Community Health II: Main Exam, 22 March 2024

Mount Kenya University · Department of Community Health, Epidemiology and Biostatistics · Diploma in Health Records and Information Technology · DPH2103

Community Health II past paper 2023-2024 from Mount Kenya University with model answers for all questions.

Instructions: ANSWER ALL QUESTIONS IN SECTION A AND ANY OTHER TWO IN SECTION B

Section A: 40 MARKS (40 marks)

1. Define the following terms;

  1. a) Health education. (2 marks)
    Model answer
    • Health education: A process of informing and empowering individuals and communities to adopt healthy behaviours and make informed decisions about their health.
    • It uses teaching methods, media and community activities to promote knowledge, attitudes and skills for disease prevention and health promotion.
  2. b) Focused Ante Natal Care. (2 marks)
    Model answer
    • Focused Antenatal Care (FANC): A client‑centred approach that provides a minimum of four targeted antenatal visits, each with specific interventions based on the pregnant woman's risk status.
    • Emphasises early detection of complications, health education, nutrition counselling and preparation for safe delivery.
  3. c) Complementary feeding. (2 marks)
    Model answer
    • Complementary feeding: The introduction of solid, semi‑solid or soft foods to an infant’s diet while continuing breastfeeding, usually from 6 months of age.
    • Aims to meet the growing child’s nutritional needs, support development and prevent micronutrient deficiencies.
  4. d) Communicable diseases. (2 marks)
    Model answer
    • Communicable diseases: Infections that can be transmitted directly or indirectly from one person, animal or vector to another.
    • Include bacterial, viral, parasitic and fungal illnesses spread by contact, droplets, food, water or vectors.
  5. e) Primary Health Care. (2 marks)
    Model answer
    • Primary Health Care (PHC): Essential health services that are universally accessible, community based, and focus on prevention, promotion, treatment and rehabilitation.
    • Delivered through a multidisciplinary team using appropriate technology and emphasizing community participation.

2. List five common conditions/diseases affecting most communities. (5 marks)

Model answer
  • Malaria
  • HIV/AIDS
  • Tuberculosis
  • Diarrhoeal diseases (e.g., cholera, dysentery)
  • Acute respiratory infections (e.g., pneumonia)

3. Explain the importance of individual birth plan. (5 marks)

Model answer
  • Individual birth plan
  • Helps parents prepare emotionally, financially and logistically for childbirth.
  • Enables clear communication of preferences to health staff.
  • Reduces anxiety and improves satisfaction with care.
  • Facilitates timely decision‑making during labour.
  • Supports continuity of care and post‑natal follow‑up.

4. State five differences between growth and Development. (5 marks)

Model answer
  • Growth refers to physical size increase; Development refers to functional and psychological maturation.
  • Growth is measurable; development is qualitative.
  • Growth is linear; development is non‑linear.
  • Growth is largely genetic; development is influenced by environment.
  • Growth can be assessed by height/weight; development by milestones.

5. State advantages of family planning. (5 marks)

Model answer
  • Family planning reduces unintended pregnancies.
  • Lowers maternal and infant mortality rates.
  • Improves maternal health and nutrition.
  • Enhances economic stability for families.
  • Promotes gender equality and empowerment.

6. Describe community financing in primary health care. (5 marks)

Model answer
  • Community financing involves pooling local resources.
  • Includes community health funds, insurance schemes and volunteer contributions.
  • Ensures sustainability of primary health services.
  • Encourages ownership and accountability.
  • Enables targeted allocation to priority health needs.

7. Significance of communicable diseases in developing countries

Model answer
  • Communicable diseases remain the leading cause of morbidity and mortality in developing countries.
  • They strain limited health infrastructure and resources.
  • They disproportionately affect children and vulnerable populations.
  • They hinder economic development through loss of productivity.
  • They create a cycle of poverty and disease.

8. Name 5 principles governing implementation of Primary health care. (5 marks)

Model answer
  • Principles of PHC implementation
  • Community participation: involve local people in decision‑making.
  • Intersectoral collaboration: link health with education, agriculture, etc.
  • Equity and accessibility: provide services to all, especially the poor.
  • Health promotion and disease prevention: focus on lifestyle and environment.
  • Primary care as first contact: ensure timely, comprehensive care.

SECTION B: (30 MARKS) (30 marks)

1. Explain ten things a CHV encourages women to do to avoid problems in pregnancy.

Model answer
  • Attend antenatal clinic visits regularly
  • Take iron and folic acid supplements as prescribed
  • Eat a balanced diet rich in protein, fruits and vegetables
  • Maintain adequate hydration
  • Avoid alcohol, tobacco and illicit drugs
  • Practice safe sex and treat any sexually transmitted infections
  • Use insecticide‑treated nets and take prophylaxis to prevent malaria
  • Manage chronic conditions (e.g., hypertension, diabetes) under medical guidance
  • Rest adequately and avoid heavy physical labour
  • Seek prompt care for any warning signs such as bleeding, severe headache or swelling

2. Fundamentals of primary health care are basic rules or beliefs that are essential to the existence, development or success of primary health care as a health professional. Describe the fundamentals of PHC?

Model answer
  • Fundamentals of Primary Health Care
  • Accessibility: services must be physically and financially reachable for all
  • Community participation: people are involved in planning, implementing and evaluating health actions
  • Health promotion and disease prevention: focus on education, nutrition, sanitation and lifestyle
  • Intersectoral collaboration: health works with education, agriculture, water, etc.
  • Appropriate technology: use low‑cost, culturally acceptable, and locally available methods
  • Equity: aim to reduce health disparities and reach the most vulnerable
  • Continuity of care: provide integrated services from birth to old age

3. Explain the following elements of primary Health care that were added by the Kenyan government to the Alma -Ata conference of 1978;

  1. a) Water supply and basic nutrition.
    Model answer
    • Water supply and basic nutrition
    • Ensure safe, potable water is available to prevent water‑borne diseases
    • Promote household water treatment (boiling, chlorination) where piped supply is lacking
    • Support construction of protected wells and boreholes in rural areas
    • Encourage consumption of diversified foods to meet macro‑ and micronutrient needs
    • Provide nutrition education on balanced meals, iron‑rich foods and vitamin‑A sources
    • Implement community‑based feeding programmes for pregnant women and children
    • Monitor growth and nutritional status through regular surveys and growth charts
  2. b) Maternal, child Health and family planning.
    Model answer
    • Maternal, child health and family planning
    • Provide antenatal care and skilled birth attendance to reduce maternal mortality
    • Offer post‑natal visits and immunisation for newborns and infants
    • Promote exclusive breastfeeding for the first six months
    • Deliver growth monitoring and nutrition counselling for children under five
    • Ensure access to a range of contraceptive methods and counselling
    • Educate couples on birth spacing and reproductive rights
    • Integrate maternal and child health services with HIV testing and treatment
  3. c) Control of endemic diseases.
    Model answer
    • Control of endemic diseases
    • Implement mass drug administration for diseases such as schistosomiasis and lymphatic filariasis
    • Conduct vector control programmes (e.g., indoor residual spraying, larviciding) for malaria
    • Promote use of insecticide‑treated nets and environmental management to reduce breeding sites
    • Provide vaccination campaigns for endemic infections like yellow fever
    • Strengthen surveillance and rapid response to outbreaks
    • Encourage community health education on prevention and early treatment
    • Support provision of essential medicines and diagnostics at peripheral health facilities

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