EXAMINATIONS COUNCIL OF HEALTH SCIENCES/UNZA

FINAL EXAMINATIONS FOR DIPLOMA IN ENVIRONMENTAL SCIENCES

FOR
ENVIRONMENTAL HEALTH TECHNOLOGISTS

HMIS 322: HEALTH MANAGEMENT INFORMATION SYSTEM II

DATE: 9 JUNE, 2015

TIME: 9:00 – 12:00 HOURS

Candidate’s Examination Number: …………………………………………………………………………………………………

Candidate’s NRC N umber: ……………………………………………………………………………………………………………..

Examination Centre:……………………………………………………………………………………………………………………….

INSTRUCTIONS TO CANDIDATES
1. Check that you have the correct examination paper in front of you.
2. There are FOUR (4) sections in this paper, ONE, TWO, THREE and FOUR
3. Read the instructions very carefully in each section before attempting to answer.
4. All questions must be answered on the examination answer booklet provided only.
5. Write down the number of the questions that you have answered on the cover of the
examination answer booklet.
6. No books, files or mechanical aids are permitted in the examination room.
7. There are shall be no form of communication between students during the
examination. Any student caught doing this will be disqualified

CELLPHONES & PROGRAMMABLE CALCULATORS ARE NOT ALLOWED IN THE EXAMINATION ROOM

DO NOT TURN THIS PAGE UNTIL YOU ARE TOLD TO DO SO BY THE INVIGILATOR

1
SECTION ONE: MULTIPLE CHOICE QUESTIONS
 There are fourty (40) questions in this section.
 Answer ALL questions in this section
 Write the best answer of your choice in the examination answer booklet provided
(Total marks = 40)

1. The acronym RAVES is used as a principle to determine an ideal:

(a) Target
(b) Vision
(c) Goal
(d) Indicator

2. In the planning cycle, at what stage are you able to find the answer to the following question:
what objectives will we set ourselves for the next period of time, say the year ahead, as we
strive to reach the ultimate goals?
(a) Stage 3
(b) Stage 1
(c) Stage 4
(d) Stage 2

3. If Kaungamashi Health Centre with a population of 15, 000 people conducted an

entomological survey to assess malaria vector density. Data documented from the survey was
as follows: 50 culex female mosquitoes, 10 culex male mosquitoes, 10 anopheles female and
3 anopheles male mosquitoes. What was the proportion of the malaria vector?
(a) 5/8
(b) 3.6/13
(c) 3/13
(d) 1/16

4. Which one of the following defines what is collected as data from health facilities?
(a) NIDS
(b) RAVES
(c) MDGs
(d) ICT policy

5. Reporting of an individual notifiable disease from facilities to the next level is done using:
(a) ND 1 forms
(b) HIA 1 forms
(c) HIA 2 forms
(d) ND 2 forms.

6. The ……………. serves to provide a precise information to management at any level on a range
of relevant issues so that decisions are objectively made.
(a) DART
(b) EDS
(c) NIDS

2
 (d) RAVES

7. A diagrammatic way of looking at information to enable the HMIS user see the links between
different stages from data collection to information use is called:
(a) Information Pyramid
(b) Information Filter
(c) Information Cycle
(d) Planning Cycle

8. Suppose Lilanda Health Centre has a population of 50 000 people and records 30 cases of
Typhoid fever in the month of May 2014. What is the incidence rate for Typhoid fever per
10,000 population?
(a) 60
(b) 0.6
(c) 6
(d) 600

9. A realistic point at which to aim to reach an indicator which measures an objective is called:
(a) Goal
(b) Vision
(c) Policy
(d) Target

10. A data presentation format that shows the proportions of a coverage as part of the whole is
known as:
(a) Pie chart
(b) Bar Chart
(c) Frequency polygon
(d) Scatter chart

11. ………………………………………… helps in the identification and illustration of factors and

relationships that influence the outcome of an intervention.
(a) Logical framework
(b) Results framework
(c) Conceptual framework
(d) None of the above

12. Suppose Mumbwa district has a population of 22 450 in which 40% is the proportion of
women of child bearing age, 5.4% are expected pregnancies and 5.2 % are expected
deliveries. If Mumbwa district relies on 1 ambulance to serve its population for any referral.
What is the ratio of an ambulance to the expected deliveries?
(a) 5.2 : 460
(b) 5.2: 485
(c) 1: 467
(d) 5.4: 467

3
13. Data handling in HMIS involves use of multiple tools at each stage. Which of the following
tool is not used at stage one in the information cycle?
(a) OPD register
(b) Graphs
(c) Activity sheet
(d) ART register

14. M&E plans should include:

(a) A plan for the utilization of the information gained
(b) A detailed description of the indicators to be used
(c) The data collection plan
(d) All the above

15. This is a data collection tool that keeps patient/client information including the identity,
history, diagnoses and/or service provided.
(a) Out -Patient Department (OPD) register
(b) Community Diagnosis register
(c) Patient record book
(d) In-Patient Department (IPD) register

16. Characteristics of a good indicator includes the following except:

(a) Reliable
(b) Verifiable
(c) Sensitive
(d) Appropriate

17. Which one of the following which is sometimes called an “M&E framework,” provides a
streamlined linear interpretation of a project’s planned use of resources and its desired ends.
(a) Logical model
(b) Conceptual framework
(c) Results frameworks
(d) All the above

18. Which of the following does not give a precise example of an input indicator?
(a) Number of ITNs distributed
(b) Number of health staff a facility has
(c) Financial support
(d) Medical equipment used in a facility

19. The …………………….. provides basis for local decisions and planning of interventions at
each facility and district.
(a) Cohort tracking tool
(b) Tally sheet
(c) Self-Assessment tool
(d) Activity sheet

4
20. Which of the following level on the information filter has the sole responsibility of
measuring child mortality?
(a) District
(b) Province
(c) National
(d) International

