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THE UNIVERSITY OF ZAMBIA

SCHOOL OF PUBLIC HEALTH

DEPARTMENT OF COMMUNITY AND FAMILY MEDICINE

PROGRAMM: MPH-ONLINE

COURSE CODE: CFM 8615

COURSE NAME: MATERNAL, NEWBORN, CHILD AND ADOLESCENT HEALTH

AND NUTRITION

TIME: 3 HOURS; 09:00-12:00HOURS

DATE: 27/07/2021

INSTRUCTIONS:
1. Write your name and computer number and intake to identify your file and folder:
Name_Computer number_Course code_AUG/2019
2. There are TWO sections in this paper:
SECTION A

1. Short Essay questions

2. Answer ALL FOUR questions
3. Each question carries 8 marks
SECTION B

1. Long Essay questions

2. Answer any THREE
3. Each question carries 20 marks

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SECTION A [ANSWER ALL FOUR – [40 MARKS (8 MARKS EACH)]

1. Addressing the following four areas can potentially increase demand for quality and high impact
maternal and newborn health services in Zambia. Give a very brief explanation of each one of
them.
 Mobilizing communities (NHC/SMAGs)
 Distributing pictorial Birth Plans & “Change Champions”
 Behavior change communication
 Use of mobile technology
2. The World Health Organization stated that health systems in many countries are unable to deliver
adequately on gender equity in health. As a result, health systems are regarded as not only producers of
health and health care but also as “purveyors of a wider set of societal norms and values”, many of which
are biased against women. Briefly describe at least two of such inequalities in health service delivery.
3. A transgender adolescent visits a health facility to seek reproductive health services. Briefly describe how
you will advise a health care provider to meet the family planning needs of such a user.
4. Challenges in Maternal and Newborn health care delivery are always addressed together. Please
justify this statement in terms of research and policy development.
5. Discuss the main concerns associated with pregnancy during the adolescent period.

SECTION B [ANSWER THREE (20 MARKS EACH)]

1. The Sustainable Development Goals (SDG) set a global maternal mortality ratio (MMR) target of
less than 70 deaths per 100,000 live births by 2030. This is an ambitious goal, particularly for low-
middle income countries like Zambia, where the MMR is 278 per 100,000 live births. Therefore,
Zambia and countries in the region must continue to increase access to high impact maternal and
newborn interventions during pregnancy and childbirth. Using the Three Delays Framework,
describe at least 2 interventions for each level that you would put in place to contribute to a
reduction in maternal mortality as we strive for global SDG target.

a) First delay (7 marks)

b) Second delay (3 marks)
c) Third delay (10 marks)

2. As a Public Health Practitioner, you are expected to play multiple roles including counselling
clients from different backgrounds and with different health conditions. Below are two situations
in which your advice may be required:
a) Briefly explain dangers associated with experiencing insulin inefficiency to a
pregnant woman during the late stages of her pregnancy and; (10 marks)
b) Discuss concerns associated with pregnancy during the adolescent period. (10 marks)

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3. Most traditional childrearing beliefs and practices persist to date in some form, although they
have been influenced by changes occurring in the society as a whole.

a) List at least Three (3) practices common to your area. (5 marks)

b) For one of the practices mentioned above, give a brief explanation on how you can
work with the community and win their confidence to save women’s and new-borns’
lives. (10 marks)
c) For the practice that you have addressed, propose a recommendation to the Ministry
of Health and ensure that the best practices are reinforced to save the lives of mothers
and their newborn babies. (5 marks)

4. Many adolescents are poor and have little control over household income, have limited knowledge
about sexual and reproductive health, and lack the ability to make independent decisions about
their health. Given this background, explain the public health impact of lack of interventions to
address adolescent health problems for Zambia and similar settings. (20 marks)

END OF EXAM
&
GOOD LUCK