DI

PLOMAI
NCOMMUNI
TYHEALTH
(
COMMUNI
TYHEALTHEXTENSI
ONWORKERS(
CHEW)
PAPERI
II
,2019
SECTI
ONB:ESSAYMODELANSWERS
l
a.Qual
it
iesofast
andar
dSani
tar
yDust
bini
nyourhousehol
d:
(
i)I
tmustbemadeofnon-
absor
bentandnot
-r
esi
stantmat
eri
al
(
ii
)Itmustbepor
tabl
e
(
ii
i)I
tmustbeconst
ruct
edt
ofaci
l
itat
eeasycl
eani
ng
(
iv)I
tmustbeconst
ruct
edwi
thwat
ert
ightmat
eri
al
(
v)I
tmustcont
ainhandl
e
(
vi)I
tmusthav
eal
i
ghtf
it
ti
ngcov
er
(
vii
)Itmustbepl
acedonr
aisedgr
ound
(v
ii
i)I
tmustbeempti
edonar
egul
arbasi
s(½mar
keachf
orany5
point
s(2½marks)
b.Benef
it
sofsani
tat
ioni
nthecommuni
ty:
(
i)I
thel
psi
nreduct
ionofspr
eadofdi
sease
(
ii
)Itr
educesoccur
rencesofnon-
communi
cabl
edi
sease
(
ii
i)I
timpr
ovesgener
alaest
het
icv
alueofhomeandcommuni
ty
(
iv)I
timpr
ovest
hegener
alst
andar
dofl
i
ving
(
v)I
tbr
ingsabouti
ncr
easei
nli
feexpect
ancy
(
vi)I
treducest
her
ateofacci
dentoccur
rence
(
vii
)Itr
educespestandv
ect
orpr
oli
fer
ati
oni
nthecommuni
ty
(
vii
i
)Ithel
psi
npr
otect
ionoff
ir
eout
break
(i
x)I
tincreasest
heconduci
velev
elofenv
ironment (
½mar
k
eachforany5point
s(2½mar ks)
C.Pr
event
ionandcont
rolofNOI
SEasanoccupat
ionalhazar
d:
(
i)Useofper
sonal
prot
ect
ivedev
icese.
g.earpl
ug,
earmuf
fl
er
(
ii
)Heal
theducat
ionondangerofNoi
se,
itspr
event
ionandcont
rol
(
ii
i)Subst
it
uti
onofnoi
symachi
nef
orsi
l
entones
(
iv)Useofnoi
sepr
oofdev
ices
(
v)Pr
operpl
anni
ngoft
hewor
kingenv
ironment
(
vi)Aut
omat
ion—r
epl
aci
nghumanwor
kerbyt
echnol
ogy
(
vii
)Tr
aini
ngofwor
ker
sont
heuseofmachi
ne/
equi
pment
(v
ii
i)Regul
armedical
check-
ups (
½mar
keachf
orany6
point
s(3marks)
D.Ty
pesofOccupat
ionalhazar
d:
(
i)Phy
sical
hazar
d
(
ii
)Bi
ologi
cal
hazar
d
(
ii
i)Psy
chol
ogi
cal
hazar
d
(
iv)Chemi
cal
hazar
d
(
v)Er
gonomi
chazar
d
(
vi)Mechani
cal
hazar
d (
½mar
kforany4poi
nts
(
2mar ks)
2a.Condi
ti
onst
hatcanpr
edi
sposepr
egnantwoment
o“Hi
ghRi
sk”
(
i)Badspr
evi
ousobst
etr
ichi
stor
y
(
ii
)Vagi
nal
bleedi
ngdur
ingpr
egnancy
(
ii
i)Hy
per
tensi
onespeci
all
ywi
thedema
(
iv)El
der
lypr
imi
granda
(
v)Ver
yyoungpr
imi
granda
(
vi)Mul
ti
plepr
egnancy
(
vii
)Mal
present
ati
onoft
hef
oet
us
(
vii
i
)Chr
oni
cil
l
nesse.
g.Tuber
cul
osi
s,Hepat
it
is,
HIV/
AIDS
(
ix)Acut
eil
l
nesse.
g.Mal
ari
a,Rubel
l
a,Chi
ckenpox
(
x)Def
ormi
ti
esi
nthepel
vi
s’
s
(
xi)Car
diacf
ail
ure
(
xii
)Renal
disease
(
xii
i
)Di
abet
esmel
l
itus
(
xiv
)Pr
e-ecl
ampsi
a
(
xv)Ecl
ampsi
a
(
xvi
)Si
ckl
ecel
ldi
sease
(
xvi
i
)Ant
epar
tum Hemor
rhage
(
xvi
i
i)Pr
evi
ousr
upt
ureofut
erus
(
xix)Recur
rentabor
ti
on (
½mar
keachf
orany5poi
nts:
(2½
marks)
b.Four(
4)st
agesofl
abor
:
(
i)Stage1/Fir
stStage:Lastf
rom onsetofst
rongut
eri
necont
ract
ions
t
ot heful
ldil
atat
ionift
hecervical
OS
(i
i)St
ageII
/SecondStage:Theper
iodf
rom t
heful
ldi
l
atat
ionoft
he
cervi
cal
OSt othedel
i
v er
yofthebabyorf
oetus
(i
ii
)St
ageIII
/Thir
dSt ate:Lastf
rom thedel
i
veryoft
hebabyt
othe
expul
sionoftheplacentaandcontrolofbl
eedi
ng
(
iv)StageIV/Four
thSt
ate:Onehourfol
lowingthedel
i
veryofpl
acent
a
whichisusuall
yacri
ti
calper
iodforpost-
part
um hemorr
hage
(
½mar
keachf
oreach4st
ages(
2
mar
ks)
c.Possi
blecausesofpost
-par
tum Hemor
rhage(
PPH)
:
(
1)Mi
smanagementoft
het
hir
dst
ageofl
abor
(
ii
)Ret
ainedpl
acent
a
(
ii
i)Weakut
eri
necont
ract
ionandr
etr
act
ions
(
iv)Pl
acent
aabnor
mal
i
ties
(
v)Bl
oodcl
othi
ngdi
sor
der
s
(
vi)Lacer
ati
onoft
hegeni
tal
tract
(
vii
)Fi
broi
ds
vi
ii
)Ant
epar
tum hemor
rhage (
½mar
keachf
orany6
poi
nts(
3mar ks)
d.Reasonst
owar
rantr
emov
alofI
ntr
aut
eri
neCont
racept
iveDev
ice
(I
UCD):
(
i)Cl
i
entdesi
respr
egnancy
(
ii
)Menopause,
noneedf
orcont
racept
ion
(
ii
i)Li
feofI
UDhasexpi
red
(
iv)Acci
dent
alpr
egnancy
(
v)Unusual
bleedi
ngorpai
n
(
vi)Geni
tal
tractmal
i
gnancy
(
vii
)Dy
spar
euni
a(pai
nful
int
ercour
se)
(
ix)Par
ti
alexpul
sionoft
hedev
ice
(
x)Cer
vical
per
for
ati
on
(
xii
)Ut
eri
neper
for
ati
on
(
xii
)Mi
ssi
ngst
ri
ngs.
(
xii
i
)Copi
ousv
agi
nal
dischar
ge
(
xiv
)Al
l
ergyt
othedev
ice(
coppert
ypes)
(
xv)Desi
ref
oranot
hermet
hodofcont
racept
ive(
½mar
keachf
orany
5poi
nts(2½marks)
Par
toft
heHumanToot
h:
(i
)Enamel :
Thisisfoundoutsi
dethedenti
neoftoot
hbutv er
yhar
da
substancebecauseitcont
ains96%mi ner
alsal
tswhi
charemainl
y
cal
cium andphosphate.Theenamelishardert
handent
ine.
(i
i)Dent
ine:I
sal iv
ingti
ssueandthesecondlay
er‘ofatoothaf
tert
he
enamelandcont ai
nsahar di
vory
-l
ikesubst
ancethatsurr
oundsthe
pulpcavi
ty.I
tissoftert
hantheenamel.
(i
ii
)Pul
pCav i
ty:
Isasof
tconnect
iveti
ssueandthethi
rdlay
erofa
toot
hwhichhousesbl
oodvessel
s,ly
mphv essel
s,ner
vesandpai
n
sensor
yrecept
ors
(i
v)Cement
um:Isabone-
li
kel
ayerwhi
chf
ixest
het
oot
hini
tssocket
andhol
dsthet
oothi
nplace
(
v)Per
iodont
alMembr
ane:
Thi
sfi
xest
het
oot
htopt
hej
awbones
(
vi)Neck:
Ist
her
egi
onorpoi
ntwher
ethecr
ownandr
ootoft
het
eet
h
meet
(
vii
)Bloodv
essel
sandNer
ves: (
½mar
keachf
orany6poi
nts(
3
marks)
b.CommonCongeni
talAbnor
mal
it
iesoft
heNewbor
n:
(
i)Congeni
tal
hear
tdi
sease
(
ii
)Down’
ssy
ndr
ome‘
.
(
ii
i)Spi
nabi
fi
da
(
iv)Cl
ubf
oot
(
v)Pheny
lket
onur
ia
(
vi)Edwar
d’ssy
ndr
ome
(
vii
)Cer
ebr
alPal
sy
(
vii
i
)Cl
eftl
i
p&cl
eftpal
ate.
(
ix)Cy
sti
cfi
brosi
s
(x)Fr
agi
lesy
ndrome (
½mar
keachf
orany6
point
s(3marks)
C.Way
sofi
mpr
ovi
ngt
hef
ami
lyandcommuni
typr
act
icei
nthe
i
mplement
ati
onofI
ntegr
atedManagementofChi
ldhoodi
ll
nesses
(
IMCI)
:
(
i)
.St
rengt
hencommuni
typar
ti
cipat
ion
(
ii
)Pr
omot
eappr
opr
iat
efami
l
yresponset
ochi
l
dil
l
ness
(
ii
i)Pr
omot
echi
l
dnut
ri
ti
on
(
iv)Encour
ageadequat
eenv
ironment
alsani
tat
ion/
handwashi
ng
(v
)Improvecommuni
tyandf
amil
yfoodpr
oduct
ione.
g.home
gardeni
ng,
small
scal
efi
sher
y,
pi
gger
yandpoul
tr
y
(
vi)Counsel
l
ingonadequat
ebr
east
feedi
ng
(
vii
)Encour
agechi
l
dspaci
ng/
fami
l
ypl
anni
ng.
(
vii
i
)Encour
ageofmi
cro-
nut
ri
ent
ssuppl
ement
ati
on
(
ix)-
Encour
ageuseofLongLast
ingi
nsect
ici
dal
treat
edNet
s(LLI
N)-
(
x)Encour
ageear
lycar
eseeki
ngbehav
ior
(
xi)Encour
agepr
operuseofmedi
cat
ion
(
xii
)Encour
agehomecar
eforsi
ckchi
l
d- (
½mar
keach
f
orany8point(
4mar
ks)
4a.Def
ini
ti
onoft
hef
oll
owi
ngTer
ms:
(i
)Delusion:Afalseper
sonalbel
ieft
hatisnotsubj
ecttoreasonor
contr
adictor
yev i
denceandisnotexplai
nedbyaperson’susual
cul
turalandrel
i
giousconcepts(sothat,
forexampl
e,itnotanart
icl
e
offai
th).
(
ii
)Hal
luci
nat
ion:
Per
cept
ionofobj
ect
swi
thnor
eal
i
tyusual
l
yar
isi
ng
f
rom di
sor
deroft
hener
voussy
stem ori
nresponset
odr
ugs.
(i
i
i)I
ll
usion:
issomethi
ngthatappearstoexi
storbeaparti
cul
art
hing
butdoesnotact
ual
lyexi
storisinreal
it
ysomethingel
se.
(i
v)Schizophr
eni
a:Ament al
il
lnesst
hati
schar
act
eri
zedby
di
sturbancesi
nthought(
suchas
del
usions),per
cepti
on(
suchashal
l
uci
nat
ions)
,andbehav
ior(
suchas
di
sorganizedspeechor
cat
atoni
cbehavi
our
s),
byal
ossofemot
ional
responsi
venessand
ext
remeapathy
,andby
not
iceabl
edet
eri
orat
ioni
nthel
evel
off
unct
ioni
ngi
nev
ery
dayl
i
fe.
(v)Hyst
eri
a:Anuncont
rol
l
abl
eout
bur
stofemot
ionorf
ear
,of
ten
charact
eri
zed
(½mar
keachf
or5poi
nts(
2½
mar
ks)
b.Waystof
aci
li
tat
ethepr
ocessofr
ehabi
li
tat
ionofment
all
yil
l
per
son:
(
i)
.Accept
anceby,andst
rongsupportf
rom t
hefamil
ymembersfor
t
reat
edpersonsi
mmediatel
ytheyaredi
schar
gedfrom t
hehospi
tal
to
r
educesti
gma
(i
i
)Pl easforaccept
anceby,
andstr
ongsuppor
tfrom f
riends,rel
igi
ous
organizat
ionandothersf
ortr
eat
edper
sonsforsoci
alinteract
ion.
(i
ii
)Seeki
ngaccept
ancefortr
eatedper
sonsbyt
heirempl
oyer
saf
ter
careorencour
agegai
nfulsel
f-
employmentt
oear
nal i
vi
ng
(
iv)Appeal
i
ngforaccept
ancefort
reatedpersonsbythei
rnetwor
ks
(
e.g.cl
ubsandassoci
ati
ons)t
owhi chtheybelongbef
oreil
l
-heal
th
(v)Ensur
ingconti
nuousmoni tor
ingoftreat
edpersonsbyfamil
y
member sinordertoensurethattheyr
emainincontactwi
thm:it
al
healt
hcarefacil
it
iesorhealt
hcarepersonnelandalsocomplywit
h
tr
eatmentregi
men
(
vi)Adequat
efol
l
ow-
upi
nthecommuni
tyt
oensur
etheydonot
r
elapse
(
½mar
keachf
orany5poi
nts(
2½
mar
ks)
Obj
ect
ivesofschoolHeal
thSer
vices(
SHS)
:
(
i)Counsel
i
ngpupi
l
s,t
eacher
sandt
hei
rpar
ent
s
(
ii
)Of
fergoodgui
dancet
ochi
l
dreni
nter
msofpr
ofessi
on/
car
eer
(i
ii
)Prov
isi
onofspeci
aleducat
ionandt
reat
mentf
orhandi
capped
chi
ldr
en
(
iv)Pr
omot
ionandpr
otect
ionofheal
thofschool
per
sonal
(
vi)Appr
aisal
ofheal
thst
atusofschool
chi
l
dren
(v
ii
)Cont
rolandprev
enti
onoft
hespr
eadofcommuni
cabl
edi
seases
amongschoolchi
l
dren
(
vii
i
)Pr
omot
ionofopt
imum sani
tar
ycondi
ti
onofschool
s
(
ix)Pr
ovi
sionofemer
gencycar
eforpupi
l
s
(x)Enshr
ini
ngandincul
cat
ingt
hepr
inci
plesofgoodheal
thand
personal
hygienet
opupil
s.