21. ………………………………… forms are used to transmit data from the Health Centre to the District
Office on monthly basis.
(a) In patient Ward form
(b) Health Information Aggregation 1 (HIA 1) 1
(c) Notifiable (ND) 1 and 2
(d) Activity sheets

22. Total number of people sleeping in an insecticide treated net (ITN) per night can be classified
as:
(a) Output indicator
(b) Input indicator
(c) Outcome indicator
(d) None of the above

23. The main reason for asking a question why in data analysis as an epidemiological thought is
to…………………………..
(a) Know the affected population
(b) Review relevant data sets
(c) Relate to a known disease
(d) Apply an appropriate data collection tool

24. The immediate results that come from the heath care or programme activities
expressed as units of service such as number of outpatient visits or children
immunized is called:
(a) Output
(b) Impact
(c) Process
(d) Outcome

25. Which one of the following acronyms stipulates the principles used in HMIS?
(a) EDS
(b) RAVES
(c) NIDS
(d) All the above
(e) None of the above

5
26. The data presentation format that shows progress towards a fixed target each month
compared total to the target line is called:
(a) Line graph
(b) Bar graph
(c) Stacked graph
(d) Cumulative graph

27. In the provision of health services, data is usually collected at various service points. Who has
the sole responsibility of keeping accurate data as it is being collected?
(a) Health Centre In-charge
(b) Registry clerk
(c) All Health workers.
(d) District Information Officer

28. The best parameter to use if a health facility or district wants to measure a health problem
and/or even compare themselves to others is:
(a) Target
(b) Indicator
(c) Objective
(d) Vision

29. During data handling and or processing, which one of the following mostly compels health
workers to engage in discussions?
(a) Data analysis
(b) Interpretation
(c) Feedback
(d) All the above

30. The MDG that looks at combating HIV/AIDS, malaria and other diseases is positioned at
number:
(a) 6
(b) 4
(c) 3
(d) 5

31. In the planning cycle, action plans strive to answer the question
(a) Where do we want to go?
(b) How do we know when we arrive?
(c) How will we get there?
(d) Where are we now?

32. Which of the following is NOT part of the Information Cycle?

(a) Data Collection
(b) Data Analysis
(c) Data Presentation

6
 (d) Data Extrapolation
33. The following except ONE are notifiable diseases in Zambia
(a) TB
(b) Acute Poliomyelitis
(c) Anthrax
(d) Yellow fever

34. Which of the following data source is NOT used during the district planning process?
(a) Proportional Head counts
(b) Census Enumeration Data
(c) Crude Counts
(d) Estimation from mapping exercises

35. Which of the following are sources of data for a health information system?
(a) Special Surveys
(b) Government Departments
(c) Specialized Data Bases
(d) All of the above

36. Data presentation tools, comprise

(a) Disease trend line bucket, fork and plate
(b) Pie chart and histogram, pyramid
(c) Registers, Tally sheets and activity sheets
(d) All of the above

37. Fully immunized indicator entails

(a) A child above one year who has had all the vaccines administered to him
(b) A child under one year who has had all the vaccines upto measles administered
to him/her before 12 months or one year.
(c) Any child that receives any vaccine.
(d) A child that attains 5 years

38. A register is a data

(a) Collection instrument
(b) Reporting instrument
(c) Presentation instrument
(d) Dissemination instrument

39. HMIS Information Pyramid

(a) Allows for local users to make additional data collection mechanisms to collect
information relevant to them
(b) Allows for local users to make additional data become a heap.
(c) Permits patients and community member to send data to the district health
office at any time

7
 (d) All of the above
40. In relation to feedback in the information cycle what does the acronym CRISP entails
(a) Confidential, reflective, important, specific and policing.
(b) Constructive, relevant, immediate, selective and presentable
(c) Confidential, responsive, important, specialand policing.
(d) None of the above
41. Which one of the following is not a data collection tool in a health facility set up?
(e) OPD register and tally sheets
(f) A pharmacy register and a patients cards/files and
(g) HIA 1 and an activity sheet
(h) Tally sheets and a Laboratory register

42. A number of factors are involved in determining data quality, which of the following
has no bearing on data quality?
(a) Local use of information
(b) Skills on data collection
(c) Prevalence of diseases
(d) Perceived relevance of the information gathered
43. Which one below can provide a comprehensive data on community diagnosis:
(a) OPD register
(b) Routine health records
(c) Environmental Health diary
(d) Surveys

44. At what stage is the transformation of data into information done on the
information cycle?
(a) Two
(b) Four
(c) Five
(d) Three

45. A data presentation format that helps to compare parts of whole is known as:
(a) Stacked column
(b) 100% stacked column
(c) Bar chart
(d) 100% stacked bar

46. Which one of the following is not a personal health variables?

(a) Age
(b) Blood group
(c) Prescription
(d) None of the above

8
 47. ……………………….. is a measure, usually expressed as a percentage, of people or
households who have actually received a particular health service compared to
those who need it.
(f) Indicator
(g) Coverage
(h) Trend
(i) Frequency

7. Which of the following is NOT considered “monitoring”?

(a) Tracking the number of liquid chlorine distributed
(b) Tracking changes in the household members who sleep in ITNs
(c) Counting the number of people trained
(d) Collecting monthly data on women using family planning methods.

