of Cancers of the reproductive systems in Male e.g. testicular and Female e.g.
Breast
Responding to concerns about Menopause and Andropause
Discouragement of harmful traditional practices and gender-based violence
Information education and counselling (IEC) on human sexuality, responsible sexual
behavior and parenthood pre-conceptual care and sexual health

20. Briefly outline the steps in organizing health education on personal hygiene for school
children in Ejisu.
21. Write short notes on the following
a. Prevention of hookworm infestation

-Avoid walking barefoot in areas where hookworm is common & where

there may be human fecal contamination of the soil

-Avoid all other skin contact with and ingesting contaminated soil

-Avoid outdoor defecation

-Establish effective sewage disposal systems

-treating infected people with anti-helminthic medications

b. Transmission of schistosomiasis
i. Contamination of freshwater by schistosoma eggs when infected people
urinate or defecate in the water
ii. The eggs hatch into MIRACIDIA which enter, develop and multiply in
freshwater snails into CERCARIA
iii. The CERCARIA leave the snail and enter the water where it can survive for
about 48 hours
iv. The CERCARIA penetrate the skins of persons who are swimming, bathing
or washing in the contaminated water
v. The parasite eventually mature into Adult worms, residing in blood vessels
of the body (mainly the hepatic portal vein) where the females produce
eggs
vi. Some of the eggs travel into the bladder or intestine and are passed into
urine or stool

c. Herd immunity
 Is a RESISTANCE to the spread of a contagious disease within a population
that results IF A SUFFICIENTLY HIGH PROPORTION OF INDIVIDUALS ARE
IMMUNE TO THE DISEASE, especially through vaccination

MORE highlights:

22. EPIDEMIOLOGY –
Is the study of the Distribution, Determinants, Pattern & Burden of disease
In a particular group of people, in a geographical area and in a specified time

23. FACTORS AFFECTING THE UTILIZATION OF HEALTH FACILITIES:

VC – F – CP
Availability, accessibility, affordability, acceptability, appropriateness

24. Define Surveillance & State uses.

Is a systematic, constant, ongoing and uninterrupted COLLECTION, ANALYSIS and

TRANSMISSION of relevant data with a feedback measure in place to gain INFORMATION
FOR ACTION, monitor trends and forecast epidemics. Types of Surveillance include Active
Surveillance, Passive Surveillance & Disease Notification…

Uses of Surveillance:
1. Priority setting (based on information for action)
2. Resources mobilization & allocation
3. Prediction & early detection of epidemics – for early and adequate response to the
epidemics
4. Monitoring & evaluating of intervention programme

25. DIFFERENTIALS OF YELLOW FEVER – control is by vaccination & surveillance

a. Leptospirosis
b. Louse-borne Relapsing fever
c. Ebola
d. Malaria
 e. Typhoid
f. Viral hepatitis

26. CONTROL GUINEA WORM:

a. Primordial – government to ensure the provision of safe-drinking water nation-wide
b. Primary – vector control (with Abate, a copecide, monthly); Education
c. Secondary – Volunteers to find and treat infected cases; Follow-up on suspected
cases; Monthly notification/Reports based on active surveillance
27. COMPONENTS OF DOTS STRATEGY for PTB control in Ghana/// COMPONENTS of STOP TB
strategy

DOTS
1 Political commitment for increased &
sustained financing
2 Case Detection with lab inv.
3 Standardization of treatment
4 System of Regular Uninterrupted supply of
Anti-TB Drugs
5 Standardized Recording & Reporting
System
STOP TB
1 Pursue high quality DOTS expansion &
enhancement
2 Address TB-HIV co-infection, MDR-TB &
the Needs of poor and vulnerable
populations
3 Contribute health system strengthening on
primary health care
4 Engage all care providers
5 Empower people with TB & communities
through partnership
6 Enable and promote research

28. HISTORY

Louis Pasteur Introduced the concept of pasteurization as

John Snow (father of epidemiology)
Ronald Ross
Edward Jenner (father of immunology)
a food processing method
Formulated and tested hypothesis
concerning the origins of CHOLERA
Found the association between Mosquitoes
and Malaria
Pioneered the concept of vaccination with
 small pox vaccine

29. NATIONAL EPI POLICY

Baccilus Calmette Guerin at birth
Oral Polio vaccine at birth, 6, 10, 14 weeks
Pentavaccine at 6, 10, 14 weeks
Pneumococcal vaccine at 6, 10, 14 weeks
Rotavirus at 6, 10 weeks
Mealses at 9 months & 18 months (Mothers obtain a bed-net at 18 months)
Yellow Fever at 9 months

Vitamin A also given every 6 months till 5 years

And every woman of child-bearing age should receive 5 doses of Tetanus toxoid –
Schedule?