(
½mar
keachf
orany5poi
nts(
2¼mar
ks)
...
4b.Act
ivi
ti
est
obecar
ri
edouti
ntheSchoolHeal
thCl
ini
c:
(i
)Physicalexaminat
ion—peri
odicmedicalexami
nati
onatleastt
wice
ayearforprimaryorpostpr
imaryschool
sbydoctorsorcommunity
heal
thwor kerswhoisalsoast
affoftheschool
(
ii
)Hei
ghtandwei
ghtmeasur
ement
(i
i
i)Gener
alexaminat
ionofski
nforr
ashes,r
ingworm andul
cer(
iv)
Examinat
ionoft
heeyes,ear,
andthr
oatfori
nfect
ions
(
v)Vi
sual
acui
tyt
estt
odet
ectdef
ici
ency
(
vi)Hear
ingt
estt
omeasur
ehear
ingabi
l
ityofchi
l
dren
(
vii
)Si
mpl
elabor
ator
yinv
est
igat
ionl
i
kest
ool
,ur
inePCV,
etc.
(vi
i
i)Radiologi
calexami
nat
ion,
chestX-
ray
,scr
eeni
ngf
ort
uber
cul
osi
s
andfinal
y earpupil
s
(
ix)Mout
hexami
nat
ionf
ordent
alcar
ies,
dent
alhy
gieneet
c.
(
x)Psy
chol
ogi
cal
exami
nat
ionbychi
l
dpsy
chol
ogi
stamongot
her
s
(
½mar
keachf
orany5poi
nts(
2¼
mar
ks)
5a.Gener
alcont
rolmeasur
eofCommuni
cabl
edi
seases:
(
i)Ear
lydi
agnosi
soft
hei
nfect
ion
(
ii
)Pr
omptandcor
rectt
reat
ment
(
ii
i)Pr
omptnot
if
icat
iont
otheappr
opr
iat
eheal
thaut
hor
it
y
(i
v)I
sol
ationofpat
ient
s/caseswhi
chi
sindi
cat
edi
nthecont
rol
of
acut
eepidermi
s
(
v)I
nvest
igat
ionoft
hesour
ceofi
nfect
ionandext
entofout
break
(
vi)Cont
actandcar
ri
ert
raci
ng
(
vii
)Concur
rentandt
ermi
nal
disi
nfect
ion
(vi
i
i)Quar
ant
ineli
mitat
ionoft
hemov
ementofper
sonswhohav
ebeen
exposedt
oinfect
ion
(
ix)Pr
otectt
hesuscept
ibl
ehostt
hroughi
mmuni
zat
ion
(x)Heal
theducati
onoft
het
argetgr
ouponmodeoft
ransmi
ssi
onand
prevent
ivemeasures
(
½mar
kforany5poi
nts(
2½mar
ks)
5b.Commonsy
mpt
omsofDi
abet
esMel
li
tus:
(
i)Excessi
vet
hir
st
(
ii
)Dr
inki
ngl
argequant
it
yofwat
er
(
ii
i)Passi
ngl
argerquant
it
iesofur
ine
(
iv)Lossofwei
ght
(
v)Fr
equentoccur
renceofboi
l
s
(
vi)I
tchi
ngofbody
,incl
udi
ngt
hepr
ivat
epar
ts
(
vii
)Pai
n,Numbness,
bur
ningort
ingl
i
ngsensat
ioni
nthel
i
mbs
(v
ii
i)Hist
oryofdel
i
ver
yofl
argebabi
es,
sti
l
l-bi
rt
hs,
orr
ecur
rent
abort
ioninwomen
(
ix)Footul
cer
sthatf
ail
ionheal
(
x)Ant
scr
owdi
ngar
oundur
ine
(
xi)Sexualweakness(
impot
ence) (
½mar
keachf
orany5poi
nt
(
2½mar ks)
c.Si
gnsandSy
mpt
omsoff
ract
ure:
(
i)Vi
sibl
efr
act
ure:
inanopenf
ract
ure,
thef
ract
ure4boneorbone
f
ragmentmaybevi
sibl
e.
(i
i
)Defor
mity
:Thebodypar
tmayappeardef
ormedduet
othe
di
spl
acementoft
hebone.
(
ii
i)Pai
n:Thecasual
tywi
l
lpr
obabl
yexper
iencepai
natapar
ti
cul
ar
l
ocati
on
(i
v)Swel
li
ng:
Ther
emaybeswel
l
ing(
edema)
att
hesuspect
edf
ract
ure
si
te.
(v
)Discol
orat
ion:Theareaaroundt
hesuspect
edfract
uresi
temaybe
brui
sedorhavehemorrhagi
cspots(ecchy
mosis)
(
vi)Cr
epitat
ion:Thefr
act
urebonesmaymakeacrackl
i
ngsound
(
crepi
tat
ion)ift
heyrubwhenthecasual
tymov
es.
(
vii
)Lossofmot
ion:
Thecasual
tymaynotbeabl
etomov
ethei
njur
e
l
i
mb.
(v
ii
i)Lossofpul
se:
ift
hef
ract
urebonei
sint
erf
eri
ngwi
thbl
ood
ci
rcul
ati
on,-t
her
emaybeno
di
stal
to(
bel
ow)t
hesi
teoft
hef
ract
ure.
(i
x)Falsemoti
on:Ther
emaybemot ionatapointwherethereis
normallynomoti
on.movementatt
hefract
uresit
ei:cal
ledfalse
motion.
(
½mar
kforany5poi
nt(
2½
mar
k)
d.Ty
pesofShock:
(i
)Anaphylact
icShock:r
eferstoaser v
iceand.l
i
fe-
thr
eat
eningall
ergi
c
reacti
on.I
tcanoccurasresultofeati
ngparti
cul
arf
oods,
taking
certai
nmedicati
ons,
oraninsectbite.
(i
i)HypovolemicShocki swhathappenst othebodywhenaper son
l
osest oomuchbl ood.Asr esultt
heheartisunabl
etopumpenough
bloodtoreachtheor gans,whichcanleadstoorganswhichcanl eads
toorganfail
ure.It
’softentheconsequencesofseverecuts,
traumat i
c
i
njuri
esinternalbl
eeding,orendometri
osis.
(i
ii
)Sept i
cShockWhenaper sonhasani nfecti
on,t
heimmunesy stem
sendsi t
’sspecialcel
lsint
othebloodtofightit.Theprocesscauses
i
nflammat ionandcanl owerbloodpressure.Ifthebl
oodpr essure
dropstool ow,theorgansmaynotr ecei
veenoughoxy genandbl ood
fl
ow, causingthepatientt
ogoi nt
osepticshock.Thisispot ent
ial
lyli
fe
threat
ening.
i
v)NeurogenicShockOccur swhenther
e’sanunev enbl
ood
di
stri
buti
onthroughoutt hebody.I
t’
soft
ent her
esultofasever
e
i
njur
y.t
othecent r
al nervoussyst
em,aspinali
njur
y,ordamagetot
he
br
ain.Lef
tuntreated,itcancausepermanentdamaget oor
gansor
evendeath.
(v
)Cardiogeni
cShockoccur swhenthehearti
sdamagedandcan’t
pumpbloodadequat el
y.I
t’
soft
entheresul
tofaheartatt
ack.Thi
scan
l
eadtoor ganfai
l
ure.Alt
houghrar
e,i
t’
s.ver
ydiff
icul
ttosurv
ive
Cardi
ogenicShocks
(vi
)Hypogl
ycemicShockLowbl oodglucose(hypogl
ycemi
a)iswhen
yourbl
oodglucosel
evelsf
all
slowenought hatyouneedtotake
acti
ontobr
ingthem backt
oy ourtar
getrange.
(
½mar
keachf
orany5poi
nt(
2½
 mar
ks)
6a.Funct
ionsofTongue:
(i
)Speech:Thetonguei
sr esponsi
blef
ordiff
erentsoundsdepending
onhowi t
’sposi
ti
onedinthemout h.Si
ncethetongueissoflexi
ble,i
t
canswit
chpositi
onsquicklytomakear api
dsuccessionofsounds
(
ii
)Taste;
budsar
eresponsibl
efortheabil
it
ytotastefood.Thereare
f
ivedi
ff
erentt
ast
esensati
ons’sweet,sour
,sal
ty,bi
tt
erandsav ory
.
(i
ii
)Masticati
on:
istheprocessofcombini
nggrindi
ngupfood
part
icl
eswi t
hnatur
all
yoccurri
ngsali
va.Mast
icati
onhappensatt
he
samet i
measgr i
nding
(i
v)Swallowi
ng:Af
termasti
cat
ingfoodpart
icl
es,t
hetonguehelps
roundthem i
ntomassesknowasbolus.Oncetheesophagusfoundi
n
thebackofthemouthbefor
efi
ndingit
swayt othest
omachf or
digest
ion
(
½mar
keachf
orany
4poi
nts(
2mar
ks)
C.Way
sofPr
event
ingEy
ePr
obl
ems:
(
i)Encour
agei
mmuni
zat
ionofchi
l
drenagai
nstmeasl
esandRubel
l
a.
(i
i
)Av oiduseofharmfultr
adit
ionaley
emedicat
iont
reat
mentand
pract
icese.g.sugar
,ur
ine,kaf
ura,sel
f-
medi
cati
on.
(i
i
i)Earlydetect
ionatbi
rt
hduri
ngimmunizat
ion,
growt
hmoni
tor
ing,
ore-schoolandschoolent
ryscr
eeni
ng.
(i
v)Avoi
dst
rauma-
beat
ingi
nheadencour
ageadul
tsuper
visi
onof
chi
ldr
en’
spl
ayPeri
odi
cmedical
check-
up.
(v)Keepabal
anceddiet
:Bet
a-car
otene,Lut
ein,Omega-
3,Lycopene,
andv i
tami
nsC,A,andEareessent
ialformaint
aini
ngyourevehealt
h.
Makesur
ethatyourdi
eti
sinf
usedwi
thdi
ff
erentf
oodst
hatar
eri
chi
n
t
hosenut
ri
ents.
(vi
)Practi
cefrequenthandwashing:Washy ourhandsregular
lyt
o
keepbacteri
aatbayandpr ev
entt hem fr
om gett
ingincontactwi
th
youreyes,ey
egl asses,
andcontactlenses
(vi
i
.)Prot
ectyourey esfrom thesun:Exposuretosunli
ghtandul t
ra
vi
oletr
aysincreasesy ourri
skforage-r
elatedmasculardegenerati
on
andmaycausecor neasunbur norphotokeratit
is,
putonsungl asses
toprot
ectyourey es.un-pr
otectedeyeglassesorcontactlensescan
beworn.Putti
ngccaps, vi
sorsandhatsar ealsoadvi
sable.
(i
x)Avoidrubbi
ngy oureyesThehandsar eexposedtoalotofdi
rt,
dustandbacter
ia,andallthesecanbeeasilyt
ransfer
redtoyour
peeperseachti
mey outouchorrubthem,soav oi
dputti
ngyourhands
toyoureyestopreventinfect
ionandir
ri
tati
on.
(x)Weartheappropri
ateeyesaf et
ygearfordifferentacti
vi
ti
es.No
mat t
erwhatyoudo,makesur ethatyoureyesar eprotect
ed.I
fy ouare
goingswimming,weargoggl estoavoidexposingy oureyesto
chlor
ine.Meanwhil
e,i
fyouar egardeningputonsgl assestoprotect
youreyesfr
om dustparti
cles,bacter
iaandinjuri
es.
(xi
)Keepy oursurr
oundingsclean.Exposuret
odi r
tanddustcan
i
rri
tat
et heeyes:somakesur etheplacesyourfrequentar
ewell
maintainedandclean.Changey ourl
inensandtowelsregul
arl
yand
keepy ourworkst
ationcl
utter
-fr
ee
(xi
i
)Getenoughsleep.Justl
iket
herestofyourbody,y
oureyesneed
torechar
getoo,andthappenswhil
eyoursl
eep.Somakesur ethat
yougetsuff
ici
entshut
-eyeeachdaytokeepyey esr
evit
ali
zedand
healt
hy.
(xi
ii
)Stayhydrated.Suffi
cientflui
dintakeisessenti
altoy
ourbody’
s
overal
lwell-
being,i
ncludi
ngt heeyes.Ify
ouar ehydrat
edenough,
you
preventyoureyesfrom get t
ingdryandi r
rit
ated.
(xi
v)Don’tsmoke.Smoki ngmakesy oumor esuscepti
bletoage-
rel
atedmacul ardegener
ationandothereyecondit
ionssuchas
cataract
.Smoki ngcanalsodamaget heopti
cnerves,whichcanhav
e
adverseeffectsonyourvisi
onovert
ime.-
(xv
)Obser
vethe20-
20-20r
ule.I
fyouwanttokeepyoureyesingr
eat
shape,
youshoul
dadheret
othe20-20-
20rul
e,whichst
atesthat

 Ever
y20minut
es,l
ookawayfrom computermoni
torandf
ixy
our
gazeOnanobj
ectt
hat’
sfeetawayfrom y
ou.

 Bl
i
nk20successi
vet
imest
opr
eventey
edr
yness

 Every20mi nut
es,getoutofyourseatandtake20steps.Thisis
notjustgoodforyourvisi
on,
butalsopromotesproperposture
andbloodthroughoutthebody,yes,
itkeepsyouf
rom being
sedentaryt
oo.