48. “Fully immunized “ is an expression of an indicator that confirms the immunization

status of:
(a) Children under the age of five years
(b) Children who are enrolled in grade one and have a BCG scar on the left arm
(c) Children under the age of one year
(d) All the above
49. The information and planning cycles are linked by an/a……………………………..
(a) objective
(b) Indicator
(c) Target
(d) Goal

50. If Sinazongwe RHC has a population of 5 000 people in which children have the
following proportion: 20% are under-five years and 16%, are one year and to five
years. What is the total number of children under one year?
(e) 200
(f) 600
(g) 800
(h) None of the above

51. Which one of the following HMIS tools is used to report environmental health
services from HCs to the district?
(a) ND 1
(b) HIA 2
(c) Self-assessment
(d) HIA 1

9
52. In HMIS the acronym EDS stands for:
(a) Essential Data Software
(b) Expected Daily Services
(c) Expected Data Segments
(d) Essential Data Sets
53. Assuming that Chiawa area has a population of 2000 households who depend on 5
hand pumps for their source of portable water. What is the ratio of hand pumps to
people in this area?
(a) 1 hand pump per to 1 000 people
(b) 4 hand pumps to 500 households
(c) 1 hand pump per to 400 households
(d) None of the above

54. In case of an outbreak, which of the forms below could be used by the HC to report
an index case to the next level?
(e) ND 2 forms
(f) HIA 1 forms
(g) Linelist forms
(h) ND 1 forms.

55. Monitoring differs from Evaluation in:

(a) Timing
(b) Focus
(c) Level of Detail
(d) All the above
(e) None of the above
56. Which of the following is not a data processing activity:
(a) Manual data quality checks
(b) Data verification
(c) Data Transformation
(d) Data collation
57. Who is an epidemiological question tag that is concerned about?
(a) A person to collect the data
(b) People affected by the disease
(c) The technical staff to implement an activity in the action plan
(d) All the above

58. The purpose of interpretation stage in data handling is to;

10
 (a) Transform data into useful information
(b) Decide how is going to be used
(c) Make meaning out of the information
(d) Set focused targets when formulating strategic plans

59. Reduction in morbidity and mortality rates for any public health problem can be
measured as a/an …………………… indicator.
(a) Outcome
(b) Impact
(c) Output
(d) Process
60. At what stage in the information cycle are graphs, tables and questionnaires used?
(a) Stage 1 & 2
(b) Stage 4 & 6
(c) Stage 1 & 3
(d) Stage 4 & 5

61. Characteristics of a good indicator includes the following except:

(e) Reliable
(f) Verifiable
(g) Sensitive
(h) Appropriate

62. Feedback does facilitate discussion on all but not:

(a) Nursing and action plan
(b) Data quality
(c) Possible interpretation
(d) Potential uses that the current information has.

63. Which of the following figure is used to describe geographical distribution of any
health problem?
(a) Bar chart
(b) Population pyramid
(c) Pie chart
(d) Map

64. Data quality is a multi- dimensional concept. Consequently, which of the following is
not a parameter frequently used to measure data quality/
(a) Correctness
(b) Completeness
(c) Timeliness
(d) Sensitiveness

11
65. An acronym CRISP is used as a key for good feedback mechanism. What does this
acronym stand for?
(a) Correctness, Relevant, Immediate, Selective, Presentable
(b) Consistent, Relevant, Immediate, Selective, Presentable
(c) Constructive, Relevant, Immediate, Selective, Presentable
(d) Constructive, Relevant, Immediate, Sensitive, Presentable

66. Reporting of a notifiable disease from facilities to the next level is done using:
(i) ND 1 forms
(j) HIA 1 forms
(k) HIA 2 forms
(l) ND 2 forms.
67. If Nangongwe RHC in Kafue district has a population of 50 000 people of which 5.4%
are expected pregnancies. Assuming all the expected pregnant women attend the
ANC services, what is the total number of pregnant women expected to be
registered in the ANC register?
(a) 270
(b) 2700
(c) 27
(d) 108
68. ……………………….. is a measure, usually expressed as a percentage, of people or
households who have actually received a particular health service compared to
those who need it.
(a) Coverage
(b) Indicator
(c) Trend
(d) Frequency

69. Which of the following level on the log frame model has the task of measuring
activities in which the programme resources are used:
(a) District
(b) Province
(c) National
(d) International

70. In HMIS the acronym EDS stands for:

(a) Essential Data Software
(b) Expected Diagnosis Sets
(c) Expected Data Segments
(d) Essential Data Sets

71. Which one of the following defines what is collected as data from health facilities?

12
 (e) Action plan
(f) RAVES
(g) NIDS
(h) ICT policy

72. Decentralization as one of the principles used in HMIS implies that:

(a) Stakeholders should have access to patients records
(b) Health Information System must be able to be adapted to address local information
needs.
(c) Data collection tools should be developed by community members
(d) All the above

73. ………………………………………… helps in the identification and illustration of factors and

relationships that influence the outcome of an intervention.
(e) Logical framework
(f) Results framework
(g) Conceptual framework
(h) None of the above

74. Characteristics of a good indicator includes the following except:

(a) Reliable
(b) Verifiable
(c) Sensitive
(d) Appropriate

75. Suppose Mwandi Health Centre has a population of 30 000 people and records 12 cases of
Typhoid fever in the month of October 2016. What is the incidence rate for Typhoid fever
per 10,000 population?
(e) 63
(f) 3.6
(g) 36
(h) 360
76. HMIS serves to provide information to health workers for the purpose of assessing?
(a) Staff workload in relation to facility establishment
(b) Quality of health service provision
(c) The number of medical conditions seen by health facilities
(d) Utilization of drugs and their proper storage
77. The tools listed below can be used in epidemiological disease surveillance except:
(a) Line list
(b) HIA 1
(c) ND 1
(d) HIA 2
(e) Contact tracing form

78. M&E plans should always include:

13
 (e) A plan for the utilization of the information gained
(f) A detailed description of the indicators to be used
(g) The data collection plan
(h) All the above

79. Reporting of a notifiable disease from facilities to the next level is done using:
(m)ND 1 forms
(n) Activity sheets
(o) HIA 2 forms
(p) OPD register

