Public Health MCQ 1

Community diagnosis: Starts with community entry/interaction, Uses tools like participant observation, Identifies needs and demands, Guides priority setting and planning. It does not end at analysis; it proceeds to action/intervention planning.

Breaking faeco-oral transmission requires sanitation + hand hygiene. Water alone without sanitation is insufficient.

Secondary data are already existing data (reports, journals, records). Other options are primary data collection methods.

Breastfeeding: Reduces breast/ovarian cancer risk, Provides complete nutrition for 6 months, Aids maternal weight loss and Associated with higher IQ. Breast engorgement is not an advantage.

Cohort studies: Start with exposed vs unexposed, disease-free at baseline, Yield true relative risks, Observe multiple outcomes and Estimate attributable risk. Starting with diseased persons describes case-control studies.

Ivermectin is safe in: Children ?5 years or ?15 kg. It should be avoided in: Pregnant women, Early lactation and People with epilepsy or severe illness.

SAM without complications requires that the child: Is alert, Has good appetite, Has no medical complications and Has no severe oedema (+++). Being unconscious indicates a complication, so it does not fit SAM without complications.

At 18 months, children receive a booster dose of pentavalent components, including pertussis. Yellow fever: 9 months, Hepatitis B: part of pentavalent earlier, OPV: earlier doses and MenA: given later (campaigns/routine per policy)

Poorly maintained incinerators release: Dioxins and furans ? highly toxic, carcinogenic. Ash and sludge are by-products, not the primary carcinogens.

At Level A (CHPS compound) in Ghana, services are community-based and delivered mainly by Community Health Officers (CHOs) and support staff. Community Health Officers provide basic preventive and curative services. Personnel trained to take care of minor ailments are part of routine CHPS activities. Personnel to oversee the environment (e.g. Environmental Health Assistants) support sanitation and environmental health at the community level. Personnel to undertake emergency deliveries: CHOs are trained to conduct basic / emergency deliveries at CHPS level. Public Health Nurses, however, are not typically stationed at CHPS compounds. They usually work at sub-district or district levels, focusing on supervision, public health programs, and coordination rather than routine CHPS compound service delivery.

Hormonal contraception usually reduces dysmenorrhoea, not cause it. Other options are known side effects.

In management and planning: External environment = factors outside the organization (PEST: Political, Economic, Social, Technological). Other options describe internal organizational factors.

Poor storm water management causes: Flooding and mudslides, Contamination of wells and food and Unintentional injuries (drowning, falls). Intentional injuries (violence, assault) are unrelated.

Hookworm larvae penetrate bare skin, especially feet, in contaminated soil—common around abattoirs.

Multiple ministries and partners working together across sectors = intersectoral collaboration.

Success rate = 0.7. Failure rate = 1 ? 0.7 = 0.3. Probability that neither patient is cured: 0.3×0.3=0.090.3 times 0.3 = 0.090.3×0.3=0.09.

High, not low, herd immunity protects unimmunized/vulnerable groups. Herd immunity refers to community-level protection, depends on robust immunization, and is weakened by high HIV prevalence. Low herd immunity ? severe epidemics are likely.

Terminal haematuria indicates urinary schistosomiasis (Schistosoma haematobium), treated with praziquantel.

The management cycle broadly involves planning ? implementation ? monitoring/control (evaluation). Other options list management functions, not the full cycle.

Ghana has an expansive population pyramid (wide base, high fertility). Population pyramids are useful for policy planning, social amenities, and comparing populations.

For transmission to occur, components of the chain of infection must exist, including: Infectious agent, Reservoir, Portal of exit, Mode of transmission, Portal of entry and Susceptible host. The agent need not be bacterial, airborne, or vector-borne.

Port Health Officers focus on: Inspection, Vaccination, Disinfection of vessels, Referral of infected cases and Ship Sanitation Certificates. Fumigation is typically an environmental health function, not core disease surveillance.

Ghana’s population policy aims to reduce high fertility, morbidity, and mortality. Other options correctly describe projections, estimates, and policy goals. Policy was revised in 1994.

Regression is used to: Predict y from x, Quantify the relationship between variables. It does not prove causation or identify outliers primarily.

Extrinsic motivation = external rewards (money, certificates, plaques). Adoration and praise are intrinsic/non-material motivators, not extrinsic rewards.

NHIS in Ghana is not risk-rated; it is largely socially pooled. It is: Universal in nature, Established by Act 650 (2003), Covers elderly ?70 years, Includes legally resident foreign nationals (with conditions).

Landfill hazards include: Poor aesthetics, Fires, Soil contamination, Disease vectors (flies, rodents). Excessive noise is not a typical landfill hazard in peri-urban settings.