(xvi
)Uset her
ightki
ndofey emake-up.Ifyouwearmake-up,
choose
thebrandsthatworkwelly
ou.Steerclearofeyeshadows,mascar
a,
andey el
i
nersthatcauseal
lergi
creacti
onst oy
our
(1markeachf
orany5poi
nts
(
5mar
ks)
7a.Medi
calpr
obl
em oft
heaged:
(
i)I
mpai
redv
isi
on
(
ii
)Deaf
ness
(
ii
i)Ar
thr
it
is
(
iv)Seni
l
edement
ia
(
v)Cor
onar
yhear
tdi
seases
(
vi)Lossofl
i
bido
(
vii
)Hy
pot
her
mia
(
vii
i
)Di
abet
icmel
l
itus
(
ix)Hy
per
tensi
on
(
x)Ment
alconf
usi
on
(
xi)Lossofappet
it
e
(
xii
)Ost
eoar
thr
it
is
(
xii
i
)Pr
onet
oacci
dent
(
½mar
kforany6poi
nts.(
3
mar
ks)
b.Measurest
obeadopt
ed.
inpr
event
ingt
heagedf
rom home
acci
dent:
(
i)Heal
theducat
iononcausesandpr
event
ionofhomeacci
dent
s
(
ii
)Av
oidanceofsl
i
pper
yfl
oor
s/t
il
es
(
ii
i)Pr
ovi
sionofwal
ki
ngst
icks-
c.Way
sofpr
event
inghandi
cappi
ngcondi
ti
ons:
a.Per
iodi
cimmuni
zat
ion
b.Ear
lydi
agnosi
sandpr
omptt
reat
mentofdi
seasecondi
ti
on
c.Heal
theducat
ion
d.Mar
ri
agecounsel
i
ng
e.pr
opermanagementofl
abor
f
.Goodant
enat
alcar
e
g.Adequat
enut
ri
ti
on
h.Roadsaf
etyt
opr
eventacci
dent
(
½2mar
keachf
or4poi
nts(
2
mar
ks)

d.Ef
fectoft
hehandi
cappedchi
ldont
hei
mmedi
atef
ami
ly
:
i
.Depr
essi
onoft
hepar
ent
s
i
i
.Economi
cdr
ainageont
hepar
ent
/fami
l
y
i
i
i.Mayl
eadt
obr
okenhome
i
v.Fearofhav
inganot
herchi
l
dren
v
.Rej
ect
ionoft
hechi
l
dbyext
endedf
ami
l
y
v
i.Mayl
eadt
ost
igmaoft
hechi
l
dandt
hef
ami
l
y
v
ii
.Educat
ionoft
hei
sexpensi
vei
.e.speci
alschool
(
½mar
keachf
or5poi
nts(
2½mar
ks)
 DI
PLOMAI
NCOMMUNI
TYHEALTH
(
COMMUNI
TYHEALTHEXTENSI
ONWORKERS(
CHEW)
PAPER1,
2019
ESSAY:MODELANSWERS
1a.Ri
ght
sofacl
ient
/pat
ienti
nheal
thcar
edel
iv
ery
:
i
.Ri
ghtofconsi
der
ati
onandr
espect
,pr
ivacyandconf
ident
ial
i
ty.
i
i
.Uncondi
ti
onedaccept
anceasahumanbei
ng
i
i
i.Recei
vi
ngheal
thcar
einaccor
dancewi
thhi
s/herspeci
fi
cneeds
i
v.I
nfor
med,vol
unt
arydeci
sion-
maki
ng,
regar
dingconsentandr
efusal
oft
reat
ment
v
.Confi
rmati
onofidenti
tyf
orpurposesofdi
agnosi
s,car
eand
t
reat
mentandcorr
ectlabel
ingofhis/
her:
(
a)Per
son
(
b)Possessi
on
(
c)Speci
mensf
ori
nvest
igat
ionpur
posel
i
kebl
oodsampl
eet
c.
(
d)Recor
dincl
udi
ng:
moni
tor
ingr
ecor
dandr
epor
ts
(
e)Hi
s/herbodyi
nthecaseofdeat
h
(
f)Reasonabl
eexpect
ati
onr
egar
dinghi
s/hert
reat
ment
(
g)Pr
otect
ionagai
nstcr
oss-
inf
ect
ionandcommuni
cabl
edi
seases
(
h)Recei
vepr
escr
ibet
reat
ment
(i
)Diewit
hdi
gni
ty (
½Mar
keachf
or5
point
s(2½mark)
b.CodeofConductf
orCommuni
tyHeal
thPr
act
it
ioner
s:
i
.Setahi ghstandar
d:Acommuni tyheal
thpract
it
ionershallsetahi
gh
standardandnotall
owhimself
/hersel
ftorecei
vegift
sfavour s,
or
hospital
it
yfor
m acli
ent
/pat
ient,orrel
ati
vesofacli
ent/pat
ientwhois
tobeorwhohasbeen, inhi
shercar e.
i
i.I
ntr
a-pr
ofessionalobli
gat
ion:Acommuni t
yheal
thpr
acti
ti
onershal
l
maint
ainfr
iendl
yr el
ati
onswithcol
leaguesandber
espect
fult
othe
seni
orcol
leagues.
i
ii
.Useofst andingorders:
acommunit
yhealthpract
it
ionermustuse
hi
s/herstandingordersandot
hermedi
calequipmentinarri
vi
ngatany
di
agnosisandmanagementofhi s/
herpat
ient.
i
v.Maintenanceoftwo-wayref
erralsyst
em:acommuni tyheal
th
pract
it
ionershal
lmaint
ainther
eferral
system byr
efer
ri
ngcases
beyondhis/herj
obdescri
pti
onoftheappropri
atel
evel
.
v.Admini
steri
ngoftreat
ment:ACommuni tyHealt
hPr acti
ti
onershal
l
notadmini
steranytr
eatmentonapatientwi
thouttheconsentofthe
pati
entrhi
s/herrel
ati
onincaseofunconsci
ousorapat ientwho
cannotspeakf
orhi
msel
f/her
sel
f.
vi.Pr
omptAttention:Acommuni tyHeal t
hPracti
ti
onershallensur
e
thesafet
yofhis/herpat
ientwhethert herel
ati
vesarearoundornot
andusewhatev ermeansathis/herdisposaltapreser
velif
ewhi l
e
waiti
ngrel
ati
on’sarri
valandassistance
vi
i
.Givi
ngofEv i
dence:ACommunit
yHealt
hPracti
ti
onershal
lsay
whathe/sheknowsisthet
rut
hwhengi
vingev
idenceasanexpert
wit
ness
vi
ii
.UseofUniform:Acommuni t
yheal
thPracti
ti
onermustalways
appeari
nhis/heruni
form onceondutyexceptduri
ngemergencyand
cal
ldutywhichareoutsi
deof f
ici
alwor
kinghours
i
x .Anti
-Professi
onalbehavi
our:Acommuni tyHealthPracti
ti
oner
shallbemember softheNationalAssoci ati
onofCommuni tyHealth
Practi
ti
onersofNigeri
abeingtheonl ylegallyrecogni
zedbodyt o
assistt
heBoar dinensuri
ngprofessional sanit
yanddignityi
nt he
country.AnyCommuni tyHealt
hPr acti
tionerthatdoesnotbelongt o
theAssociati
onwouldnotber ecognizedbyt heBoard.
x.
.Absenteei
sm:Acommuni
tyHealthPracti
ti
onershoul
dnotabsent
hi
mself/
hersel
ffr
om dut
ywi
thoutper
mission.
(
½mar
keachf
orany6poi
nts(
3
mar
ks)
c.Dut
iesofaCommuni
tyHeal
thPr
act
it
ioner
:
1.Caringforthesickandinj
uredconsider
ingtheresour
cesofthe
resourcesofthepati
ent,hi
sfamil
yaridenvir
onmentandt heservi
ces
avail
able,i
ncorpor
ati
ngpersonalneedstohis//
herrecoveryand
rehabi
lit
ati
oninaccordancetothefi
ndingsandactionsofthe
St
andi
ngOr
der
s.
i
i.Helpingt
hei
ndi
vidual
andthefamil
ytotakeposi
ti
veact
ioni
nrel
i
ef
ofil
lnessandi
mprovementofhi
s/heri
ndi
vidual
famil
yandcommunit
y
needs.
i
i
i.Tr
aini
ngOt
her
s:Tof
unct
ionasmember
soft
heheal
tht
eam.
i
v .Adoptingcommunit
yhealt
hservi
ces:Tocor
respondwit
h
responsiblepl
anni
ng,
author
it
iesemergenci
esl
i
kedisast
er,
out
breaks;
andwar s.
v.Eval
uati
ngandconducti
ngresearcht
oimpr
oveheal
thcar
eand
adequatel
ymeet
ssociet
y’sneeds.
v
i.Shari
ngwit
hother
sinthedi
ssemi
nat
ionofheal
thi
nformat
ionto
i
ndiv
idual
sandint
hecommunity (
½mar keach
f
orany5point
s(2½mar ks)
d.Communi tyHeal
thPr
acti
ti
onerandHis/her
scoll
eagues
Relat
ionshi
p:ACommunityHeal
thPract
iti
onershal
l
:
i
.Behonestinhi
s/herpr
ofessi
onal
discussi
onwi
thcol
l
eaguesl
i
ke
dur
ingr
eportwri
ti
ng
i
i
.Tr
usthi
s/hercol
l
eaguest
oel
i
citcooper
ati
on
i
i
i.Hav
erespectf
ort
hecont
ri
but
ionofot
her
s
i
v.Takeappropr
iat
eacti
ont
osafeguardthecli
ent
/pat
ientwhen
hi
s/hercar
eisendanger
edbyworkerorother
s.
(
½mar
keachf
or4poi
nts:
(2
mar
ks)
2a.Agent
sofsoci
ali
zat
ion:
i
.Famil
yisthefir
stagentofsoci
ali
zati
on.MothersandFather
s,
si
bli
ngsandgrandparent
s,member sofanext
endedf amil
y,al
lteacha
chi
ldwhathe/sheneeds.toknow,andhowtor el
ateother
s.
i
i.Peergr oupismadeupofpeopl ewhoar esimil
arinageandsoci al
stat
usandwhoshar esinteract
ion.Peergroupsociali
zati
onbegi nsin
theear l
i
esty ears.Aschildrengrowi ntoteenager
s,thi
sprocess
continues.Peergr oupsar eimpor t
anttoadolescentsinanewway ,as
theybegint odev el
opandexer tindependence.Peergroupprovide
adolescents’fir
stmaj orsociali
zationexperi
enceoutsidetherealm of
thei
rf amil
ies.
i
ii.Schoolchi l
drenspendaboutsev enhoursaday,180day sayear,
in
school whichmakesi thar ddenythei mport
anceschoolhasont hei
r
soci ali
zati
on.St udentsar enotinschool onl
ytostudymat hemati
cs,
readi ng,science,andot hersubjects-.t
hemanifestfunct
ionofthi
s
sy stem.School al
soser v ealat
entf uncti
oninsoci
etysocial
izi
ng
chi l
drenintobehav ioursl i
kepracti
cingteamwor k,
foll
owinga
schedul e,andusi ngtext books.
i
v .Religion-Reli
gionisani mportantavenueofsoci al
izat
ionf ormany
peopl e.Likeotherinsti
tuti
onchur chesandmosquest each
parti
ci pantshowt ointeractwit
ht hereli
gion’smat eri
alcultur
e.Mai
reli
giousi nst
it
utionsalsoupholdgendernor msandcont ributetothei
r
enforcementt hroughsoci ali
zat
ion.Organi zedrel
igionfostersa
sharedsetofsoci ali
zedv al
uesthatar epassedt hroughsoci ety.
v.GovernmentManyoft heri
tesofpassagepeopletothr
ought oday
arebasedonagenor m est
abli
shedbyt hegover
nment.Tobedef i
ned
asan“ adul
t”usuall
ymeansbei ngeight
eeny eol
d,theageatwhi cha
personbecomesl egal
lyresponsi
bleforhim/her
sel
f.Anysixt
y-f
ivey e
bidisthest
artof“oldage”sincemostpeoplebecomeel i
gibl
efor
seni
orbenef
it
satt
hatpoi
nt.
vi.Massmedi adistri
but eimpersonal informat iontoawi deaudi ence
‘
Vi at el
evisi
on,newspaperr adio,andt hei nternet.Withtheav er age
personspendi ngov erf ourhoursadayi nf rontoftt el
evision( and
childrenav er
agingev enmor escr eentime, medi agreatl
yi nfl
uences
soci alnorms.Peopl el earnaboutobj ectsofmat er
ialcul
t ure(li
kenew
technol ogyandt ranspor tat
ionopt i
ons) ,
wel l asnon-mat erialcultur
e
whati str
ue( bel
iefs).Whati simpor tant(v alues)andwhati s‘expected
(norms) .
vi
i.Wor kplaceisanotheragentofsociali
zati
on.Att hewor kpl ace,a
personmeet speopleofdiffer
entagegroupandbel ongingtodi ff
erent
social andcul t
uralbackgrounds.Thismakeshi m comei ncl ose
cont actwi thdif
fer
entthoughtprocesses,bel
iefsy stemset c.The
i
nter actionthatthenhappenshel psapersont obroadenhi s/ her
horizonsi nt er
msofsoci alacceptanceandtolerancet owardst he
other s.
i
ii.Communi ty-Communi tyi
sanimportantinfor
mal andact iv
eagency
ofsoci al
izati
on.Justast hef
amil
yandschool haveagreati nfl
uence
upont hechi l
d,muchint hesamewayt hecommuni t
yalsomodi fi
es
thebehav i
orofchil
dthroughsocial
contacts,groupacti
v i
tiesalsoand
groupdy nami csinsuchawayt hathebeginst opart
ici
patei nallt
he
desirableactivi
ti
esofthecommuni ty‘
ofwhi chheisani ntegralpart
.
(½mar
keachf
orany5poi
nts(
2½
mar
ks)
b.Char
act
eri
sti
cs/
feat
uresofcul
tur
e:
i
.Cul
tur
eisuni
ver
sal
tomanki
ndandnotpecul
i
art
oapar
ti
cul
argr
oup
i
i
.Cul
tur
edi
ff
ersf
rom pl
acet
opl
ace
i
i
i.Cul
tur
eiscont
inuousanddoesnotdi
ewi
thpeopl
e
i
v.Cul
tur
eis’
lear
nedov
ert
ime,
iti
snoti
nbor
ninpeopl
e
v
.Cul
tur
echangesandi
tisnotper
manent
v
i.Cul
tur
egr
owsf
rom gener
ati
ont
ogener
ati
on
v
ii
.Cu1t
urcanbebor
rowedespeci
all
ygoodcul
tur
es
v
ii
i.Cul
tur
ecanbei
nher
it
edf
rom onegener
ati
ont
otheot
her
i
x.Cul
tur
ecant
ransf
err
edf
rom per
sont
oper
son,
communi
tyt
o
communit
y
(
½mar
keachf
orany5poi
nt(
2½
mar
ks)
c.Fact
orst
hatcausef
orget
ti
ng:
i
.Int
erfer
enceduet
omassi
ngofsi
mil
arl
ear
ningexper
iencesorov
er
l
oadingofthememory
i
i
.Fadi
nganddecayduet
olackofpr
act
iceandexer
cise
i
ii
.Insuf
fi
cientt
ime,
whi
chl
eadst
oahast
ysear
choft
hememor
y
st
ore
i
v.Repr
essi
onarisi
ngfr
om st
rongemoti
onatt
achmentorgui
l
t
f
eeli
ngsImper
fecti
onofthememorypr
ocess
v
.Changeofcont
extorsur
roundi
ngsleadingtot
her emovalof
r
eminder
sandreduct
ioni
ntheeffect
ivenessofr
etr
ievalcues
vi
.Fearoranxi
etyari
singf
rom l
ackofconfi
denceaswel
las
exempli
fi
edinstagefr
ight
,mentalbl
ackoutorbrai
nwav
e
(
½mar
keachf
orany5poi
nts(
2½
 mar
ks)
d.Dev
ianty
out
hbehav
iori
nyourcommuni
ty:
i
.Dr
ugabuse
i
i
.Rape
i
i
i.Vi
ciousat
tackonot
herandev
enpar
ent
s
i
v.Yout
hful
banal
i
zat
ion
v
.Exami
nat
ionmal
pract
ice
v
i.Menaci
ngt
hreatandext
ensi
on
v
ii
.Tr
uancy
v
ii
i.Ov
erspeedi
ng
i
x.Danger
ousexper
iment
ati
on
x.Ear
lysexual
behav
ior
3a.Fact
orst
hatpr
omot
eef
fect
iveheal
theducat
ion:
i
.Bui
l
dingonwhatpeopl
eknow
i
i
.Fav
orabl
eenv
ironment
i
i
i.El
i
minat
ionofbar
ri
ers
i
v.Tr
eat
ingpeopl
ewi
thr
espect
v
.Bei
ngagoodl
i
stener
v
i.Respectt
radi
ti
onsandCul
tur
es
(
½mar
keachf
orany6poi
nts(
3
mar
ks)
b.Har
mf ult
radi
ti
onalandcul
tur
alpract
icest
hatinf
luenceheal
th
behav
ioursandheal
thacti
oninthecommunity:
(
i)Ear
ly/
for
cedf
emal
emar
ri
age
(
ii
)Tr
ibal
mar
k/TabooScar
if
icat
ion.
