Community Health II: Main Exam, 20 November 2018
Mount Kenya University · Department of Environmental Health · Certificate in Health Records and Information Technology · CPH2301
Community Health II (CPH2301) Mount Kenya University 2018-2019 past paper with model answers.
Instructions: ANSWER ALL QUESTION IN SECTION A AND ANY TWO IN SECTION B
INSTRUCTIONS
ANSWER ALL QUESTION IN SECTION A AND ANY TWO IN SECTION B
SECTION A: (40 marks)
1. Outline five Components of maternal child health. (5 marks)
Model answer
- Health promotion: education on nutrition, hygiene and family planning
- Disease prevention: immunisation, antenatal screening and malaria prophylaxis
- Curative care: treatment of maternal and child illnesses, obstetric emergencies
- Rehabilitation: post‑natal physiotherapy, growth monitoring and early intervention
- Support services: psychosocial counselling, community health worker visits and referral networks
2. Describe the Criteria of mother child health. (5 marks)
Model answer
- Accessibility – services must be physically reachable and affordable
- Acceptability – culturally appropriate, respectful of beliefs and gender norms
- Quality – competent staff, adequate equipment and evidence‑based protocols
- Continuity – seamless care from pre‑pregnancy through post‑natal period
- Equity – no discrimination; all mothers and children receive needed care
3. Illustrate Maternity Cycle. (5 marks)
Model answer
- Pre‑conception – health optimisation before pregnancy
- Antenatal – regular visits, screening and health education
- Intrapartum – labour monitoring, safe delivery and emergency care
- Immediate post‑natal – mother‑baby bonding, breastfeeding support, newborn assessment
- Post‑natal – follow‑up visits, immunisation schedule, family planning
4. Describe the components of antenatal care. (5 marks)
Model answer
- Risk assessment – medical history, obstetric history and physical exam
- Health education – nutrition, danger signs, birth preparedness
- Screening tests – blood pressure, haemoglobin, HIV, syphilis, urine analysis
- Preventive interventions – iron/folic acid supplementation, tetanus toxoid, malaria prophylaxis
- Psychosocial support – counselling, referral for high‑risk cases
5. List five high-risk mothers in maternal child health. (5 marks)
Model answer
- Mothers aged <20 years
- Mothers aged >35 years
- Mothers with pre‑existing medical conditions (e.g., hypertension, diabetes, HIV)
- Mothers with a history of previous obstetric complications (e.g., pre‑eclampsia, stillbirth)
- Mothers with low socioeconomic status or poor nutrition
6. Describe the factors affecting health seeking behavior in the community. (5 marks)
Model answer
- Socio‑economic status – income, education and occupation influence ability to seek care
- Cultural beliefs – traditional practices, gender roles and perceived causes of illness
- Accessibility – distance to health facility, transport availability and cost
- Perceived quality – trust in health workers, past experiences and facility reputation
- Health knowledge – awareness of symptoms, benefits of early care and available services
7. Illustrate the factors influencing family size in Kenya. (5 marks)
Model answer
- Economic factors: income level, cost of living, and employment opportunities influence how many children a family can afford.
- Cultural and religious beliefs: traditions valuing large families and religious teachings on contraception.
- Education: higher education, especially of women, is associated with smaller family size.
- Access to family planning services: availability and use of contraceptives reduce desired family size.
- Health considerations: child mortality rates and maternal health affect decisions on number of children.
8. Identify any five determinants of disease. (5 marks)
Model answer
- Biological factors: genetics, age, and immunity.
- Environmental factors: climate, pollution, and housing conditions.
- Behavioural factors: diet, smoking, alcohol use, physical inactivity.
- Socio‑economic factors: income, education, occupation.
- Health‑care system factors: access to preventive services, quality of care.
SECTION B
9. Discuss the major child health problems. (15 marks)
Model answer
- Malnutrition: acute and chronic under‑nutrition, micronutrient deficiencies (e.g., vitamin A, iron).
- Respiratory infections: pneumonia and bronchiolitis, leading cause of under‑5 mortality.
- Diarrhoeal diseases: caused by unsafe water, poor sanitation, and inadequate hygiene.
- Malaria: endemic in many regions, severe in children under five.
- HIV/AIDS: mother‑to‑child transmission and opportunistic infections.
- Vaccine‑preventable diseases: measles, pertussis, and diphtheria outbreaks.
- Birth injuries and congenital anomalies: complications during delivery, neural tube defects.
- Oral health problems: early childhood caries affecting nutrition and growth.
- Neglected tropical diseases: schistosomiasis, soil‑transmitted helminths.
- Injury and accidents: drowning, burns, road traffic injuries.
- Mental health issues: early childhood trauma, developmental delays.
- Growth monitoring failures: lack of regular assessment leading to missed interventions.
- Immunisation gaps: low coverage increasing susceptibility to preventable diseases.
- Water‑borne diseases: cholera outbreaks in flood‑prone areas.
- Socio‑economic determinants: poverty, low parental education, and limited health‑seeking behaviour.
10. Discuss the purpose of conducting community diagnosis. (15 marks)
Model answer
- Identify health needs: determine the most pressing health problems and priorities of the community.
- Resource allocation: guide efficient use of limited financial, human, and material resources.
- Program planning: provide baseline data for designing appropriate health promotion and disease‑prevention interventions.
- Community participation: engage residents in recognizing their own health issues, fostering ownership.
- Policy development: supply evidence for local health policies, regulations, and legislation.
- Monitoring and evaluation: establish benchmarks to assess impact of interventions over time.
- Risk identification: detect emerging health threats and vulnerable groups.
- Inter‑sectoral collaboration: highlight need for cooperation between health, education, agriculture, and other sectors.
- Advocacy: generate data to advocate for funding and support from government and NGOs.
- Capacity building: reveal gaps in skills and infrastructure that require training or upgrades.
- Improved health equity: pinpoint disparities to target interventions for marginalized populations.
- Strategic planning: assist in setting realistic, measurable objectives and timelines.
- Community empowerment: promote self‑assessment and problem‑solving within the community.
- Evidence‑based decision making: ensure actions are grounded in reliable local data.
- Sustainability: facilitate long‑term planning by understanding community trends and resources.
11. Enumerate and discuss responsibilities individuals and local authorities in controlling endemic diseases. (15 marks)
Model answer
- Individuals
- Health education: adopt healthy behaviours (nutrition, hygiene, safe water use).
- Personal protection: use insecticide‑treated nets, wear protective clothing, practice safe sex.
- Early health‑seeking: report symptoms promptly and adhere to treatment regimens.
- Environmental hygiene: keep surroundings clean, eliminate stagnant water, proper waste disposal.
- Community participation: join local health committees and support vector‑control campaigns.
- Local authorities
- Surveillance and reporting: establish disease‑monitoring systems and timely notification of cases.
- Vector control programmes: organise indoor residual spraying, larviciding, and environmental management.
- Provision of health services: ensure accessible clinics, supply of medicines, and trained staff.
- Health education campaigns: conduct mass media and school‑based awareness on endemic diseases.
- Infrastructure development: improve water supply, sanitation, and housing to reduce breeding sites.
- Regulation and enforcement: enforce laws on waste management, pesticide use, and building codes.
- Resource mobilisation: allocate budget, seek donor support, and coordinate with NGOs.
- Research and evaluation: support local studies on disease patterns and assess intervention effectiveness.
- Emergency response planning: develop outbreak response teams and stockpiles of essential supplies.
- Collaboration with other sectors: work with agriculture, education, and environment ministries for integrated control.