Clostridium perfringens causes food poisoning via toxin production in the intestines after ingestion. Staphylococcus aureus produces pre-formed toxins in food, not intestines.

Bilateral partners ? one country assisting another (e.g. USA ? Ghana). USAID = agency of the US government. UNICEF, UNFPA, WHO, World Bank are multilateral organizations.

This is the correct formula for old-age dependency ratio.

The Food and Drugs Authority (FDA) is the statutory body that regulates registration, manufacture, importation, and sale of herbal and alternative medicines in Ghana. Other bodies may support research or policy but do not regulate use.

Systematic sampling requires a random start (e.g. balloting). Stratified and cluster sampling are probability methods. Snowball sampling is non-probability.

To prevent faecal contamination of groundwater, wells must be: Upstream of latrines and At least 30–50 metres away. This is standard environmental health and water sanitation guidance.

Safety measures include: Tiled/non-slip floors, Ground-floor room, Easy-reach storage and Bathroom handrails. Dim lighting increases fall risk; good lighting is needed.

In positive (right) skewness: Mean>Median>Modetext{Mean} > text{Median} > text{Mode}Mean>Median>Mode.

Case–control studies: Are cheaper and quicker, Are suited for rare diseases, Are prone to recall bias and Yield odds ratios, not true relative risks.

Rodents are associated with: Lassa fever, Leptospirosis, Hantavirus and Plague. Brucellosis is mainly transmitted via livestock and unpasteurized dairy products, not rodents.

Indirect causes: HIV/AIDS, hepatitis, diabetes, cardiac disease. Sepsis is a direct obstetric cause of maternal mortality.

Aedes africanus transmits sylvatic (jungle) yellow fever, common among people working near forests. Aedes aegypti ? urban yellow fever. Plasmodium species are parasites, not vectors.

The pth percentile is the value below which p% of observations fall.

Guinea worm disease (Dracunculiasis) has been targeted for eradication. Others are controlled, not eradicated.

NHIS was introduced in 2003/2004, not the early 1990s. Cash and carry = user fees and limited access for the poor. IGF is a major funding source for public facilities.

DANIDA is a bilateral donor, not part of Ghana’s health sector structure. GHS, CHAG, military hospitals, and alternative medicine are recognized components.

In informal/unplanned settlements: Eviction risk discourages permanent structures, Appropriate interventions include: Family planning, STI prevention, Substance abuse rehabilitation and Income generation. Latrine construction may be destroyed during eviction.

Dementia is a disorder of older adults, not adolescents. Depression, suicide, truancy, and juvenile delinquency are common adolescent problems.

Copper T IUCD is non-hormonal. All other options are hormonal methods.

BEmOC includes: Parenteral anticonvulsants, Manual removal of placenta, Removal of retained products and Assisted vaginal delivery. Blood transfusion is part of Comprehensive EmOC (CEmOC), not BEmOC.

Good sampling requires: Representativeness ? reflects the population. Adequate sample size ? ensures validity and precision. Other options describe methods or conditions, not the core principles.

CHPS focuses on: Community mobilization, CHPS compounds (not hospitals/clinics), Bringing services closer to communities, Use of community volunteers. Hospitals/clinics are not constructed in every CHPS zone.

Sleeping rooms per house ? discrete count data. Weight, haemoglobin, urine volume ? continuous. Total fertility rate ? treated as continuous in analysis

Pearson’s r: Measures strength and direction of linear association, Ranges from –1 to +1 and Does not imply causation.

Palliative care: Can start early, alongside curative treatment, Is not limited to terminal stages, Involves families, volunteers, and community carers and Is related but not interchangeable with hospice care.

The law permits abortion in cases of: Rape or incest, Risk to physical or mental health and Foetal abnormality. Abortion on request alone is not permitted.

Health education focuses on information, knowledge, attitudes, and skills. Health promotion is broader and includes policies, laws, supportive environments, and inter-sectoral collaboration. Other options describe health promotion, not health education.

The four legs are: Family planning, Antenatal care, Skilled/supervised delivery and Emergency obstetric care. Primary health care before pregnancy is important but not one of the four legs.

WHO defines adolescents/teenagers as 10–19 years.

The five pillars of health promotion are: Building healthy public policy, Creating supportive environments, Strengthening community action, Developing personal skills and Re-orienting health services.

Typical funding sources include: Government of Ghana, NHIS, Donor funds and Internally Generated Funds (IGF). Philanthropy is not a typical/structured source in Ghana’s health financing.

Relevant outbreak history includes: Food and water sources, Travel history, Occupation and Physical activities. Menstrual history is irrelevant.

Shift systems reduce: Fatigue, Burnout and Stress. These are psychosocial hazards.