(
ii
i)Wi
ndowhoodpr
act
ice
(
iv)Foodt
aboo
(
v)Femal
egeni
tal
mut
il
ati
ons
(
vi)Abr
uptWeani
ng
(
vii
)Cut
ti
ngumbi
l
ical
cor
dusi
nghotkni
fe
(
vii
i
)Dr
inki
ngbl
ueorpot
ashf
orf
ami
l
ypl
anni
ng
(
ix)Bur
ningoff
eetdur
ingconv
ulsi
on
(
x)Appl
i
cat
ionofcowdung/
yam f
lourt
oumbi
l
icus
(
xi)Expr
essi
onofcol
ost
rum’
sanddi
scar
d
(
xii
)Depr
ivi
ngchi
l
drenf
rom t
hemot
herf
orweani
ng
(
½mar
keachf
orany8poi
nts(
4
mar
ks)
c.Met
hodsofHeal
thEducat
ion:
i
.Inter
view:Thisisadiscussi
onbetweent wopeopleinaquesti
on-and
—answerf r
om.I tisusual
’bet
weent hehealt
hpersonnel
andtheclient
orpati
ent,especial
lywhenanindi
vidualhasaspechealthpr
oblem for
whichhe/sheisseekingasoluti
on.Thismet hodi
sidealf
ordecisi
on-
making
(
½mar
ks)
i
i.GroupDi
scussion:Thisismut ual chatshar i
ngofi deasorar gument
betweenmember sofat argetgroupof‘ about3- 12indivi
dualswho
haveacommonpr obl
em.Theai m oft hediscussioni stocomeup
wit
hasoluti
onfrom withinthegr oup.Usual l
ytheheal thpracti
tioner
,
whoi samemberoft hegroup, guidest hem throught hediscussion
andactsasaresourceper son,providingexpertadv i
cewhenneeded.
(
½mar
k)
i
ii
.Demonst r
ati
on: Thisi
sar eal-l
i
feactivi
ty.Atechniqueinwhicha
sequenceofstepsiscarri
ede’ toill
ustr
ateapr obl
em, showa
procedur
eorprovideabasi sfordrawingconclusions.Thismethod
usuall
yall
owsforthe-specialsensesofhear i
ng,sight,
touch,
feeli
ng
andtastetobeinvolvedforeffecti
velearni
ng.
(
½mar
k)
i
v .Roleplay:Thisisrat
heraspecifi
edfor m ofacti
ng.Iti
swhenan
i
ndi v
idual t
akesthepartofanothercharacter,especi
all
yasr el
atedto
theaspect sofhumanf uncti
oni
ngordai lylivi
ngrelat
ion(behavi
or).I
t
i
sapopul artoolforpor
trayi
ngasocialsituati
on.Thismet hodisideal
foratti
tudedev el
opment ,mast
eri
ngdeci sion-makingandimprov i
ng
communi cati
onskill
s.
(
½mar
k)
v.Brai
nstorming:Thisi
sacr i
ti
cal examinati
onofi deas,
probl
ems,
sit
uati
onandappr aisal
ofbetweent hecl
ientsorinacommi tt
eewit
h
theaim ofgenerat
ingsolut
ions.Itisanidealandef f
ecti
vemethodi
n
decisi
onmaki ngandcommuni cati
onskilldevel
opment .
(
½mar
k)
v
i.Lect
ureMet
hod:
Thi
sinv
olv
esast
rai
ght
for
war
ddi
scussi
on;
apr
e-
pl
annedstr
uctur
edschemedeli
veredonat opi
c.Themai nvaluei
sto
prev
entasuit
abl
eortopi
ctoalargeaudienceofat arsgroup.Iti
s
commonmet hodofprov
idi
ngspecif
ichealt
hinfor
mat ion.This
methodi
sidealf
ordevel
opi
ngknowl edgeanddecision-makingskil
l
s.
(
½mar
k)
4a.Fact
orst
hatf
aci
li
tat
eint
egr
atedser
vicedel
iv
eri
nPHC:
i
.Acohesi
veheal
tht
eam
i
i
.Funct
ional
communi
tydev
elopmentcommi
tt
ee(
CDC)
i
i
i.Ef
fect
iveandef
fi
cienti
nfor
mat
ionsy
stem
i
v.Oper
ati
onal
,twoway
sref
err
alsy
stem
v
.Ef
fi
cientdr
ugr
evol
vi
ngsy
stem
v
i.Adv
ocacySuppl
yofessent
ial
drugspi
l
l.
v
ii
.Pr
ovi
sionoff
und
b.Nat
ional
Heal
thI
nsur
anceScheme(
NHI
S)
(½mar
keachf
orany6poi
nts(
3
mar
ks)

4b.Adv
ant
agesofi
ntegr
atedpr
imar
ycar
eser
viceDel
iv
ery
:
i
.Tohar
nessPHCr esour
cesi
nthecount
ry,
toi
ncr
easepr
oduct
ivi
ty,
andt
opreventdupl
i
cit
yandwastage;
i
i
.Toeconomi
zei
nmanpower
,moneyandmat
eri
als
i
ii
.Toof
ferawi
derr
angeofser
vicest
othecommuni
tywi
thi
neach
PHCuni
t
i
v.Tomai
ntai
nandsust
aingoodor
derf
orPEGser
vices
v.Toassi
stt
he-manager
sofPEGi nadopt
ingaholist
icappr
oacht
o
PHCimplement
ati
on,managementandevaluat
ion
vi.Torecordt
hepr
ogr
essofPHCinawaythatwil
lser
veasa
refer
enceforPHCpol
i
cy-maker
s,uni
tmanager
s,f
iel
dworker
sand
coordinat
ors.
v
ii
.Toenhancet
heprov
isi
onofcompr
ehensi
veheal
thcar
eser
vicesat
t
hecommunityl
evel
vi
i
i.Topr
omoteavail
abi
l
ityandaccessi
bil
i
tyofheal
thcar
eser
vicest
o
alar
genumberofpeopl
einthecommuni t
y.
i
x.Toeconomizei
ntheuseofpati
entsti
meandf i
nance,enhance
sat
isf
act
ionwitht
heser
viceandenablepat
ient
stoputtheirt
imeand
moneytobet
teruse.
x.Tosust
aint
hel
i
fespanoft
heser
vicespr
ovi
dedandt
hei
nter
estof
thecommunit
y
xi
.Topr
omot
ejobsat
isf
act
ionf
ort
hecommuni
tyheal
thwor
ker
s
(
½mar
keachf
orany8poi
nts(
4
mar
ks)
c.Funct
ionoft
heheal
tht
eam:
(
i)Pr
omot
eheal
thser
vices
(
ii
)Impr
ovegoodwat
ersuppl
y
(
ii
i)Ensur
eant
enat
alser
vices
(
iv)Educat
ethecommuni
tyonchi
l
drennut
ri
ti
onal
stat
us
(
v)Ensur
ethateachchi
l
disi
mmuni
zedwi
thi
nagi
vencommuni
ty
(vi
)Ident
if
ydi
seasest
hatr
equi
reear
lyt
reat
mentorr
efer
ral
communi t
y
(
vii
)Car
ryoutheal
theducat
ioni
nthecommuni
ty
(v
iii
)Li
aisewi
thcommuni
tyt
ofi
ndsol
uti
ont
oident
if
iedheal
th
probl
ems
(
ix)Encour
agecommuni
typar
ti
cipat
ion
(
xi)Heal
thcounsel
i
ng
(
½mar
keachf
orany6poi
nts(
3mar
ks)
5a.St
epsi
nvol
vedi
nCommuni
tymobi
li
zat
ion
i
.Ident
if
ycommuni
tyheads/l
eader
s
i
i
.Makei
nit
ial
cont
actwi
tht
hel
eader
s
i
i
i.Communi
cat
eyouri
ntent
ions
i
v.Acquai
ntsel
fwi
tht
hecul
tur
eandsoci
alpr
otocol
oft
hecommuni
ty
v
.Ar
rangef
ormeet
ingwi
tht
hecommuni
tyheadsandr
epr
esent
ati
ves.
v
i.Dev
elopanagendaf
ort
hemeet
ingwi
tht
heot
herheal
thwor
ker
s.
v
ii
.At
tendt
hemeet
ing.
v
ii
i.Expl
ainpur
poseoft
hemeet
ingi
nanaccept
abl
elanguage
i
x.Requestt
hem toconv
eythemessagetoothercommuni
tymember
andbri
ngfeedbacki
nsubsequentmeet
ings
x.Encouragequest
ionsandpart
ici
pat
ionf
rom t
heaudi
encet
ocl
ari
fy
all
issuesbefor
emeet i
ngdisper
ses
xi
.Deci
dewi
tht
hepar
ti
cipant
sthedat
e,t
imeandv
enueoft
henext
meet
ing
xi
i
.Hav
easmanymeet
ingsasnecessar
yunt
ilaconsensusi
sreached:
(
½mar
keachpoi
nts12(
6mar
ks)
b.Rol
eofcommuni
tyDi
agnosi
sinpr
imar
yheal
thcar
e:
Communit
ydiagnosi
sident
if
iesr
esour
ceswi
thi
nthecommuni
tyt
o
sol
vei
dent
ifi
edhealt
hprobl
ems
i
.Iti
dent
if
ieshealt
handr
elat
edneedsofacommuni
tyanduset
hem
asbasi
sforplanni
ng
i
i.I
tenhancesi
nter
act
ionbet
weent
hecommuni
tyandt
heheal
th
worker
s
i
ii
.Communit
ydiagnosi
sident
ifi
esconst
rai
ntswhi
chcanbe
addr
essedi
ntheplanni
ngprocess
i
v.Ifpr
ovi
desbasel
i
nedat
aforev
aluat
ionofcommuni
tyi
nter
vent
ions
t
reatment
.
(½markeachf
orany4poi
nts
(
2mar
ks)
c.Met
hodsusedi
ncommuni
tyDi
agnosi
s:
i
.Obser
vat
ion/Phy
sicalExami
nat
ion:
Itisv er
yimpor tantt
o4et errni
nethediseaset hataffectthe
communi tythroughobser v
at i
onandphy si
cal exami nati
onbecause
somedi seasesar enotrecognizedinthecommuni t
ye.g.Anemia,
dent al-
care,malnutr
it
ion,diabetes.I
nobserv ati
ony ouobservetheir
sur r
oundings,livi
ngconditi
ons, eati
nghabitsandl if
epat t
ernt
oav oid
wr ongi mpressionInobserv at
ionalsoyouar et’useey estoseeand
alsohearsomer el
evantinformationwit
hy ourear s.
i
i.Int
ervi
ew:Thisi nvol
vescommuni cat
ingwi t
hsomebodye. g.
householdheads, mothers.Thesepeopl ewhopl ayimpor t
antrolein
thecommuni tyindecisi
onmaki ngonheal thmat tersorissues.You
shouldcreat
eagoodr apportwi ththeper sonsot hathe/shewi l
lfeel
freet
otalkwithy ouandgi vey outhecor rectinformat i
onaboutwhat
youneed.Int
er v
iewmaybef acetof ace( verball
y)ct hr
ough
questi
onnair
e( f
il
lingaprepar edform) .
i
ii
.GroupDiscussi
on:I
ngroupdi
scussi
on,unli
keint
erview,i
sheldwit
h
gr
oupsofpeopleandnoti
ndivi
dual
.Iti
susefuli
ngettinginf
ormati
on
onhealt
hneedsofthecommunity(
thatiswhattheyfeelasthei
rmost
pr
essingpr
oblems).
i
v .Revi
ewofExi st
ingRecords:Usef uli
nfor
mat i
oncanbeobtainedby
reviewi
ngexist
ingrecordspart
icularl
ywhent ry
ingt
odeterminethe
populati
onofacommuni tyt
heheal thfaci
li
ti
esandthehealt
h
personnelaswellasdiseasepatterninthearea.
(½mar
keachf
or4
poi
nts)
6a.Met
hodsofAdmi
nist
rat
ionofdr
ugs:
(i
)Or al
:Theoral
methodstakest
heform ofapi
l
l,capsuleorl
i
quid
thatyouswall
ow.Thi
sistheeasi
estandmostconv eni
entmethod
sinceitcanbedoneathome:
(
ii
)Int
ramusculardr
ug:
arei
nject
edi
ntot
hemuscl
e,usual
l
yint
hear
m,
t
highorbut
tock.
(
ii
i)Subcut
aneousdr
ug:arei
nject
edi
ntot
het
issueundert
heski
n
i
nsteadofi
ntothemuscl
e.
(
iv)I
ntr
avenousr
out
e:Aneedl
eisi
nser
teddi
rect
lyi
ntoav
ein.A
soluti
oncontai
ningthedr ugmaybegi veni
nasingledoseintothe
vei
norbycont i
nuousi ntravenousinfusi
onthr
oughacannul a,
Int
ravenousadmi ni
strat
ionist hebestwaytodeli
verapreci
sedose
quickl
yandinawel l-controll
edmannert hr
oughoutthebody .
(
v)I
ntrat
hecalrout
e:Aneedleisinsertedbet
weentwovertebr
aef r
om
t
hel
owerspineandi nt
ot hespacearoundthespi
nalcor
d.Thedr ugis
t
hei
njectedi
ntothespinalcanal
.Asmal lamountofl
ocalanesthet
ic
i
soft
enusedt onumbt heinj
ecti
onsite.