BCG – intradermal
Pentavacccine, Yellow fever, measles – Intramuscular

30. STORAGE OF VACCINES:

Storage is based on the Cold Chain –
Duration & Temperature:
6 months at the National level, 3 months at the Regional level – OPV is kept between -15 to -
25 degrees Celsius & the rest at 2 – 8 degrees Celsius

1 month at the District level & Health centres – all vaccines are kept at 2 – 8 degrees Celsius

31. COMPONENTS OF AN EFFECTIVE COMMUNICABLE DISEASE CONTROL PROGRAMME:

a. Surveillance
b. Epidemiology
c. Diagnosis
d. Treatment
e. Environmental change
f. Legislation
 g. Antibiotic therapy
h. Immunization
i. Chemoprophylaxis
j. Education
k. Vector Control

32. REASONS for failure of a health education campaign

‘the campaign plan itself’ ‘the people’

Lack of understanding of target population Low literacy level of target population

Poor content Language barrier
Lack of follow-up from providers Lack of co-operation from community
leaders

33. INVESTIGATING A SUSPECTED OUTBREAK in an institution. HOW?

a. PREPARE for fieldwork (research about the disease and gather logistics)
b. ESTABLISH the EXISTENCE of the outbreak
c. VERIFY DIAGNOSIS with appropriate tests
d. Define and identify the CAUSES
e. DESCRIBE and ORIENT data in terms of person, place and time
f. Develop a HYPOTHESIS
g. EVALUATE the hypothesis
h. REFINE the hypothesis & carry out additional studies
i. IMPLEMENT control & preventive measures
j. COMMUNICATE your findings (with appropriate authority and health directorates)

34. INTERVENTIONS IN AN OUTBREAK – OF MEASLES:

a. Isolation
b. Serological confirmation
c. Treatment of isolated individuals
 d. Quarantine non-infected individuals in another location

e. Vaccinate – everyone who hasn’t had measles vaccination in 10 years prior to

outbreak

35. CSM outbreak – measures to limit outbreak:

a. Early detection & Treatment
b. Chemoprophylaxis
c. Mass vaccination
d. Education on good ventilation & prevention of over-crowding

36. SCREENING:
a. Positive predictive value – Proportion of subjects with positive test results who are
correctly diagnosed (True / True + False)
b. Negative predictive value – Proportion of subjects with negative tests results who
are actually negative (True/ True + False)
c. PRE-EMPLOYMENT medical exam:
i. Determine suitability of a job
ii. Detect untreated/asymptomatic pathological conditions
iii. Provide baseline for future medical reviews

37. NUTRIENT DEFICIENCIES

Vitamin A Xerophthalmia, Night blindness, Follicular

hyperkeratosis
Vitamin C Scurvy
Iodine Goitre, Cretinism
Iron Microcytic anaemia, pica disorder
Protein Marasmus, Marasmic Kwashiorkor

38. MICRONUTRIENT deficiency of public health importance in Ghana

Iron, Folate Vitamin A Iodine Zinc

39. NUTRIENTS IN
a. Orange – Vitamin C, Carbohydrates
b. Palm oil – Vitamin A, Fatty acids
c. Banana – Potassium, Carbohydrates
d. Snails – Proteins

40. CLASSIFICATION of RISK FACTORS

a. Modifiable (…),
b. Non-modifiable (Age, Sex, Genes – Race and family hx)
c. Modifiable but not easily amendable to change / Intermediate (Co-morbidities)

41. FACTORS INFLUENCING TEENAGE PREGNANCY

Poverty, lack of parental guidance, level of formal education, inadequate sex education, peer
pressure

42. ENVIRONMENT:
a. Characteristics of a good house:
i. Suitable material
ii. Adequate Space
iii. Good ventilation
iv. Cooking facilities
v. Storage room
vi. Excreta & other waste disposal facility
vii. Access to potable water
viii. Bathroom & toilet facility

43. OCCUPATION HAZARDS- auto-mechanic

Trauma, Chemical, Biological, Psychological

44. 4 methods of waste disposal:

a. Crude tipping
b. Controlled tipping
c. Incineration (challenge of global warming)
d. Pulverization (render into powdered form)
45. RATES
a. Stillbirth – Number of foetal deaths DIVIDED BY the Sum of livebirths AND foetal
deaths; occurring in the same population during the same time period
b. Causes of STILLBIRTH
i. MOTHER: DM, Eclampsia, Syphillis, Rhesus Incompatibility
ii. FOETUS: Chromosomal abnormalities, IUGR, Placenta abruption
c. THE USE OF VITAL STATISTICS?
d. CASE FATALITY RATE –
e. CRUDE DEATH RATE –
f. Secondary Attack Rate –a measure of the number of new cases among contacts of
the primary cases (during a period) DIVIDED BY the total number of contacts

46. MANAGEMENT
A. DIFFERENCE between EVALUATION, MONITORING, SUPERVISION

EVALUATION MONITORING SUPERVISION

To assess The process of following up The process of following up

the VALUE OR IMPACT OF the implementation of the implementation of
AN INTERVENTION planned activities to ensure planned activities to ensure
maximum outcomes maximum outcomes
to measure the outcome
against an expected
standard Based on TiGO – targets, That focuses on SKILL &
goals and objectives PERFORMANCE
Types:
Formative
Summative

B. SWOT ANALYSIS: Strengths, Weaknesses, Opportunities, Threats

C. SMART: Specific, Measurable, Achievable, Realistic, Time-bound
D. CORE FUNCTIONS OF MG’T:
a. Coordination, Evaluation, Financial mg’t
 b. Planning, Organizing
c. Staffing, Supervision
d. Guiding, Monitoring
e. Ordering & storing
f. Recording & Reporting

E. FUNCTIONS OF DISTRICT DIRECTORATE OF HEALTH SERVICES:…. As above..

47. STATS /POPULATION

A. Stable Population:
Closed to migration
Subject to unchanging age specific fertility & mortality rates
It attains a fixed age structure with proportions remaining the same &
grows at the same rate
B. Young Population:
Characterised by a High Fertility Rate
That is translated into a High Birth Rate
& the age structure is Characterised by a wide base

48. PUBLIC HEALTH IMPORTANCE OF:

a. Alcoholism –
Increased risk of Chronic liver disease
Mental Health problems
Risky sexual behaviour
RTAs from drunk-driving
Absenteeism
Broken homes