80. Which of the following does not give a precise example of an output indicator?
(e) Number of ITNs distributed
(f) Number of health workers trained in Smart Care.
(g) Number of people who slept in a LLIN last night
(h) Total number of condoms distributed

81. This is a data collection tool that keeps patient/client information including the identity,
history, diagnoses and/or service provided.
(e) Out -Patient Department (OPD) register
(f) Community Diagnosis register
(g) Patient record book
(h) In-Patient Department (IPD) register

82. The purpose of the fourth stage in the planning cycle include all the following except?
(a) Formulation of an operational Plan
(b) Assessing the impact of an intervention
(c) Monitor service coverages
(d) Inform stakeholders on how activities are being implemented

83. If Sioma RHC has a population of 8 450 in which children have the following proportion: 20%
are 12 – 59 months and 4%, are 0 -11 months. What is the total number of children between
one to five years?
(i) 1 690
(j) 2 028
(k) 1 352
(l) 338

84. The immediate results that come from the heath care or programme activities expressed as
units of service such as number of outpatient visits or children immunized is called:
(i) Coverage
(j) Output
(k) Outcome
(l) All the above

85. Which of the following process in the health sector does not use data analysis tool?

14
 (a) Data aggregation
(b) Self- assessment
(c) Performance Assessment
(d) None of the above

86. In order for the Ministry of Health to manage compare data between facilities, districts and
provinces, the HMIS has standardized:
(a) Computers programmes
(b) Data collection tools
(c) Ministry of Health vision, objectives and targets
(d) Annual Action plans

87. At what stage in the planning cycle do you formulate a statement like “reduce malaria
incidence in under- fives by 26% by the end of 3 years.
(a) Stage 3
(b) Stage 2
(c) Stage 1
(e) Stage 4

88. The ……………. serves to provide a precise information to management at any level on a range
of relevant issues so that decisions are objectively made.
(e) DART
(f) EDS
(g) NIDS
(h) RAVES

89. Assuming that Mahopu location in Chisankane area has a population of 2000 people who
depend on 4 hand pumps for their source of portable water. What is the ratio of hand
pumps to people in this area?
(e) 1 hand pump per to 8 000 people
(f) 4 hand pumps to 500 people
(g) 1 hand pump to 500 people
(h) 4 hand pump to 8000 people
90. Reduction in morbidity and mortality rates for any public health problem can be measured
as a/an …………………… indicator.

(a) Outcome
(b) Impact
(c) Output
(d) Process

1. The following are records maintained by the facility on behalf of the District Health
Information System except for…………………?

a) Tick registers
b) Tally sheets

15
c) Program registers
d) None of the above

2. Which of the following shapes of a population pyramid is most consistent with a young
population?
a) Tall, narrow rectangle
b) Short, wide rectangle
c) Triangle base down
d) Triangle base up

3. The catchment area map, is an integral part of the DHIS which shows all services provided by
each facility except?
a) Outreach points
b) Satellite clinics
c) None governmental organizations
d) None of the above

4. The basic building blocks of a decision analysis is

a) Decisions
b) Outcomes
c) Probabilities
d) All of the above

5. ………………………………….is a branching chart that indicates the evolutionary lineage or genetic

relatedness of organisms involved in outbreaks of illness
a) Decision tree
b) Probability tree
c) Phylogenetic tree
d) All of the above

6. Bar charts may be distinguished from histograms at a glance because?

a) Bar charts are not used for time series data
b) Histograms are used to display discrete data
c) Bar charts are based on area under the curve
d) Histograms do not have spaces between consecutive columns

7. What type of graph is most appropriate for comparing rates of change of disease occurrence
over several years?
a) Arithmetic-scale line graph
b) Semilogarithmic-scale line graph
c) Histogram
d) Frequency polygon

8. Compared with a scatter diagram, a dot plot:

16
a) Is another name for the same type of graph
b) Differ because a scatter diagram plots two continuous variables; a dot plot plots one
continuous and one categorical variable
c) Differ because a scatter diagram plots one continuous and one categorical variable; a dot
plot plots two continuous variables
d) Plots location of cases on a map

9. In terms of good quality data, ……………………. data is one which shows the true reflection of
what is prevailing on the ground.
a) Correct
b) Complete
c) Consistent
d) All of the above

10. ……………………….is a process that turns good quality data into information.
a) Data collation
b) Data processing
c) Data analysis
d) Data presentation

11. The following are part of the use of information process except…………………….
a) Regular review of data
b) Flow of information
c) Relate to operational plans
d) Monitor service coverage and quality

12. Which of the following is referred to as a check sheet.

a) Register
b) Client record card
c) Tally sheet
d) Tick sheet

13. Which of the following is part of the data interpretation process?

a) Making sense of information
b) Possible interpretation
c) Explore
d) All of the above

14. …………………….data is one that is within the normal range.

a) Complete
b) Consistent
c) Correct
d) None of the above

15. What is to be considered when describing a health problem?

a) Place
b) Person

17
c) Time
d) All of the above
16. …………………….. is the process of summarizing, organizing and communicating information
using a variety of tools.
a) Data presentation
b) Data interpretation
c) Data collection
d) Data processing

17. Which data collection tool is an easy way of counting identical data on conditions that do not
require follow-ups?
a) Register
b) Client record card
c) Tally sheet
d) Tick sheet

18. The data collected using a…………………….is quantitative.

a) Register
b) Client record card
c) Tally sheet
d) Tick sheet

19. Data ………………..is a process were data is put in the right order.
a) Collation
b) Verification
c) Validation
d) None of the above

20. What type of graph is most appropriate for comparing the magnitude of events which have
occurred in different places, but no map is available?
a) Arithmetic-scale line graph
b) Bar chart
c) Frequency polygon
d) Histogram

21. Project monitoring is sometimes referred to as:

a) Evaluation
b) Impact evaluation
c) Process evaluation
d) Performance evaluation