(
vi)Subl
ingualandbuccalroute:Afewdrugsareplacedunderthe
t
ongue(takensubli
ngual
ly)betweenthegumsandt eeth(bucal
l
y )so
t
hattheycandissol
veandbeabsor beddirect
lyi
ntothesmallbl
ood
v
esselsthatl
iebeneatht
het ongue.Thesedrugsarenotswall
owed.
(v
ii
)Rectalroute:Manydrugst hatareadministeredoral
lycanalsobe
admini
steredrectal
lyasasupposi t
ory.I
nthisform, adrugismixed
wit
hawaxysubst ancethatdissol
vesorli
quef i
esaf t
eriti
sinser
ted
i
ntotherectum.Becauset herectum’swalli
st hinanditsbloodsuppl
y
ri
ch:t
hedrugi sreadil
yabsorbed.
(
vii
i
)Vaginalr
oute:Somedr ugsmaybeadmi nist
eredvaginal
lyt
o
womenasasol ut
ion,t
ablet
, cr
eam,gel
,supposit
ory,
orring.Thedr
ug
i
sslowl
yabsorbedthroughthev agi
nal
wall
(i
x)Ocul
arroute:
Dr uguset otr
eatey edi
sorders(suchasglaucoma,
conj
unct
ivi
ti
sandi njur
ies)canbemi xedwithinacti
vesubst
ancesto
makealiqui
d,gel
,oroint mentsothattheycanbeappl i
edtotheeye.
(x)Opti
croute:Drugsuset otr
eatearinfl
ammat i
onandi nfect
ioncan
beappli
eddirectl
ytot heeff
ectedears.Eardropscontai
ningsolut
ions
orsuspensi
onsar etypical
l
yappliedonlytotheouterearcanal.
(
xi)Nasal
rout
e:I
fadr
ugi
stobebr
eat
hedi
nandabsor
bedt
het
hin
mucousmembranet hatl
inethenasal
passages.I
tmustbe
tr
ansfor
medint
otinydroplet
sintheai
r(at
omized)onceabsor
bed,
the
drugent
erst
hebloodstream.
(xi
i)I
nhalati
onroute:Drugsadmi ni
steredbyinhal
ati
onthroughthe
mouthmustbeat omizedintosmallerdropl
etsthanthose
administ
eredbythenasal route,
sot hat,
thedrugscanpasst hr
ough
thewindpipe(t
rachea)andi nt
othelungs..,
(xi
ii
)Cutaneousr out
e:Drugsappl i
edtotheskinareusual
lyusedf
or
thei
rlocaleffectsandthusar emostcommonl yusedt otr
eat
superfi
cialskindisor
ders,suchaspsor i
asi
s,eczema,skin
i
nfecti
ons(v i
ral,
bacteri
alandf ungal
)anddryskin.
(
½markeachf
orany5poi
nts(
2
½mar
ks)
b.Adv
ant
agesofessent
ialdr
ugs:
i
.Iti
seconomi
cal
int
ermsofcost
i
i.I
tisaff
ordabl
eandaccessi
blesi
ncemaj
orl
yoft
hepopul
ati
oncan
aff
ordtopay
i
ii
.Itenabl
esomeagenci
esr
elat
edt
odr
ugscont
rol
toper
for
m
ef
fecti
vely
i
v.Dr
ugusagei
nourheal
thf
aci
l
iti
escaneasi
l
ybemanaged
v.I
tmakespr
escr
ipt
ionofdr
ugsv
eryeasysi
ncet
hedr
ugsar
ereadi
l
y
avai
labl
e.
vi
.Theout-
stocksy
ndr
omei
nourheal
thf
aci
l
iti
esi
sreduced
dr
asti
cal
ly
v
ii
.Ther
educt
ioni
nthenumberofdr
ugsusedi
ntheheal
thcar
e
sy
stem makespur
chasi
ngst
orageanddi
str
ibut
ioneasi
er.
(
½mar
keachf
orany5poi
nts(
2½
mar
ks)
c.Reasonswhydr
ugsr
evol
vi
ngf
und(
DRF)mayf
ail
:
i
.Ift
hei
nit
ial
(speed)capi
tal
isunder
est
imat
ed
i
i
.Pr
icesar
esetbel
owr
epl
acementcost
s
i
i
i.Fail
uret
ocoll
ectpay
mentfordrugswit
houtequi
val
entsubsi
dy(
for
i
nstancefr
om chi
ldr
en,
theagedand!orhandi
capped)
i
v.Delay
sincashf l
ow,makingmoneyr
ecei
vedf
rom sal
esnoteasi
l
y
avai
l
ableforsubsequentpur
chases
v.Rapi
dpr ogrammedexpansi
onf
orwhi
chaddi
ti
onal
capi
tal
findsar
e
notavai
lable
vi
.Lossesduetot
hef
tofdrugsormoney,
andal
soduet
o
det
eri
orati
onofdr
ugsbyexpir
yorspoi
l
age.
v
ii
.Pr
icei
ncr
ease(
inf
lat
ion)out
str
ipsexpect
ati
on
v
ii
i.Lackofbusi
nessor
ient
ati
ont
oDr
ugRev
olv
ingFund.
(
½mar
keachf
orany6poi
nts(
3
mar
ks)
d.St
epsf
ori
ssui
ngDr
ugs:
i
.Fi
l
li
ngr
egi
str
ati
onf
ormf
rom r
equest
inguni
t
i
i
.Recei
vi
ngmoneyf
orqual
i
tyofdr
ugst
obesuppl
i
ed
i
i
i.I
ssui
ngdr
ugs
i
v.Bal
anci
ngl
edgerbookf
oreachdr
ugi
tem bysubt
ract
ingt
henew
i
ssuef
rom pr
evi
ousbal
ance
v
.Issui
ngt
her
ecei
vi
ngnot
e,si
gnar
ecei
ptv
oucher
.
(
½mar
keachTorany4poi
nts(
2
mar
ks)
7a.Fact
orst
oconsi
derbef
oreconduct
ingout
reachser
vices:
i
.Cul
tur
alpr
act
ice
i
i
.Communi
tyf
unct
ion(
act
ivi
ti
esofmar
ketday
s)
i
i
i.Soci
al-
economi
cst
atusoft
hecommuni
ty
i
v.Lev
elofeducat
ion
v
.Popul
ati
onmeans
v
i.Locat
ionoft
hecommuni
ty
v
ii
.Logi
sti
cssuppor
t
v
ii
i.Av
ail
abl
eper
sonnel
i
x.Nat
ural
disast
erse.
g.f
loodi
ng,
ear
thquake
x.Communi
tydi
sput
ese.
g.war
,cl
ashes
xi
.Har
dtor
eachar
ease.
g.r
iver
,badr
oad
(
½mar
keachf
orany6poi
nts:
(3
mar
ks)
b.Fact
orsf
ort
hesuccessofanef
fect
iver
efer
ralsy
stem:
i
.Ori
ent
ati
onofallheal
thpersonneltothet
wo-wayref
erralsyst
em.
Somehospit
al-
basedpersonnelarenotawareoft
hedi
fferent
cat
egor
iesandcompetenceofst af
foperat
ingatt
hePHCl evel
.
Ref
erral
oughttobeaccepteddespi
tet
hef actthati
sfr
om alower-
l
evelworker.Or
ient
ati
onshoul
dincl
udetheuseofhomebasedr ecor
d
car
dsinsteadofnewpati
entscardt
omai ntai
nconti
nui
tyofcare.
i
i
.Simpl edesignoffor
ms, pr
ovidi
ngasystemat
icwayofrecordi
ng
r
elevantinfor
mationaboutpati
ent.Awel
ldesi
gnedfor
m should
i
ncludeaf eedbackmechanism toensur
econti
nui
tyofcare.
i
ii
.Communitymobil
i
zati
on.Thecommuni tymustbeinstr
uctedto
ar
ranget
ranspor
tandanyotherassi
stanceneededf
orr ef
err
al.
i
v.Awarenessfortheftli
mitat
ionsqthepartofthevil
l
ageheal t
h
workerandthepersonnelinprimaryheal
thcentr
e.Wheni ndoubtthey
mustreferpat
ient
sappr opri
atel
y.Ateachstageofrefer
ralr
elevant
i
nformationi
ssenttot hecentrefr
om whichthepat
ientwasr efer
red.
(
½mar
keachf
or4poi
nts(
2
mar
ks)
c.Consequencesofi
rr
ati
onal
sdr
uguse:
i
.Resi
stance
i
i
.Adv
ersepossi
blel
ethal
eff
ect
s
i
i
i.Addi
cti
on
i
v.Tol
erance
v
.Ov
eruseofdr
ug
v
i.Ri
skofi
nfect
ion
v
ii
.Ant
imi
crobi
alr
esi
stance
v
ii
i.Habi
tuat
ion
(
½mar
keachf
orany6poi
nts(
3mar
k)
d.Fact
orswhi
chmayi
nfl
uencedosageofdr
ugs:
i
.Age:Ageisanimport
antfactor
,especi
all
yinpeopleatt
hetwo
ext
remesofli
fe,
i.
e.i
nfant
s,thedrugmetaboli
zingenzymesarenot
ful
l
ydevel
oped.Asaresul
t,drugdosageininf
antsneedtobereduced.
i
i.Int
hecaseofelder
lypat
ientdet
eri
orati
ngli
vermayleadtoslow
drugmetaboli
sm,whi
lefai
l
ingdeteri
orat
ingki
dneymayl eadt
o
accumul
ationandrai
sedbloodlev
elsofdrugsdosageinsuchpati
ent
s.
.
i
ii.Weight:Weightpl
aysani mportantroleindeter
mini
ngdrugdosage.
Forheav yweightpat
ients,dosagemaybehi ghert
hannormal,andt he
reversei
st hecaseforleanindiv
iduals.Dosageofsomepot entdrugs
l
ikegentami ci
nanddigoxinisusuallybasedont heweightofthe
patienti
.e.mg/kg.
i
v.Sur faceArea:Dosageofcer t
ainpot entdrug,
especial
lycy
tot
oxic
drugsl i
kedoxorubicinandvincr
isti
near ebasedont hebodysurf
ace
areai.e.mg/m2.Thehei ghtandwei ghtoft hepati
entaredet
ermined
andbodysur facear eaofthepatientesti
mat edi
nt er
msofsquare
met erusingascale.
v.RouteofAdmi nistr
ation:Theamountofadr uggiventoapati
ent
mayal sodependont her outeofadmini
str
ation.Forpar
enter
alr
out
es,
absorpti
onismor ecertain,andhencewil
lrequir
emai l
erdosest
han
theoralrout
e,wher eabsorptionmaybeuncer t
ainandirr
egul
ar.
(
½mar
keachf
or4poi
nts(
2mar
ks)
 COMMUNI
TYHEALTHEXTENSI
ONWORKERS(
CHEW)
PAPER1
ESSAY(
70MARKS)
1.(a)Waybywhi
chcommuni
tyheal
thpr
acti
ti
onercanr
elat
e
eff
ecti
vel
ywit
hmemberoft
hecommunity:
(
i)Li
sten,
lear
nandunder
standt
hemember
soft
hecommuni
ty.
(
ii
)Tal
k,di
scussanddeci
dewi
tht
hemember
soft
hecommuni
ty.
(i
ii
)Encourage,
organi
zemember soft
hecommunit
ytopart
ici
pat
e,
encouragethem t
otakeupheal
thybehav
ior
sandhabi
ts.
(i
v)Beinv
olv
edandact
ivel
ypar
ti
cipat
eint
hecommuni
tydev
elopment
acti
vi
ti
es.
(
½mar
kforany4poi
nt:
2
mar
ks)
(
b)Ri
ght
sofapr
act
ici
ngcommuni
tyheal
thpr
act
it
ioner
sar
e:
(i
)Practi
cinginaccordancewiththescope,whichislegall
y
permissi
bleforspeci
ficpracti
ce.(
ii
)Properor
ientati
onandgoal
di
rectedinservi
ceeducationinrespectoft
hemodesandmet hodsof
tr
eatmentandpr ocedurerelev
anttoherworki
ngsi t
uation.
(i
ii
)Negoti
ati
onwi
tht
heempl
oyerf
orsuchcont
inui
ngpr
ofessi
onal
educat
ion.
(i
v)Advocacyforprot
ecti
onofpatient
sandper
sonnel
forwhen
he/shehasacceptedresponsi
bil
i
ty.
(v)Equalandful
lpart
ici
pat
ioni
nsuchpol
i
cydeter
minat
ion,
planni
ng
anddecisionmakingasmayconcernt
hetr
eat
mentandcareofthe
pati
ent.
(
vi)Asaf
eworkingenv
ironment,whi
chi
sequippedwi
thatl
east
mini
mum phy
sical
,materi
alsandper
sonal
requir
ement
s.
(vi
i
)Refusi
ngtocarryoutataskreasonablyregar
dedasout si
dethe
scopeofhi
s/herpract
iceandforwhichhe/ shehasinsuf
fi
cient
tr
aini
ngorforwhichhe/shehasinsuff
ici
entknowledgeorskill
.
(
vii
i
)Wi
thhol
dingpar
ti
cipat
ioni
nunet
hical
pract
ice.
(
ix)Obt
aini
ngwri
tt
enpolicygui
del
i
neandpr
escr
ipt
ionsconcer
ningt
he
managementofhi
s/her
wor
kingenv
ironment
.
(x)Ref
usingtoimpl
ementapr escri
pti
onortopart
ici
pat
einacti
vi
ti
es,
whichaccordi
ngtohis/
herprofessi
onalknowl
edgeandjudgement
,
arenotinthei
nter
estofthepatient
.
(xi
)Discl
osur
etohis/hert
hedi
agnosi
sofpat
ient
sforwhom he/
she
acceptsr
esponsi
bil
it
y.
(
xii
)Aworki
ngenv
ironment
,whi
chi
sfr
eeoft
hreat
s,i
nti
midat
ionor
i
nter
fer
ence
(xi
ii
)Amedicalsupportorr
efer
ral
syst
em t
ohandl
eemer
gency
sit
uati
onsef
fecti
vely
(xi
v)Amanageabl
ewor kl
oadsot
hatadequat
est
andar
dsofheal
th
carecanbemaint
ained.
(
xv)Wagescommensur
atet
oheal
thser
vicer
ender
ed.
(
½mar
kforany6poi
nts:
3
mar
ks)
(c)Fi
veway sofmai
ntai
ningcor
dialr
elat
ionshi
pbet
weent
he
pati
ent/
cli
ent
(i
).Respectacli
ent
/pat
ienti
rr
espect
iveofhi
s/herr
ank,
rel
i
gion,
cult
ure,sever
it
ycondi
ti
on.
