Introduction to Health and Public Health

(b) Kazakhstan

The International Conference on Primary Health Care was held at Alma-Ata (now Almaty) in the Kazakh SSR in September 1978, jointly organised by WHO and UNICEF. It gave the historic "Health for All by the Year 2000" declaration.

(c) Respiratory rate 56 per minute

Fast breathing is the single most reliable sign for diagnosing pneumonia in a child with cough. As per WHO/IMCI, a child aged 12 months to 5 years with cough has pneumonia if the respiratory rate is 40/min or more; 56/min in a 3-year-old therefore indicates pneumonia. Barking cough suggests croup, SpO₂ 96% is normal, and fever alone is non-specific.

(d) Emergency treatment to community member

PHC-ORC (Primary Health Care Outreach Clinic) is a periodic mobile outreach service that delivers the basic primary health care package to the community — safe motherhood, newborn and child care (including immunization and growth monitoring), family planning, and counselling/health education — along with referral of complicated cases. Emergency treatment is not part of its service package; emergency and 24-hour services are provided at health posts, primary health care centres and hospitals, to which PHC-ORC refers such cases.

(d) All of the above

Family planning aims at spacing or limiting the number of children, preventing unwanted pregnancy, and thereby improving overall reproductive health — so all three options together describe its objective.

(a) Diptheria, pertusis, tetanus, HIB and Hep B

Pentavalent vaccine (DPT–HepB–Hib) is a five-in-one vaccine that gives protection against five diseases — diphtheria, pertussis (whooping cough), tetanus, hepatitis B and Haemophilus influenzae type b (Hib) pneumonia/meningitis. In Nepal's routine immunisation schedule it is given at 6, 10 and 14 weeks of age.

(c) Health post incharge

The Health Post Management Committee is chaired by the Ward Chairperson, while the in-charge (प्रमुख) of the health post serves as its member secretary.

(d) Material management

Inventory management means the management of materials — ordering, storing, and controlling the stock of goods and supplies so that the right quantity is available at the right time without excess or shortage. Hence it is a part of material management.

(d) All of the above

Zero reporting means reporting “no cases” even when none are seen. In Nepal’s disease surveillance system (EWARS), zero reporting is required for epidemic-prone and elimination-targeted diseases such as malaria, kala-azar and cholera.

(c) Ministry of health and population

The Ministry of Health and Population (MoHP) is the apex policy-making and coordinating body of the health sector in Nepal. The Department of Health Services, provincial health directorates and district health offices all work under it as implementing tiers.

(c) NHPC

Health assistants in Nepal are registered and accredited by the Nepal Health Professional Council (NHPC), which regulates allied health professionals such as HA, staff nurse, pharmacy assistant, and lab assistant. NMC (Nepal Medical Council) accredits doctors, not health assistants.

(b) October 2017

The Health Insurance Bill was passed by the Legislature Parliament on 14 October 2017 (28 Ashoj 2074) and came into force as the Health Insurance Act, 2074, providing for insured health services through contributory health insurance.

(c) Sterilization

PHC-ORC (Primary Health Care Outreach Clinic) provides basic services such as first aid, growth monitoring, ANC check-up, immunization, family planning counselling and short-term contraceptives. Sterilization (permanent family planning method) is a surgical procedure and is not performed at the ORC — it is available only at health facilities/hospitals.

(c) Tuberculosis

Caseous necrosis is the characteristic type of necrosis seen in tuberculosis — the necrotic tissue is soft, cheese-like (caseous), and granulomatous, as in the tuberculous lung lesion and lymph nodes. Bacterial pneumonia causes fibrinopurulent exudation, not caseous necrosis.

(d) Culex mosquito

Japanese encephalitis is transmitted by the bite of infected Culex mosquitoes (mainly Culex tritaeniorhynchus), which breed in flooded rice fields and stagnant water and feed on pigs and birds as reservoir hosts.

(c) Streptococcus pneumoniae

Streptococcus pneumoniae is a gram-positive coccus that characteristically occurs in pairs (diplococci), each pair being lancet-shaped and often capsulated. Staphylococcus aureus is also gram-positive but arranges in clusters; Mycoplasma pneumoniae lacks a cell wall (so it is not classically gram-stained); and Hemophilus influenzae is a gram-negative coccobacillus.

(d) Typhoid

Pea-soup diarrhoea is classically associated with typhoid (enteric) fever. In the second week, the stool may be yellow-green, watery, and offensive, resembling pea soup. Cholera classically causes profuse, pale, watery “rice-water” stool with a fishy odour; amoebiasis causes “anchovy sauce” stool; bacterial dysentery causes bloody, mucoid stool with tenesmus.

(c) Gonorrhoea

Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae, so it is not a viral disease. Rabies (rhabdovirus), hepatitis (hepatitis viruses) and AIDS (HIV) are all caused by viruses.

(c) 0, 3, 7, 14, 28 days

Under the new national PEP guidelines, ARV is started as soon as possible (within 72 hours, ideally within 2 hours) of exposure and continued for a full 28 days. The client is followed up (ARV dispensed and reviewed) on days 0, 3, 7, 14 and 28, with HIV testing at baseline, 6 weeks, 3 months and 6 months.

(c) IgG

IgG is the most abundant immunoglobulin in serum, making up about 75–80% of total serum immunoglobulin. It is the only antibody that crosses the placenta and provides the main long-term humoral immunity.

(b) Scabies

Mites (Sarcoptes scabiei) are the vector/causative agent of scabies. Relapsing fever is transmitted by ticks and lice, filariasis by mosquitoes, and plague by fleas.

(b) Phosphate test

The phosphatase (phosphate) test detects the enzyme alkaline phosphatase in milk; this enzyme is destroyed by proper pasteurization, so its presence indicates inadequate pasteurization or recontamination. Turbidity and nitric acid tests are used for other purposes (e.g., detecting added water or formalin), not for pasteurization.

(c) Stunted

Weight for height >80% indicates the child is not wasted (normal weight relative to height), while height for age <90% indicates stunting due to chronic undernutrition. Hence the nutrition status is stunted.

(b) Fat

Fat provides about 9 kcal per gram, while carbohydrate and protein each provide about 4 kcal per gram, and vitamins yield no energy. Hence fat has the highest calorie value.