22. Which of the following is NOT considered monitoring?

a) Counting the number of people trained
b) Tracking the number of brochures disseminated
c) Attributing changes in health outcomes to an intervention
d) Collecting monthly data on clients served in a clinic

18
23. Evaluations measures:
a) The timeliness of a program’s activities
b) He outcomes and impact of a program’s activities
c) How closely a program kept its budget
d) How well the program was implemented
a) Throughout the life of the program

24. Which of the following is not an example of an input indicator

a) Utilization rate
b) Staff population ratios
c) Immunization coverage rate
d) Workload indicator

25. An analysis of the routine monthly reports allows an assessment of the quality of and
balance between except……………………..?
a) Regulative
b) Preventative
c) Promotive
d) Curative

26. Which of the following shapes of a population pyramid is most consistent with an old
population?
a) Tall, narrow rectangle
b) Short, wide rectangle
c) Triangle base down
d) Triangle base up

27. At what stage of a program should monitoring take place?

a) At the beginning of the program
b) At the mid-point of the program
c) At the end of the program
d) Throughout the life of the program

28. A good monitoring system helps answer which of the following questions?
a) Is the project progress according to schedule
b) Have periodic benchmarks been met?
c) Is the project under or over achieving output targets?
d) All of the above

29. The following are examples of ongoing plans except for?

a) Continuity
b) Policy
c) Procedure
d) Rule

19
 30. Which of the following is not an example of an input indicator
a) Utilization rate
b) Staff population ratios
c) Immunization coverage rate
d) Workload indicator

31. Which of the following is not part of data processing

a) Data presentation
b) Collection
c) Data quality checks
d) Data validation

32. The following are reasons for dissemination of information except for………………?
a) Share knowledge
b) To promote understanding
c) To facilitate monitoring of progress made
d) To enhance return of patients

SECTION B: TRUE OR FALSE QUESTIONS

 There are ten (10) questions in this section.
 Answer ALL questions in this section
 Each question carries one (1) mark
 Indicate the best answer of your choice either TRUE or FALSE in the answer booklet
(Total marks = 10 marks)

1. In order to realistically measure the success of a programme, M&E plans should be

formulated/designed at the last phase of a program and can be organized in a variety of ways.
TRUE or FALSE

2. When measuring frequency rate expressed as a ratio, numerator may be completely different
from the denominator. TRUE or FALSE

3. In DHIS, uniform data capturing tools help to ensure that data captured at different sites can be
used to represent what is expected to be found in other health facilities. TRUE/ FALSE.

4. Transparency in HMIS implies that records for patients should be accessed by concerned
stakeholders. TRUE or FALSE

5. The role of “Priority Indicator List” from EDS is to monitor health service provision in the key
areas of maternal and child health. TRUE or FALSE

6. In DHIS, the term trend in time during data analysis compares indicators according to different
reporting periods. TRUE or FALSE

20
7. A District Health Information Officer can delegate his accountability to any Health Centre staff if
quality reports are to be produced. TRUE or FALSE

8. A quantitative indicator can use parameters like colour or shape of ITNs to analysis the impact
of a malaria programme. TRUE or FALSE

9. The difference between data and information is minor since both can be used for planning and
budgeting. TRUE or FALSE

10. Community diagnosis is one of the tools used at data analysis stage in the information cycle.
TRUE or FALSE

1. Conceptual frame works are sometimes referred to as research frameworks.

TRUE/FALSE
2. A quantitative indicator does not assess parameters such as colour or shape of ITNs
when analysing the impact of a malaria programme. TRUE/FALSE
3. Clustered Column chart is the most appropriate data presentation format if one
wants to show the disease trend over time. TRUE/FALSE

4. When measuring frequency rate expressed as a proportion, numerator may be completely

different from the denominator. TRUE/FALSE

5. In HMIS, Uniform data capturing tools help to ensure that the data captured at different
sites has similar targets. TRUE/ FALSE.

6. The 5thNational Health Strategic Plan (NHSP) was implemented from 2006-2011-
Health Sector. TRUE/ FALSE

7. The role of “Priority Indicator List” from EDS is to monitor health service provision in
the key areas of maternal and child health. TRUE/ FALSE

8. Monitoring is sometimes referred to as process evaluation. TRUE/ FALSE

9. When analyzing quantitative indicators, one does not need to use a denominator.
TRUE/ FALSE

10. Group discussions, surveys and self-assessments are some of the tools used at data
analysis stage in the information cycle. TRUE/FALSE

11. The term trend in timeduring data analysiscompares indicators according to different
reporting periods. TRUE/FALSE

12. There is no difference between an Incidence and an Epidemic. TRUE/FALSE

21
13. An Impact from the action plan can be said to be the immediate results that come from
programme activities expressed as units of services such as number of children
immunized. TRUE/FALSE

14. Stage number five in the information cycle allows a health worker to understand the
meaning of any data that is being handled.TRUE/FALSE

15. Targets can be used by health institutions to compare their performance with other
institutions. TRUE/ FALSE

16. At data presentation stage, one can either use a Pie chart or Clustered charts to depict
the proportion of an outcome.TRUE/ FALSE

17. Process evaluation can be used to determine if activities need adjustments during the
implementation of an intervention in order to improve desired outcomes.

18. The 5thNational Health Strategic Plan (NHSP) was implemented from 2006-2011-
Health Sector. TRUE/ FALSE

19. Most of the data from health facilities are numerical in nature and therefore qualitative
indicators are usually used. TRUE/FALSE.