(
ii
).Useprof
essi
onal
ski
l
landt
hest
andi
ngor
der
sasagui
det
o
managethecli
ent
s.
(i
i
i).Maint
ainabsol
uteconfi
dent
ial
i
tyoni
nfor
mat
ionconcer
ningt
he
cl
ient/
pati
entbeenreveal
t
ohi
m/her
.
(i
v).Pr
ovi
deadequat
ecl
i
ent
/pat
ientcar
eregar
dlesssoci
alst
atus,
age,
andethni
ci
ty.
(
v)Shar
einf
ormat
ionconcer
ningcl
i
ent
susi
ngcr
uci
alj
udgment
.
(
vi)Behonesti
nper
sonal
andpr
ofessi
onal
act
ivi
ti
esoft
hecl
i
ent
s.
(
vii
)Beanadv
isert
othecl
i
enti
nst
eadofadeci
sionmaker
.
(
vii
i
)Gi
vequal
i
tycar
etot
hecl
i
ent
s.
(i
x)Expl
ainal
lprocedur
est
obecarri
edoutont
hecl
i
entandmake
sureheunder
standsandgi
veconsent
.
(x)Beawareofthedanger
sofeachpr
ocedur
etobecar
ri
edoutona
cli
entandprepar
efortr
eat
ment.
(
xi)Wher
enecessar
y,r
eferi
mmedi
atel
y,andnott
odel
ay.
(½mar
kforany5poi
nts:
(2½
mar
ks)
(
d)Gener
alwor
ket
hicsofacommuni
tyheal
thpr
act
it
ioner
:
(i
)Actwithsenseofmat ur
it
y:Personalandprof
essi
onalski
lls
cont
ribut
etoachievementmaturi
ty.Maturi
tyi
sanachievementwhi
ch
i
snotdependentonagebutonsev eral
aspect
sofpersonali
tyofmany
ski
ll
ssuchast hepracti
ceofposi
tivehabi
tsatt
it
udesandskill
s
cont
ribut
estomat uri
ty.
(i
i)Developthesenseofsel f-
motivation:Hav ethewilli
ngnesstolearn
newi deas,dut
iesandprocedures,especiallyawi l
li
ngnesstolearn
aboutthecommuni ti
es;beingservedbyt hehealthfacil
it
y.Bei
ngal er
t
wheni nthehealthf
acil
it
yandi nthecommuni tyenablesthehealt
h
practi
ti
onertoobserveandunder standpr oblemst hatneedtobe
solvedandantici
patetheclient
/patient’
sorcommuni tyneeds.
(i
ii
)Beaccurat
einallacti
vit
ies:Anerrorinhealt
hpr acti
ceevenwhen
minorcoul
dhaveal ast
ingeffectontheindiv
idual,f
ami l
yorthe
community.Al
ldat
a, i
nfor
mat i
oneducat i
on,i
ntroductionheal
th
acti
vi
ti
esandprogrammer s,shouldbeasaccur ateaspossibl
e.
(i
v)Practi
cethoroughness:Provi
deacarefulandcompleteatt
enti
on
toalldet
ail
sofalli
nformati
onandheal t
hactivi
ti
esprovi
ded.This
i
nv ol
vestheabil
i
tytolist
enandt akeamplenotesandpayattenti
onto
thewho,when,why ,whereandhowanswer sandv er
ifyi
nfor
mat i
on
giventoyoubytheclient
/pati
entand/orbytherel
ati
on.
(v
)Practi
cedependabil
it
y:Thati
sinvol
veotherspeci
ali
stsi
nheal
th
pract
iceandcommunicateswil
li
ngl
ytowor kasateam member.The
dependabl
ehealt
hpracti
ti
onerasksquest
ionsandrepeats
i
nst
ruct
ionstoavoidmist
ake,askforassist
ancewit
hunfami
li
artasks
f
rom ot
hercoll
eaguesandhealthpract
it
ionersandt
akecompl
etedata.
(vi
)BeFlexibl
e:Thati
srespondcalmlytoevenlastminutesacti
vi
ti
es,
avoidbei
ngunderpressureandhandlecomplexsituat
ionswithcal
m,
Developtheabil
i
tyimpl
ementnewi deas,andgoodsuggest i
onswith
confi
denceareamar kofflexi
bil
i
ty.
(
vii
)Haveagoodj udgement:Usetheknowledge,
exper
ienceandlogi
c
t
oassessallaspectofasi
tuati
on;toensur
eforasounddecisi
on.It
i
nspir
etheconfi
denceofcl
ient/pat
ient
sandmember sthecommuni t
y.
(vi
ii
)BeHonest :Expressinawor dsandact i
onsthetrustgi venbya
cl
ient/
patient
;atalltimesandi nsi t
uati
ons, t
rustwort
hyheal th
pract
it
ionerunderstandst heseriousnat ureofthepatient’
scondi ti
on
andtheconf i
denti
alityinv
olvedindeal i
ngwi th;t
hecli
ent /patient
s.Do
notrevealanyofapat i
ent’
sdataandconv er
sati
onsoranydet ai
l
s;
whichmustal waysr emainconf i
dent i
al.Honestyiscentralintegri
ty
andthisisnecessaryt oeffect
ivelyrepresenttheprofession.
(i
x)Hav eInit
iat
ives: Ther
ea‘erout
ineandguidedutiesofaheal t
h
pract
it
ioner,howev er,comessometimeswherepositiv
eact i
ons
shoul
dbet akenout sider
outi
neduti
es;t
hisiswheregoodi ni
tiat
ive
becomesi mpor t
ant .Theabi
li
tytomoveforwardandt oresolv
eissues
byusingone’ si
niti
at i
vesisv
aluabl
eskil
li
nhealthpracti
ce.
(x)Possesstheabi l
itytosolvepr obl
ems: Analysi
ngsituati
on,aski
ng
foradvi
ceandpl anningoutt hestepneededt oaccompl ishahealth
programmeandact ivi
ti
eswiselydemonst ratestheabili
tytosolve
probl
emsef fecti
vely.Theresultisachi
evingt hegoal
ssett o
i
mpr ovi
ngtheheal thstatusofthecommuni ty.Li
keplanningfora
successful
out r
eachi mmuni zati
onprogramme, pl
anningfor
control
li
ngandepi demic.
(xi
)Be- Punctual:Beingther
eont i
me, all
owt hehealthpract
it
ionerto
organizetasks,Furthermore,bepunctualforallmeetingswit
ht he
member softhecommuni tyorotherorganizat
ions.Thisshows
mat ur
ityandr esponsibi
li
ty.
(xii
)Possesstheatt
it
udeofef fi
ciency:
Anef f
ici
entheal
thpracti
ti
oner
,
plansthedayworkinadvance:makespl ansforcomplet
ionofjobs
andassembl emater
ial
sandr esourcesnecessaryt
ocompl et
etasks.
(xii
i
)Beamemberoft heteam: Haveapositi
veat t
it
udeofateam
player,bybei nggenerouswi t
htimeandpr ovi
dinghelpwhere
necessar y.Partofbeingagoodt eam pl
ayeri
nvolvessimpl
es
courtesieslikepersonalacti
vit
iesinthehealt
hf aci
li
tyandi
nthe
communi ty.
(xi
v)Bet act
ful:Workwithpeoplei
nwaysthatshowsi gnsof
sensi
ti
v i
tytotheirpossi
blepr
oblemsandworktowar dsachievi
ngthe
goalofsolvi
ngt heprobl
emssmoot hl
yandwithoutbeingoffensi
ve.
Tactf
ul mannersandspeechcr eat
egoodwil
lwit
hclients/pati
entsand
wit
hot herstaf
fmember s.
(xv)Beassertive:Accur
ate,dependabl eandhonest,whounderstands
andper f
ormtaskswi thi
ntell
igenceandgoodj udgement,beconfident
anddost epforwardtomakeapoi ntinapositiv
emanner ,He/she
contri
butespositi
vel
ytoamor eeffi
cient,
mor ecordi
alworki
ng
envi
ronment.Itisquit
eunlikeaggressivenesswhichishosti
leand
overbeari
ng.
(xv
i)Beamemberoft hepr
ofessi
onalassoci
ati
on:
Bei
ngamember
ofthepr
ofessi
onal
i.
e.
NACHPN
(
½mar
kforany5poi
nts:
2½
 mar
ks)
2.(
a)Qual
it
iesofagoodpost
er
(
i)I
tshoul
denhancedi
scussi
on.
(
ii
)Itshoul
dbeabl
etodr
awqui
ckat
tent
iont
othepubl
i
c
(
ii
i)I
tshoul
dbeconspi
cuoust
otheey
eoft
hepubl
i
c
(
iv)Thewor
kshoul
dbel
egi
ble
(
v)I
tshoul
dbesi
mpl
e
(
vi)I
tshoul
dbet
houghtchal
l
engi
ng
(
vii
)Itshoul
dpr
omot
eneededchangei
nhabi
tsofi
ndi
vi
dual
s
(
½mar
kforany5poi
nts:
2½
mar
ks)

b.Ty
pesofv
erbal
andnon-
ver
bal
;communi
cat
ion
Verbal Non-verbal
1.Talking 1.Facialexpression
 Di scussing  Frowni ng
 Readi ng  Smi l
ing
 Debat ing  Raisingey ebrows
 Quar rell
i
ng  Closingey es
2.l
aughi ng 2.Gestures( bodyexpr
essi
ons)
3.Crying  Shaki ngshoulder
s
4.Shout i
ng  Shaki nghands
5.Yell
ing  Wav inghands
6.Exclaiming  Pr ost
rati
ng
7.Singing  Gai t
8.Rhymi ng 3.Action
9.Belching 4.Stance
10.Sighing 5.Mut e
11.Hissing 6.Shar pcol
oursee.g.r
ed
12.Groaning 7.Signsandpost ers
13.Whi speri
ng 8.Time
9.Phy si
calappearance
10.Touch
11.Silence
12.Listeni
ng

v
erbal
½mar
kforany5poi
nts(
2½mar
ks)
Nonv
erbal
½mar
kanypoi
nts(
2½mar
ks)
(
c)Obj
ect
ivesofcommuni
cat
ion:
(
i)Togett
hingsdone.
(
ii
)Tol
ear
nmor
eaboutoneanot
her
.
(
ii
i)Tol
ear
naboutt
opi
csofmut
ual
int
erest
.
(i
v)Toenabl
epeopl
etothi
nkoractt
heway
sthatposi
ti
vel
y
contr
ibut
est
othei
rli
fe(
heal
th)
.
(
v)Topr
ovi
deaset
ti
ngf
ort
heaski
ngandanswer
ingofquest
ions
(
vi)Tost
imul
atepar
ti
cipat
ioni
ndeci
sionmaki
ng
(
vii
)Todev
elopmor
especi
ali
zedexpect
ati
onsaboutoutt
orel
atet
o
oneanot
her
.
(
vii
i
)Toef
fect
ivel
ycont
rol
act
ivi
ti
esandpr
ogr
ammes
(
ix)Tol
i
sten
(
x)Topr
ovi
deent
ert
ainment
(
½mar
kforany5poi
nt2½mar
ks)
3.(
a)Ai
msofPr
imar
yHeal
thcar
e(PHC)
(
i)I
tmakesheal
thcar
eav
ail
abl
eandaccessi
blet
opeopl
ewhenev
er
t
heyli
veandwork
(
ii
)Itmakesuseofappr
opr
iat
etechnol
ogyt
opr
ovi
det
heser
vice.
(
ii
i)I
tpr
omot
esi
ndi
vi
dual
ari
dcommuni
tysel
f-
rel
i
ance
(i
v)Itr
educesmor
bidi
tyandmor
tal
i
tyi
nhi
ghr
iskgr
ouporv
ulner
abl
e
group.
(
v)I
tpr
event
sil
l
nessi
nthecommuni
tyt
hroughheal
theducat
ion.
(
vi)I
tpr
ovi
desadequat
eandef
fect
iveheal
thcar
eatt
hegr
assr
oot
.
(vi
i)Toensuret
hatinimplementi
ngtheheal
thpr
ogr
ammes,the
communi tymustbeinvol
vedinpl
anning,
impl
ement
ati
onand
evaluat
ion.
(
½markeachf
orany5poi
nts:
2
½mar
ks)
(
b)Shor
tnot
eoft
hef
oll
owi
ngt
erms:
(I
)PHC: I
sanessentialheal
thcarebasedonpracti
calsci
ent
if
icall
y
sound,soci
all
yacceptabl
emet hodsandtechnol
ogy,madeuniversal
ly
accessi
blet
oi ndi
vi
dualandfamili
esinthecommuni t
ythr
ought hei
r
fullpar
ti
cipat
ionandatacostt hatcommuni
tyandcountr
ycanafford
tomai nt
ainatev er
ystageofthei
rdevel
opmentint
hespir
itofsel
f-
reli
anceanddet erminat
ion.I
tmeansbri
ngi
nghealt
hcareservi
ceas
closeaspossibletowher epeopl
eliv
esandwork.
(i
i)Qual
ityAssur
ance:pri
maryHeal
thCareemphasi
zesanqual
i
tat
ive
carebothinheal
thfaci
l
iti
esandser
viceev
enwithappr
opr
iat
e
technol
ogy.
(i
ii
)CostRecov er
y :
Costrecov
erref
erstorecover
ingmoneyinvol
ved
i
nser v
icesrenderedasintheuseofdrug.Ther
efore,
drugrev
olvi
ng
fundsystem isavit
altooli
nPHCservi
cesi nor
dertorecov
erthecost
ofdrugandr evol
veit.
(i
v)Down-upAppr oach:I
tmeansthatPHCProgr
ammer equir
estobe
pl
annedf r
om downt oup.Thepl
anningi
sfr
om communitylevel
!
grassr
ootstolocalGover
nment,St
ateandt
oFederal
.ThePHC
approachisf
rom bottom t
otop.
(v)UseofAppropri
ateTechnol
ogy:Maki
nguseoflocal
l
yav ai
l
abl
e
resourcesi
nthecommunitytosol
veheal
thandhealt
hrelat
ed
problems.
(
1mar
kforany5poi
nts:
5mar
ks)
(
c)ReasonswhyI
ntegr
atedSer
viceDel
iv
eryi
sdi
ff
icul
tormayf
ail
:
(
i)Lackofcompet
entandcommi
tt
edst
aff
.
(i
i)I
nadequat
eequipmentdrugsandsuppl
i
est
ocopewi
tht
he
consumersoftheser
vices.
(
ii
i)Lackofmot
ivat
ionofexi
sti
ngst
aff
.
(i
v)Cult
ureoft
hepeopl
easregar
dsfesti
val
,andmar
ket
sday
swhen
serv
icesarepr
ovi
dedatt
hehealt
hfaci
li
ti
es.
(v)I
gnor
anceont
heav
ail
abi
l
ityofser
vicesbymember
soft
he
community
.
