Community Health II: Main Exam, 18 July 2022
Mount Kenya University · Department of Community Health · Certificate in Health Records and Information Technology · CPH2302
Community Health II past exam 2021-2022 from Mount Kenya University with model answers for each question.
Instructions: ANSWER ALL QUESTION IN SECTION A AND ANY OTHER TWO FROM SECTION
SECTION A
1. Give two reasons why community fails to participate in Immunization programmes. (5 marks)
- Misinformation and fear: rumours about vaccine safety deter participation.
- Logistical barriers: distance, transport costs, and inconvenient clinic hours limit access.
2. Immunization is useful in disease prevention and have saved many lives. What other factors affect the general immunity of a person? (5 marks)
- Nutrition: Adequate intake of macro‑ and micronutrients supports immune cell function.
- Stress levels: Chronic psychological stress suppresses immune responses.
- Sleep quality: Sufficient restorative sleep enhances lymphocyte activity.
- Age: Very young and elderly have weaker immune systems.
- Comorbidities: Chronic diseases (e.g., HIV, diabetes, TB) impair immunity.
- Lifestyle habits: Smoking, excessive alcohol, and sedentary behavior reduce immune competence.
- Environmental exposures: Pollution and poor sanitation increase infection risk.
- Genetic factors: Inherited variations influence immune responsiveness.
- Vaccination status: Prior immunizations prime specific immunity.
- Socio‑economic status: Access to healthcare and hygiene resources affects overall immunity.
- More answers: Physical activity, gut microbiota balance, hormonal changes (e.g., pregnancy), and use of immunosuppressive drugs.
3. Illustrate the factors influencing family size in Kenya. (5 marks)
- Economic capacity: household income determines ability to support more children.
- Cultural norms: beliefs about ideal family size influence decisions.
- Education level: higher education often correlates with smaller families.
- Access to family planning: availability of contraceptives affects birth rates.
- Health status of parents: fertility issues or chronic disease can limit family size.
4. Using examples describe the principles of managing communicable diseases. (5 marks)
- Early detection and isolation: identify cases quickly to prevent spread.
- Vaccination and prophylaxis: immunise populations to build herd immunity.
- Public education: inform about hygiene and symptom recognition.
- Environmental control: improve sanitation, vector control, and water quality.
- Surveillance and reporting: monitor outbreaks to guide interventions.
5. Outline FIVE possible causes of missed opportunities in immunization. (5 marks)
- Inadequate cold chain management: vaccine spoilage.
- Shortage of trained staff: insufficient personnel to administer vaccines.
- Poor record keeping: missed doses due to data errors.
- Community mistrust: fear of side effects reduces uptake.
- Supply chain disruptions: delays in vaccine delivery.
6. Enumerate FIVE ways by which Health Education can be used in the promotion of health. (5 marks)
- Health talks at community meetings: raise awareness of disease prevention.
- School health education programmes: teach children healthy habits.
- Mass media campaigns: use radio/TV to disseminate health messages.
- Peer‑education groups: empower community members to spread knowledge.
- Printed materials (posters, leaflets): provide visual reminders of health practices.
7. Describe the linkage between the community and the health facility and sustainability. (5 marks)
- Linkage
- Community health workers act as a bridge between residents and the health facility.
- They collect health data, refer patients, and relay facility information back to the community.
- Facility staff provide training, supplies, and support to the community.
- Regular community meetings keep both sides informed and engaged.
- Sustainability
- Continuous training ensures skills remain current.
- Community ownership of health programmes encourages local funding and volunteerism.
- Integration of services into existing community structures (e.g., local councils) reduces duplication.
- Monitoring and evaluation create evidence for ongoing resource allocation.
8. Explain the classification categories of communicable diseases. (5 marks)
- Classification
- Infectious: caused by bacteria, viruses, fungi, parasites.
- Non‑infectious: caused by environmental or lifestyle factors.
- Acute: short‑term, rapid onset.
- Chronic: long‑term, persistent.
- Epidemic: sudden increase in cases in a specific area.
- Endemic: constant presence in a population.
- Pandemic: widespread across countries or continents.
SECTION B
9. Community Health Volunteers form a basic workforce of community strategy in the provision of level one services. Identify any five roles they play. (15 marks)
- Health promotion: educating community on hygiene and disease prevention.
- Disease surveillance: recording and reporting cases to health authorities.
- Referral: directing sick individuals to health facilities.
- Basic care: administering first aid, wound care, and basic treatments.
- Community mobilization: organising health campaigns and volunteer groups.
10. Basic health services should be available to everyone in Kenya under the Kenyan constitution. They should be provided at the dispensaries and health centres. Outline the components of such basic health services that should be available in your area of work. (15 marks)
- Health promotion & education: Community outreach on nutrition, hygiene, family planning, and disease prevention.
- Preventive services: Immunisation programmes, antenatal care, growth monitoring, and screening for TB, HIV, and non‑communicable diseases.
- Curative care: Basic outpatient treatment for common illnesses (malaria, diarrhoea, respiratory infections), wound care, and minor procedures.
- Maternal & child health: Antenatal visits, safe delivery referrals, post‑natal care, immunisation schedule, and growth monitoring.
- Reproductive health services: Contraceptive counselling, provision of family‑planning methods, and STI management.
- Pharmacy services: Essential drug dispensing, stock management, and patient counselling on medication use.
- Laboratory services: Basic diagnostics (malaria rapid test, HIV rapid test, urine dipstick, haemoglobin, blood glucose).
- Referral system: Established links to higher‑level hospitals for emergencies and specialised care.
- Health information system: Recording of patient registers, disease surveillance, and reporting to district health office.
- Water, sanitation & hygiene (WASH): Provision of safe water, latrines, and health education on hygiene practices.
- Nutrition support: Supplementary feeding programmes for children under‑5 and pregnant women.
- Community health worker (CHW) outreach: Home visits, health education, and follow‑up of chronic patients.
- Emergency care: Basic first aid, stabilization, and transport arrangements for critical cases.
- Health financing: User‑fee exemption for vulnerable groups and integration of NHIF services.
- More answers: Mental health screening, oral health promotion, and occupational health services.
11. Using a diagram illustrate the ideal number of visits and minimum visits periods of maternal care during pregnancy. (15 marks)
- Diagram description
- A vertical timeline from conception to delivery.
- Key points:
- 1st trimester: 1 visit (early booking).
- 2nd trimester: 3 visits (at 20, 24, 28 weeks).
- 3rd trimester: 4 visits (at 32, 36, 38, 40 weeks).
- Labels: "First visit", "Second visit", "Third visit", "Fourth visit", "Fifth visit", "Sixth visit", "Seventh visit", "Eighth visit".