20. The acronym CRISP is used as one of the rules for validation of quality data.
TRUE/FALSE

21. A cumulative frequency curve plots the actual frequency rather than the cumulative
frequency distribution of a variable. TRUE/FALSE
22. To create a scatter diagram you must have a pair of values (one for each variable) for
each person, group, country, or other entity in the data set, one value for each variable.
TRUE/FALSE
23. A spot maps use dots or other symbols to show where each case-patient lived or was
exposed. TRUE/FALSE
24. In an oral presentation, three-dimensional pie charts and three-dimensional columns in
bar charts are desirable because they add visual interest to a slide. TRUE/FALSE
25. A 100% component bar chart shows the same data as a stacked bar chart. The key
difference is in the units on the x-axis. TRUE/FALSE
26. An under-five card is a source of a health management information system data source.
TRUE/FALSE
27. Evaluation is a continuous process on health management information systems.
TRUE/FALSE

22
28. Reduce malnutrition is of children under 5 years of age by 20 percent is an example of
an outcome indicator. TRUE/FASLE
29. Impact assessment assesses an individual’s performance within the organization or in
relation to the projects impact on the external environment. TRUE/FALSE
30. Outputs are the actual deliverables that an operation can be held accountable for
producing. TRUE/FASLE

SECTION THREE: SHORT ANSWER QUESTIONS

 There are six (6) questions in this section
 Answer all questions in this section
 Each question carries 5 marks each
(Total marks = 30)

1. Briefly, discuss the activities that take place at data aggregation stage in the
information cycle.

2. Give a short explanation on the differences between data analysis and data
interpretation.

 Data analysis is the process of inspecting, transforming data into useful

information and cleansing the data that has been compiled while data
interpretation is that making sense and critical thinking out the data that has
been collected.

3. List five common sources of errors during data handling.

 Maths error
 Typing error
 Duplication error
 Gaps in data
 Inconsistency
 Thumb suck calculation error

4. Write short explanatory notes on any two qualities of good quality data.

5. State six examples of semi-permanent data at the health facility level

6. List any three reasons why heatlh facilities collect quality and credible data

23
7. Justify the importance of indicators at the 6th stage in the information cycle.

8. What does the acronym RAVES stands for as used in HMIS?

 R-Reliable A- Appropriate V-Validity E-Easy S-Sensitive

1. State four key questions that guide health workers during the planning cycle.
 Where are we now
 Where are we going
 How will we get there
 How will we know when we arrive

2. List five uses of a catchment area map.

3. Draw and label the information pyramid.

4. Tabulate ant five acronyms you know in HMIS and what they stand for

 ESD; essatial set data

 RAVES: reliable, appropriecte, vaild, easy, sensitive
 DHIS: district, health, information, systems
 CRISP: constructive, relevant, immediate, selective, presentable
 NIDS: national, indicator, data, set
 ND: notifable disease
 LLIQ
 OPD: out patenit deparment
 HIA: health ifomation aggregation
 DART: decentralisation, action, responsive, transparent

5. Explain interpretation of information as a tool in decision –making

6. Draw the Information cycle stating clearly and correctly each stage and at least on tool(s)
that is used at that particular stage

24
7. What do the acronyms HMIS stand for? hence define HMIS and state at least 3 of its
objectives

 HMIS stands for Health Management Information Systems

 HMIS is define is that it is specially designed for management and planning of health
proramma as opposed to service delivery
Objectives of HMIS

8. In detail discuss the significance of letter ‘A’ used as a principle in HMIS

9. Write brief explanatory notes on the following qualities of good information

 Timeliness
 reliability

10. Define the following

 Community diagnosis: it is a qualitive and qualitative description of health of the

community and the factor that influence their health

 Health Information system: it is the system that integrates data collection,

processing, reporting and use of the information for improving health service
effectiveness and efficiency through management at all levels of health services
 Data: it’s the collection of facts and figures which are in unprocessed
 Information: it is the data which is processed and used for decision making

25
11. Giving precise examples, justify the purpose of putting a data flow policy in place when
dealing with health information

The data flow policy is important because it helps in reporting of activities that are taking
place at each level and it also helps you understand your process or system.

M&E Committee
National M&E (HMIS)

Province Data League tables

Export and appraisal
NHO M&E
By 5th of 3rd month By 15th of 3rd month

Province M&E (HMIS)

Prov Director,
Prov Programme
DMS District Data Export League tables
and appraisal
By 30th of 2nd month By 20th of 3rd month

District M&E (HMIS)

Director, DHIO,
Programme focal persons
Summary sheets & Self Data & League tables
assessment performance and appraisal
By 7th of 2nd month by 30 of 2nd month
th By 30th of 3rd month

Health Facility
Sister in Charge

HIA (Monthly
Summary Report)
DailyTally
Sheet

Date due:
Every D/W/M

Patient As Patient Facility

Record Consulted
Registers
12.

13.

14. Define the following terms

 Impact
 Trend
 prevalence

15. List any three activities that one must undertake when conducting data processing.
 Data quality checks
 Data verification
 Data validation

26
16. Suppose Kaungamashi Health Centre with a catchment population of 10 000 people
recorded 20 cases and 4 deaths of Yellow fever during the year 2016. Calculate:
(i) the incidence rate for yellow fever per 1000 people in Kaungamashi area?

(ii) Case fatality rate for such an outbreak in that community.

17. In detail discuss any two data collection tools used for information use at a health facility
level.
Tally sheets: These are sheets used for headcounts, children weight in a month or week this
data is important for understanding the frequency of how many children are being weighed
during under five services
Clients record card: (Most detailed) This is where you write the information about the
patient, sex, age and address. It is both qualitative and quantitative.
Tick sheets/ check sheets: the data is quantitative. This is used to check how many children
have been immunised at infant and what immunisation has been given e.g OPV O dose
Register: e.g OPD registers, under5 cards register, antenatal card register, and family
planning cards. The register contains what is on the client record card e.g information such
as follow ups on family planning visits

1. Write brief notes on the activities done at stage number two in the information
cycle.
ANSWER
At stage two in the information (data processing) this where that data that is
collected is being sorted out in order for the data to be of good quality. At this stage
the data under goes verification, validation, and collation and quality checks. The
following are the tools used in sorting out the data that is
HIA1= collects data on diseases e.g communicable and non communicable
HIA2= collects data on services that are offered to clients
HIA3= collects hospital data

ND= notifable disease

HIA4= collects data from the community it is used by community health assistants
HIA4 A= used by the EHT to collect data
HIA B= used by the community health assistant

2. State three main reasons why the National level on our Information pyramid only
accept to work with quality data.

4. List five examples of inputs you can consider when putting up an action plan for a

27
 Health facility.




5. Briefly explain the significance of data flow policy as used in the Ministry of
Health.

This is to emphasise on the importance of providing feedback to at each level. This

can be done in two ways that is by providing feedback from the top to bottom or from
bottom to top.