(
vi)Communi
cat
iongapbet
weenst
affandcl
i
ent
s.
(
vii
)Hi
ghcostofser
vices.
(
vii
i
)Si
deef
fectoft
reat
mentet
c.
(
b)Shor
tnot
eon:
(i
)CopingMechani
sm: I
sameansofi nventi
ngownconsci
ousness
eff
ortt
osolveper
sonalandint
erper
sonalprobl
em i
nor
dertotryand
mastermini
mizeort
olerat
esstr
essconfli
ct..
(i
i)For getti
ng:I
st heapparentlosse.g.modi
ficat
ionofinf
ormation
al
r eadyencodedandst oredintheindivi
dual
longt er
m memor y
.Itisa
spont aneousorgr adualprocessinwhicholdmemor i
esareunableto
ber ecalledfrom memor ystorage.
(i
i
i)Sel
f-
Concept:I
sacoll
ect
ionofbel
iefaboutonesel
fthati
ncludes
el
ementsuchasacademicperf
ormance,genderi
denti
f5j,
sexual
i
denti
fyandraci
ali
dent
it
y.
(
iv)At
ti
tudes:Arewaysofthi
nki
ngorf
eel
i
ngaboutsomethi
ngitis
mannerofdisposi
ti
on,
feel
i
ng,Fposi
ti
onwit
hregar
dstoaperson.
(v)Memory:
Isthepr
ocessesbywhi
chhumanbei
ngencode,
stor
ed
andret
ri
eveinf
ormat
ion.
Encodingist
heini
ti
alper
cepti
onandr egi
str
ationofinfor
mat i
on:
stor
ageistheret
enti
onofencodedinformati
onov erti
em: r
etri
evesi
s
theprocessi
nvol
vedinusi
ngstoredinfor
mation.
(
1mar
kforeach5poi
nts:
5mar
ks)
4c.Ty
pesofmemor
y:
(
i)ShortTerm Memory:
Mater
ial
sar
est
oredf
orshor
tint
erv
alsi
.e.f
or
matterofsecondsormi
nut
es.
(i
i
)LongTerm memory
:Mat
eri
alsar
est
oredf
orl
ongi
nter
val
i.
e.f
or
days,
months,
year
s.
(i
ii
)Sensor
yMemory :
ini
ti
almomentaryrecordi
ngofinf
ormat
ioni
n
oursensor
ysy
stem aswhenamanf i
rstseeaperson,t
hememoryof
thesensor
yor
gansofsighti
sfi
rstacti
vated.
(
½mar
kforany5poi
nts:
2½
mar
ks)
(
a)Soci
o-cul
tur
albehav
iour
sthati
nfl
uencesheal
thoft
hecommuni
ty:
(
i)Cul
tur
e
(
ii
)Tr
adi
ti
on
(
ii
i)Rel
i
gion/
Myt
h
(
iv)Cust
om
(
v)Taboo
(
vi)Super
sti
ti
on
(
½mar
ksf
orany6poi
nts:
3
mar
ks)
5.(a)Situati
onAnalysis:
Istheprocessoffindingouttheactual
statusofhealthinagivencommuni tywhichincludesinfor
mationof
Local GovernmentAreapopulat
ionbyv i
l
lages, andwar dsandage,
healthbudget,heal
thfacil
i
tybytypeheathper sonnelbytypeand
l
ocat i
onet c.
 (
1mar
k)
(
b)Rat
ional
eforsi
tuat
ionanal
ysi
sinPHC
(
i)Todeter
minet
heeff
ect
ivenessoft
heheal
thservi
ceandtor
espond
t
otheproblemsf
oundi
nthecommuni t
yorLocalGover
nmentArea.
(
i)Topr
ovi
decompl
etei
nvent
ory
(
ii
i)Toi
dent
if
ythedi
str
ibut
ionofheal
thf
aci
l
iti
esi
nthecommuni
ty
(
iv)Toi
dent
if
ycat
egor
yandnumberofper
sonnel
int
hef
aci
l
iti
es
(v
)Topr ovi
deinf
ormati
onont
het
ypeandadequacyofser
vices
prov
idedinall
thefaci
l
iti
es
(vi
)Topr
ovidei
nfor
mati
ononthenumberofset
tl
ement
sineach
communit
yorLocalGov
ernment
(vi
i
)Toprovi
deacompleteover
viewofheal
thserv
ices,t
her
est
rengt
h
andweakness,
heal
thr
elatedpr
oblemsandinf
rastr
uctur
e.
(
½mar
keachf
orany6poi
nts:
3mar
ks)
(
c)Ther
oleofCommuni
tyDi
agnosi
sinPHC:-
(i
)Thehealt
hneedsofthecommuni
tyar
eident
if
iedt
hrough
communitydiagnosi
s
(
ii
)Theav
ail
abl
eresour
cesar
eident
if
ied.
(
ii
i)I
tpr
ovi
dest
hepl
atf
ormf
orpl
anni
ng
(i
v)I
mprovest
her
elat
ionshi
pbet
weent
heheal
thwor
ker
sandar
e
communit
y
(
v)Hel
pst
oaddr
essobst
acl
esandconst
rai
nts.
(
vi)Hel
pst
oident
if
ythel
ear
ningneedsoft
hecommuni
tywhi
chi
sa
goodbasi
sforheal
th
educat
ion.
(
vii
)Pr
omot
esequi
tabl
edi
str
ibut
ionofser
viceswi
thi
nthecommuni
ty
(
vii
i
)Itmakesev
aluat
ionoft
heheal
thpr
ogr
am easy
(
½mar
kforany6poi
nts:
3
mar
ks)
(d)Advocacy
:Ist
hepr
ocessofsensi
ti
zi
ngt
he‘
pol
i
cymaker
sto
progr
ammes.
I
tisal
sopr
ocessofcr
eati
ngawar
enessconcer
ninganyheal
thmat
ter
amongpol
i
cymakersin
or
dert
ogett
hei
rsuppor
t
(
e)Rat
ional
eforAdv
ocacy
:
-Advocacyisnecessar
yf oracquai
ntpol
icymaker
soft
hei
rrol
esand
responsi
bil
i
tiesi
nrelat
iontoidenti
fi
edhealt
hgoal
s.
-Forpol
i
cymaker
stopr
ovi
det
her
equi
redsuppor
tfori
mpl
ement
ing
PHCservi
ces
(
1mar
keachf
or2poi
nts:
2
mar
ks)
6(
a)Mi
sopr
ost
ol:I
ndi
cat
ionf
oruse
i
.Iti
susedt
ost
artl
abour
i
i
.Iti
susedt
otr
eatst
omachul
cer
i
i
i.I
tisusedt
opr
eventandcont
rol
post
par
tum Haemor
rhage
(
1mar
keachf
or2poi
nts:
2mar
ks)
Cont
raI
ndi
cat
ion
(
i)Pr
egnancy
(
ii
)Mul
ti
-gr
avi
da
(i
n)Cephl
o-pel
vi
cdi
spr
opor
ti
on (
½mar
kforany2
point
s:1mark)
Si
deef
fect
s:
(
i)Fev
er
(
ii
)Ri
gour
(
ii
i)Ut
eri
ner
upt
ion
(
½mar
kforany2poi
nts:
1mar
k)
(
b)Reasonsf
orDr
ug-
Drugi
nter
act
ion
(
i)Mi
suseandabuseofdr
ugsi
ncl
udi
ngal
cohol
(
ii
)Pat
ient
sfai
ltocompl
ytodi
rect
ionsf
ort
heseofdr
ug
(
ii
i)Pat
ient
susebot
hpr
escr
ibeddr
ugsandun-
prescr
ibeddr
ugs
(
iv)Pat
ient
sonmul
ti
pledr
ugsatt
hesamet
ime
(
v)Lackofknowl
edgeaboutsomedr
ug.
(v
i)Self
-medi
cat
ion. (
½mar
kseachf
orany4
point
s:2marks)
(
c)Def
ini
ti
onofsel
f-
medi
cat
ion
(1)Self
-Medicati
onisahumanbehav i
orinwhi
chanindivi
dual
usesa
substanceoranyexogenousinf
luencetosel
f-
admi
nistert
reat
mentf
or
physi
cal orpsychol
ogi
calai
l
ment s.
(
mar
ks)
i
)Dr
ugst
hatar
eabused
(
i)Codei
ne
(
ii
)Par
acet
amol
(
ii
i)Ant
ibi
oti
cs
(
iv)Sedat
ivese.
g.Di
azepam
(
v)Pent
azoci
ninj
ect
ion
(
vi)Aspi
ri
n
(
vii
)Mi
sopr
ost
ol
(
vii
i
)Tr
amadol
(
ix)Post
inor2 (
½mar
keachf
orany4poi
nt:
2marks)
(
ii
i)Pr
event
ivemeasur
es:
(
i)Moni
tor
ingandsuper
visi
onofchi
l
drenact
ivi
ti
es
(
ii
)Heal
theducat
ioni
nschool
aboutdangerofabusi
ngdr
ugs.
(
ii
i)Pol
i
ciesagai
nstsubst
anceabusei
nthewor
kpl
ace
(
½mar
keachf
or2poi
nt:
1mar
k)
(
d)St
epsi
nDr
ugsquant
if
icat
ion:
(i
)Col
lectinf
ormati
ononthenumberoftr
eat
mentepi
sodesr
equi
ri
ng
dr
ugi.
e.orderi
ngint
erv
ale.
g.6months.
(
ii
)Ident
if
ymaj
orheal
thpr
obl
emsseeni
ntheheal
thf
aci
l
itymal
ari
a
(
ii
i)Getst
andar
dtr
eat
mentschedul
eforeachdr
ugf
ormul
ati
onoran
i
l
lnessepi
sode
(i
v)Cal
cul
atet
hequant
it
yofdr
ugf
ormul
ati
onr
equi
redf
oreach
di
seases
(
½mar
kfor4poi
nts:
2mar
ks)
7.(
a)Reasonsf
orr
efer
ral
:
(
i)Thepat
ientr
equest
sthathe/
sheshoul
dber
efer
red
(
ii
)Inadequat
efaci
l
iti
es
(
ii
i)I
nadequat
etr
ainedper
sonnel
att
her
efer
ri
ngcent
re.
(
iv)Whenpat
ienti
snotr
espondi
ngt
otr
eat
ment
(
v)Whenpat
ientcondi
ti
oni
sget
ti
ngwor
st
(
vi)Whent
her
eisneedf
orspeci
ali
stat
tent
ion
(
vii
)Whent
hecasei
snotcov
eredbyt
hest
andi
ngOr
der
(
vii
i
)Whent
hecaser
equi
remaj
orsur
ger
y.
(
½mar
kfor8poi
nts:
4
mar
ks)
(
b)Rat
ional
eforout
reach/
Mobi
leser
vices:
(i
)Toextendheal
thserv
icestocommuniti
esatgr
assrootl
evel
that
aregeogr
aphi
call
yinaccessi
blee.
g.poorr
oadnetwor
k.
(
ii
)Forf
oll
ow-
upcar
eofpat
ientt
hatar
eundert
reat
ment
(i
i
i)Ext
endPHCservi
cestothecommuni
ti
est
hatneedspeci
alheal
th
att
enti
one.
g.epi
4pmic,
ref
ugeesetc.
(
iv)Toensur
etot
alcov
erageofPHCser
vice.
(v
)Topromoteul
ti
li
zat
ionofmoder
nheal
thcar
eser
vicest
her
eby
si
mpli
fi
esheal
thpl
anni
ng.
(
vi)Toassi
sti
nthecont
rol
ofi
nfect
iousdi
seasest
hrough
i
mmunizati
on
(
vii
)Tor
educet
rav
elcostofr
efer
ral
.
(v
ii
i)Topr
ovi
dei
mmedi
ateandef
fect
ivecar
e. (
½mar
kfor6
point
s:3mar
ks)
(
c)Act
ivi
ti
esi
npl
anni
ngout
reachser
vices
(
i)Theobject
ivesf
orti
eputreachservi
cesshoul
dbecl
ear
lyst
atedi
n
r
espectofwhatistobedone,where,
whenbywhom andwithwhat
r
esources
(
ii
)Pr
epar
ati
onofschedul
eofv
isi
tforeachv
il
lage.
(i
i
i),
Prepar
edut
yrost
erf
ort
hest
affbasedav
ail
abi
l
itycat
egor
iesof
staf
f
(
iv)Car
ryoutor
ient
ati
onf
orst
afff
ort
hem t
obeabr
eastwi
tht
he
f
uncti
ons
(
v)Prov
ideandensurethatequi
pment,
suppl
iesandresour
cesneeded
f
ortheout
reachser
vicesareingoodor
derandavai
labl
e.
(v
i)Liai
sewiththev i
l
lageheal
thworkersandcommuni
tyleaderi
n
ordertoensur
et hattheobj
ect
iveofprogrammear
eachieved.
(v
ii
)Deter
minei fthevil
lageheal
thworkersandvi
ll
agedev
elopment
havebeenselectedandt rai
nedother
wisearr
angefort
hei
rselect
ion
tr
aini
ngandlogistics.
 (
½mar
keachf
or6poi
nts:
3
mar
ks,
)
2017PAPERI
I
MODELANSWERS(
70MARKS)
1a.Funct
ionsofwat
er
i
.Tr
anspor
tnut
ri
ent
stocel
l
s
i
i
.Regul
ati
onsofbodyt
emper
atur
e
i
i
i.Mai
ntai
nst
heneededbal
anceofsl
ateandwat
er
i
v.Remov
eswast
epr
oductt
hroughur
ineandsweat
v
.Pr
ovi
descushi
oni
ngf
orj
ointandsof
tti
ssues
v
i.I
tincr
easest
heef
fi
cientofi
mmunesy
stem i
nthebonemar
row
v
ii
.Provi
sionofmoisti
nter
nal
env
ironmentwhi
chi
srequi
redbyal
l
l
i
vingcel
lainthebody.
v
ii
i.Di
l
utepoi
sonoussubst
ancesi
nthebody
i
x.Hel
ptor
educest
ress,
anxi
etyanddepr
essi
on
x.Cont
ainedi
nsal
i
vaf
ordi
l
uti
ngt
hemoi
stenedf
ood
(
½mar
keach8poi
ntsI
mar
ks)
b.Fact
orsaf
fect
ingt
heNut
ri
ti
onalSt
atusofacommuni
ty
(i
)Seasonalv
ar i
ati
on:Foodproduct
ionoccur
sduri
ngt her
aini
ng
seasonsmakingfoodv er
yabundantandcheapbutbecomesscarce
andcostl
yduringdryseason
(
ii
)Lackoft
ranspor
tleadi
ngt
odi
ff
icul
ti
esi
ntr
anspor
ti
ngf
oodi
tems
t
othetowns
(i
ii
)Lackofstor
agefaci
li
ty:
Manyf
oodi
temsar
edest
roy
edandl
eadt
o
scarceduri
ngdryseason
(i
v)Cult
ural
bel
ief
saboutfood:somecommunit
iesf
orbi
deat
ingof
cert
ainmeate.
g.cow,snai
lspork,
snake,
cat
.Et
c.