It is important to use the data flow policy because it helps in achieving the following;

 Facilitating monitoring of progress made towards achieving stated objectives

against set targets,
 Aids in sharing knowledge by providing feedback on performance and,
 Promotes understanding by making sense out of the information.

6. List sis examples of inputs found at any level of a health facility

 Physical equipment
 Infrastructure
 Human resources
 Financial resources
 Clinical guidelines
 Operation polices

1. Give an example of an indicator used at each level of reporting on the information

pyramid. (5 marks)

2. Give categories of indicators used in the DHIS. (5 marks)

3. Outline five reasons why it is important to have data of good quality (5 marks)
 Facilitates good decision-making,
 Facilitates appropriate planning,
 Facilitates ongoing monitoring and evaluation,
 Facilitates improved coverage and quality of care and

28
  Facilitates knowledge of an accurate picture of a health programmes and
services.

4. List the five basic epidemiological questions that relate to the patient. (5 marks)
 Who gets sick?
 What condition or problem ?
 Where are they coming from?
 When do they get sick?
 Why do they get sick?

5. What does the acronym CRISP stands for in good feedback? (5 marks)
6. CRISP
C- Constructive Feedback should be constructive in that it should be able to
build the capacity of Health Care Workers. The focus should not be finding faults of
the Data Collectors and Processors but to help in improving the service delivery to the
clients.
R- Relevant Feedback should only be provided for information or indicators which
are relevant to the Health Facility or Health Care Workers.
I- Immediate It is cardinal that feedback is provided as soon as possible after the
data is analysed. If it takes too long, the feedback can be out of time hence irrelevant
to the Health Care Workers. Immediate feedback ensures that corrective measures are
promptly taken
S- Selective There is a lot of data that is generated in Health Facilities, it is not
possible to provide feedback on all the information that is collected and sent to higher
level. If this was to be done, it can easily be information overload on the people who
are receiving this feedback. This can make them miss out on the most important
aspects of the feedback. It is for this reason that feedback is supposed to be selective.
P- Presentable In making feedback presentable, it will be easy for the recipient
of the feedback to understand what is being communicated to them

7. State three key discussion points which could be initiated by provding feedback to
health workers at any level

8. List types of planning

29
 Types of Planning

 Operational Plans
 Tactical Plans
 Strategic Plans
 Contingency Plans and
 Action Plans

9. Name any two types of bar charts

 Stacked bar
 Grouped bar

10. Formulate or discuss any three classical epidemiological questions DHIS strives to
answer
 Who gets sick or who is affected e.g it the young or old
 What condition( is it communicable disease e.g TB or Non – communicable
diseases
 Where do the clients or patients come from e.g which area or province
 When do people get sick e.g during what season
 Why do they get sick:e.g its because of the bad water, or poor sanitation or
economic conditions
 How do we overcome the problems: there is need to identify the common
problems are they affecting the young or the old and the places they occur.

SECTION FOUR: ESSAY QUESTIONS

 There are FOUR (4) questions in this section.
 Answer two (2) questions only from this section
 Each question carries 10 marks
(Total marks = 20)

1. Suppose Lukona Health Centre has a population of 30 000 people. When their 2014
2nd quarter reports were reviewed, the following data was discovered:
Table 1 Table 2
Serial # Diagnosis # of
cases in
Type of # < fives
vaccine immunized
1 Diarrhoea 105
BCG 480
2 Measles 40
OPV 509
3 Malaria 23
DPT 490
4 Coughs 189
Measles 456
5 Pneumonia 17
Rota vir. 510 30
 From the data shown in the two tables above, calculate:
(i) the pneumonia incidence rate per 1000 population in under-fives;(2 marks)
(ii) the total number of actual BCG doses required to cover all the expected
newly born children during the year under review.(2 marks)
(iii) If during the formulation of their objectives in an Action Plan, immunization
target was set at 80%; calculate their coverage for fully immunized children
and interpret the findings. (3 marks)
(iv) List three DHIS tools that Lukona HC could have used to capture data for the
purpose of epidemiological surveillance.(3 marks)
NB: take population breakdown as follows:
- 4.2% = Expected deliveries
- 20% = 0 to 59 months
- 16% = 12 to 59 months

2. Construct a logical framework and explain its importance in a programme

management.

3. Using a detailed flow chart, explain how data captured during service provision,
flows from the community to the clinic- and finally to the district health office. At
each stage of the flow, list and name data capturing tools which are used, what type
of data is captured?

1. Explain three epidemiological questions and their significance in data analysis.

2. In detail discuss the types of feedback and the importance of this stage in the
information cycle.
Types of feedback

 Written feedback: This includes the following

(i) Simple tables or monthly data
(ii) Program reports e.g child health, maternal health, communicable
disease and management issues
(iii) Comparative indicator reports done by the district concerning service
coverage, case rates, workloads and disease incidences

31
 (iv) Computer generated grasp showing district trends achievements or
problems
(v) Written quarterly and annual reports and other reports to health
centres
 Verbal feedback: This includes the following
(i) Staff meetings
(ii) Supervision
(iii) Feedback to the community
(iv) Feedback to other health-related sectors
Importance of feedback

 It is Persistent effort
 It helps in learning and personal growth
 It provides creativity and skill development
 It helps improved job performance
 It mproves morale to the workers
 Increases job satisfaction
 Builds and maintain healthy professional relationships
 Generate meaningful discussions
 It helps to share goals and the standards of performance and achievement
 Reducing uncertainty about what should be achieved and how it should be
achieved
 Communicates wider organizational requirements

3. Mapungu Zonal HC with a total number of 250 households conducted an IRS campaign
during the 2015 malaria transmission season. The facility recruited 6 spray operators and set
a target of 710 structures to be sprayed in order to cover the vector hot spots. Considering
all the logistics required to successfully achieve their objectives, the team agreed to give
each spray operator a target of 15 houses per day for 10 days.

Below is table showing the actual coverage up to the end of 8 days.

Day 1 2 3 4 5 6 7 8
# of
structures 78 84 66 58 52 72 56 64
sprayed

32
Imagine you are the supervisor for this programme and you are required to give a report at the end
of the campaign exercise. Interestingly, the report format only requires you to answer the following
key points:

(a) Construct a cumulative graph to show the daily coverage.

(b) What was your coverage in percentage by the 4 th day?
(c) During the planning stage, you agreed with the stakeholders and set a target of covering 80
% of targeted structures. Show the calculation for coverage achieved by end of the campaign
and give a comment for your answer.

1.Discuss key data collection tools that help HC staffs to manage handle data on HIA1 and
HIA2 forms.

3. Using a well labelled chart, discuss four basic questions that are considered during the
planning process.

i. Where are we now?

This helps in checking where the health facility is in terms of disease trends and
health services. This helps in knowing the set targets and objectives. When this is
done, they can then put the priority health problems that the facility is facing, the
resources (human, financial, transport etc).

ii. Where are we going?

33
 This helps in measuring progress towards the goals and objectives set for a period.
What indicators will we use to measure progress towards these goals and
objectives?.

iii. How will we get there?

This is the stage where we need to put up put plans into action by coming up with
the Action Plan which will show activities to be done and how much will be spent.

iv. How will know when we arrive?

At this stage we need to monitor and evaluate the progress of the activities that
where set during stage 3.

4. Discuss the information cycle. (20marks)

5. Information is collected as part of the routine provision of health services. Discuss the
data collection tools. (20marks)

Data Collection Tools

The main types of data collection tools used are:

34
a) Client Record Card: This is where the information of the client is entered and kept on initial
and subsequent contact with the Health Facility. The client record card or book is the most
detailed data collection tool and the data is more qualitative in nature.
The information collected will include:
 Name of Patient and number
 Date of Birth
 Sex
 Physical Address
 History of illness- Complaints (including duration of complaints)
 Further examination
 Laboratory test requested
 Final Diagnosis or refer if indicated.
 Treatment given

Examples of client records used are OPD Book, Under 5 Card, Antenatal Card, TB
Treatment Card etc.

b) Registers: The register aggregates what is reflected on the Clients Record Card. They are
records of data that need continuity such as conditions that need follow-up over long
periods such as ANC, immunisation, family planning, tuberculosis or chronic illnesses.
Examples of registers include OPD, ANC, delivery, and full immunisation of the infant.

c) Tally sheets: This is a sheet used for checking, scoring or counting as clients are seen. They
are an easy way of counting identical data on condition that no follow-up is required. They
are used for headcounts, minor ailments, children weighed etc. This data is important to
collect to understand the frequency of a condition or the number of services provided, but is
not useful for follow-up or public health activities.

d) Tick Sheet: This is also referred to as a ‘Check sheet’. It basically a document demarcated
into regions or columns and rolls and the user is only required to tick the appropriate cell.
Like the Tally Sheet, the data collected in this manner is more quantitative. Figure 3 below
shows a Child Health Activity Sheet and it is an example of a ‘Tick Sheet’

6. What is evaluation (20marks)

35
  Evaluation is accessing an on-going or completed program of policy as
systematically and objectively as possible. It is concerned with the evaluation
of the programs impact on the health and lives of the community involved.

7. Discuss the types of evaluation

 Process evaluation
This is used to measure the activities of the program, programme quality and
who it is reaching
 Impact evaluation
It use measure the immediate effect of the program and is aligned with the
programs objectives. It measures how well the programs objectives have been
achieved
 Outcome evaluation
It concerned with the long term effects of the program and is generally used to
measure the program goal. Consequently, outcome evaluation measures how
well the program goal has been achieved.
 Summative evaluation
At the completion of the program it may also be valuable to conduct
summative evaluation. This considers the entire program cycle and assists in
decisions.
 Timing for evaluation
At regular intervals in the life of a project e.g yearly after 2 years etc.

8. What is monitoring
 This is the systematic and routine collection of data during project
implementation for the purpose of establishing whether an intervention is
moving towards the set objectives or project goals

9. Discuss the types of monitoring

 Process monitoring/ physical progress monitoring
In process monitoring, routine data is collected and analyzed in order to
establish whether the project tasks and activities are leading towards the
intended project results
 Technical monitoring
It involves assessing the strategy that is being used in project implementation
to establish whether it is achieving the required results
 Assumption monitoring
Any project has its working assumptions which have to be clearly outlined in
the project log frame. These assumptions are those factors which might
determine project success or failure, but which the monitoring involves
measuring these factors which are external to the project
 Financial monitoring

36
 This simply refers to monitoring project/ program expenditure and
comparing them with the budget prepared at the planning stage

 Impact monitoring
It is the type of monitoring which continually assess the impact of project
activities to the target population
 Timing for monitoring
Throughout the life of a grogram e.g daily, weekly, monthly and quarterly
10.

END OF EXAMINATION

37