(v)Famil
ysize:
Al ar
gefamil
ysizeof
tenputsalotofeconomi
cand
social
burdentothefamil
yleadi
ngtopoornut
ri
tion
(vi
)Il
l
iter
acyandmi spl
acementofpri
ori
ti
es:Lackofadequat
edi
et
knowledgecanleadtopm nutr
it
ional
status
(vi
i
)Poli
ti
calf
act
or:Foodpr oducti
onsuff
erssetbackift
he
Gover
nmentneglectagricultur
e.(vi
ii
)Nat
uraldi
saster
s:Draught
,fl
ood
andsoi
lerosi
oncandr asticall
yreduceav
ail
abil
i
tyoffooditems
(i
x)Env
ironmental
hygiene:poorsewagedisposalhousi
ngdrainage
caneasilycont
aminat
ef oodandwaterleadi
ngt osuscept
ibi
l
ityto
epi
demics
(
½mar
keachf
or6poi
nts:
3mar
ks)
(
c)Pr
event
ionofNut
ri
ti
onal
Probl
ems:
i
.Gai
nful
empl
oyment
i
i
.St
udyofagr
icul
tur
alsci
enceandi
tspr
act
ice
i
ii
.Gover
nmentsupportf
ori
ncr
easedf
oodpr
oduct
iont
hroughsuppl
y
ofmanureav
ail
abi
li
ty
l
andi
mpr
ovedcr
op,
adequat
eeducat
ion,
impr
ovedani
mal
set
c.
i
v.Heal
thandnut
ri
ti
onal
educat
ion
v
i.Popul
ati
oncont
rol
measur
es
v
ii
.Goodeat
ingpr
act
ices
v
ii
i.Chi
l
dspaci
ng/
fami
l
ypl
anni
ng
i
x.Adequat
ebr
east
feedi
ng
x.I
mmuni
zat
ion
(
½mar
keachf
or6poi
nts:
3
mar
ks)
2a.CHEW St
andingOr
der
,2010edi
ti
onsect
ion2:Chi
ldHeal
th
Secti
ononArm and
pr
obl
emspage106:
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erecondi
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 Nutri
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akesbabytot
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cor
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Si
gnat
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……………………………….
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………………………………….
.
Desi
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ion:
………………………….
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e:……………………………….
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ti
on/
pagenumber (
1mar
k)
Cl
i
nical
judgement (
1mar
k)
Act
ion/
Heal
thEducat
ion (
2mar
k)
Si
gnat
ureandDat
e (
1mar
k)
(
b)Char
act
eri
sti
csoft
heNor
malPul
se
(
i)Ther
ate
(
ii
)TheRhy
thm
(
ii
i)
Vol
umeofSt
rengt
h
(
iv)Tensi
on
(
½mar
keachf
or6poi
nts:
3mar
ks)
(
c)React
ionassoci
atedwi
thi
njunct
ionadmi
nist
rat
ion
i
.Di
zzi
ness
i
i
.It
chi
ng
i
i
i.Per
spi
rat
ion
i
v.Lossofconsci
ousness(
fai
nti
ng)
v
.Nausea
v
i.Ti
nni
tus(
ri
ngi
ngi
ntheai
r)
v
ii
.Bl
urr
edv
isi
on
(
½mar
keachf
or6poi
nts:
3mar
ks)

3a.Def
ini
ti
on
i
.Col
dChai n:I
stheprocessofdi st
ri
buti
onandstorageorvacci
nesi
n
t
hepotentstatef
rom themanuf act
urestot
herecipi
ents.I
tisa
l
ogi
sti
csy st
em ofkeepingvaccinescol
dattherecommended
t
emperaturetoensur
et hei
rpotency.
i
i.Herdimmuni t
y :AHer di
mmunityist
helevelofresi
stanceofa
communi tyorgroupofpeopletoaparti
cul
ardisease,whenher d
i
mmuni tyislowitcanbet osever
eepidemics,
wheni ti
shi gh,t
he
i
ntroduct
ionofinf ect
ionmaynotleadtopr
opagatedspr ead.
i
ii
.Immuni zat
ion:Theprocedurethatkeptasuscept i
blepersonfree
fr
om diseaseorhelpsthepersonov er
comeadi seaseorthe
product
ionofimmuni t
yagainstspecif
icdiseasesbyar ti
fi
cial
means
i
nawayofhel pi
ngtopr ev
entcertai
ndiseasesespeciallyinchil
dhood
(½mar
keachf
orcor
rectanswer1½
mar
ks)
b.Fact
orst
oconsi
derwhenst
ori
ngv
acci
ne:
i
.St
oreeachv
acci
neati
tsst
oraget
emper
atur
e.
i
i
.Recor
dTemper
atur
etwi
cedai
l
ythati
smor
ningandev
eni
ng
i
i
i.i
nser
tcol
dchai
nmoni
tor
ingchar
twhi
chi
sdesi
gnedt
olastf
ort
he
whol
eyear
.
i
v.i
nsertfunct
ional
dialther
momet erwhichwi
ll
enhanceeffect
ive
monit
oringoftemperaturev.v
acci
nes,shoul
dbearrngec1accordi
ngl
y
e.
g.f
rozenandnon-f rozensepar
atel
y
v
i.al
lrecei
vedandst
oredv
acci
nesshoul
dber
ecor
dedaccor
dingl
y
v
ii
.vacci
neshoul
dnotbest
oredatt
her
efr
iger
ator
sdoor
vi
ii
.tet
anustoi
d,DPTandHBVshoul
dbestor
edatt
emper
atur
e-20C+
40C (½markeachfor8poi
nts;
4marks)
c.Way
sofacqui
ri
ngI
mmuni
ty:
i
.Byhav
ingt
hedi
sease
i
i
.Byr
ecei
vi
ngact
ivei
mmuni
zat
ion
i
i
i.Byr
ecei
vi
ngpassi
vei
mmuni
ty
i
v.Byhav
ingmat
ernal
ant
ibodi
es
d.Fact
orst
hati
nfl
uencei
mmuni
ty-
i
.Age:
Youngandol
dpeopl
ehav
elowi
mmuni
ty
i
i.PoorNut
ri
ti
on:
Undernut r
it
ionandmal
nut
ri
ti
onof
tengr
avi
ty
weakenimmuneresponse
i
i
i.Pr
egnancy
:Pr
egnancyt
endstolowerimmunit
yandmanyi
nfect
ion
f
indt
hei
rwayeasi
lyi
nthebodyofpregnantwoman.
i
v.Drugs:Manydrugssuchasthoseusedtotreatmali
gnant
condi
tionsshowtoxi
cit
ynotonl
ytomalignst
ycellsbutal
sotonor
mal
cel
lsincl
udingt
hoseinvol
vedi
nimmunity.
v
.Di
seasespr
esenti
nthebody
:Manyi
nfect
ionsanddi
seaseaf
fect
depr
essimmunity
,leadi
ngt
oreduceproduct
iont
oot
herdi
seases,
poorant
ibodyr
esponseegHIV/AIDS
v
i.Genet
icfactor
s:Thepossessi
onofcer
tai
ngenesi
sli
nkedt
o
i
mmunedi sorder
sandsome
ant
oimmunedi
sease(
½mar
keachf
or6poi
nts:
3mar
ks)
4a.Funct
ionalofabone:
i
.Thebonepr
ovi
dest
hesuppor
ti
ngf
ramewor
koft
hebody
i
i
.Thebonegi
vesat
tachmentt
omuscl
esandt
endon
i
i
i.Pr
ovi
demov
ementbyt
heact
ionofmuscl
e
i
v.Pr
ovi
desofr
edbl
oodcel
l
sint
hebonemar
row
v
.Pr
ovi
desr
eser
voi
rofcal
cium.
vi
.Formstheboundar
iesofthecr
ani
al,
thr
oraci
andpel
vi
ccav
iti
es
pr
otecti
ngorganst
heycontain
(
½mar
keachf
or6poi
nts:
3mar
ks)
(
b)St
agesofheal
ingMechani
sm ofbr
okenbones:
i
.Formati
onofhaemat omabet
weent
heendsofbonesandi
n
sur
roundi
ngsoftt
issues
i
i
.Dev
elopmentofacut
etr
aumat
ici
nfl
ammat
ion
i
i
i.Accumul
ati
onofmi
crophages
i
v.Gr
owt
hofgr
anul
ati
ont
issueandnewbl
oodv
essel
s
v
.Dev
elopmentofl
argenumberofost
ecol
ast
sthatsecr
etenon-
l
amel
l
arosteoi
d
vi
.Shapi
ngoft
henewbonebyost
eocl
ast
swhi
chr
emov
esexcess
cal
lus
(
½mar
keachf
or6poi
nts:
3mar
ks)

(
c)Di
seasesoft
heDi
gest
ivesy
stem:
(
i)Pept
icul
cer
(
ii
)Appendi
cit
is
(
ii
i)I
ntest
inal
obst
ruct
ion
(
iv)Const
ipat
ion
(
v)Haemor
rhoi
d
(
vi)Si
ckl
ecel
lanaemi
a
(
vii
)Var
icosev
ein
(
vii
i
)Cor
onar
ythr
ombosi
s
(
ix)Har
deni
ngofar
ter
ies(
Art
eri
osecl
erosi
s)
(
x)Angi
napect
ori
s
(
½mar
keachf
or4poi
nts:
2mar
ks)
5a.Labor
ator
ySaf
etyRul
es
i
.Mouth-pi
pet
ti
ngshoul
dbeav
oided.Al
way
suseapeppet
teai
dor
suci
ti
onbul
b
i
i
.Eati
ng,dri
nki
ng,smoki
ngandappl
ymake-
upmustnotbeal
l
owedi
n
t
helabor
atorywor
kingar
ea
i
i
i.Washhandsbef
oreandaf
teranyl
abor
ator
ypr
ocedur
e,af
ter
r
emov
inggl
ovesandatot
hert
imesbef
orel
eav
ingt
hel
abor
ator
y
i
v.Thelabor
ator
yshoul
dbekeptneat
,cl
eanandf
reeofmat
eri
alsnot
r
elevantt
othework
v
.Keept
hebenchareacl
earofal
lequi
pmentot
hert
hant
hatr
equi
red
f
ori
mmediat
eprocedur
e
vi
.Centr
if
ugespeci
mensonlyinseal
edcent
ri
fugebucket
sto
mini
mizedropl
etsoraer
osolspr
ay
vi
i
.Di
sposabl
eequi
pment(
e.g.gloves)mustnotbere-usedasthey
mayr
etai
ncontami
nat
edmat er
ialandmaydeteri
oratewhencleaned
vi
i
i.Laborat
orycoat
s,gowns,oruni
for
m shoul
dbeworni
nt he
l
aborator
y,l
aborat
orycl
othi
ngshouldnotbeworni
nnon-
laborat
ory
ar
ea.
i
x.Glovesshouldbewornforal
lproceduresthatmayi
nv ol
ve
acci
dentaldi
rectcont
actwi
thblood,i
nfecti
ousmateri
alsorhazar
dous
chemical
s
x.Neverputany
thi
ngi
nyourmout
hint
hel
abor
ator
y(e,
g,f
inger
s,pens,
penci
l
)
xi
.Donotl
eav
ecut
,opensor
es,
orwoundst
opossi
blei
nfect
ion
xi
i
.Avoidi
njur
ythatmi
ghtbecausedbyanyshar
pobj
ectusedi
nthe
l
abor
atory
xi
i
i.Longordangl
i
ngj
ewel
ryshoul
dnotbewor
nint
hel
abor
ator
y
xi
v.Di
sinf
ectbench-
topsbef
oreandaf
terwor
kingandwhenev
er
cont
aminati
onissuspect
ed
xv
.Donotusebarehandst
opi
ckupbr
okengl
ass.Useabr
oom or
br
ushandadustpan
xv
i.Di
sposi
ngsaf
etyofspeci
mensofcont
ami
nat
edmat
eri
als.
(½mar
keachf
or10poi
nts:
5
mar
ks)
b.Expl
anat
ionofTer
ns
(
i)Di
sinf
ect
ions:
Disinfect i
onmeansf reei
ngofanar t
iclefrom someoral ll
if
eof
anykind, whichmi ghtcausei nfect
iondur i
ngi t
suse.Disinfect
ionmay
notkil
l al
l f
ormsofl ifepresentinoramat erial
.Theyonlyreducet he
i
nfecti
v it
yofsuchmat er
ial.Manydisinfectantsareinuseinhealth
careset t
ings: andmusthav ebeenf oundtoi nacti
vateHIV.Howev er
chemical disinfectantsmaynotber el
iabl
e, becausetheymaybe
i
nacti
v atedbybl oodorot herorganicmat t
erpr esent
.Theymayal so
l
osethei rstrengt h,especiall
ywhenst oredi nawar m pl
ace.
(1mar k)
i
i.St
eri
li
zat
ion:
Steri
li
zati
onistheactofrenderi
ngnaysubst ancefr
eefrom al
lli
feof
anykind.Thismeansthear t
icl
ebecomesf reef r
om mi
croorgani
sm.
Thereisnosucht hi
ngasbei ng‘al
mostst eri
le’orpr
act
ical
lyster
il
e.An
objectisei
therst
eri
leorisnotsteri
le.Therear eanumberof
steri
li
zi
ngmet hodsinuse.
(
1mar
k)
c.I
ntest
inalpar
asi
tet
hatmaybef
oundi
nst
oolspeci
men:
i
.Ascar
isWor
ms
i
i
.Tr
ichur
iswor
ms
i
i
i.Tr
ichi
nel
l
aSpr
ial
i
s
i
v.Anky
lost
omawor
ms
v
.St
rongl
oids
v
i.Ti
neasagi
nat
a
v
ii
.Gi
ardi
aLi
mbi
a (
½mar
keachf
or6poi
nts:
3mar
ks)
6a.I
dent
if
icat
ionoft
rai
ningneedsofVVHWs:
i
.Byaski
ngquest
ions
i
i
.Obser
vat
ionofper
for
mance
i
i
i.Di
scussi
on
i
v.Feedback
v
.Rev
iewofpr
evi
ousknowl
edge
v
i.Cont
inuousassessment
v
ii
.Rev
iewofannualper
for
mancer
ecor
d (
½mar
keach
f
or4point
s:2marks)
b.Adv
ant
ageofon-
the-
job-
tr
aini
ng:
i
.Incr
easet
heef
fi
ciencyofwor
ker
s/st
aff
i
i
.Itboost
sthemor
aleofwor
ker
s
i
i
i.I
timpr
ovestheheal
thst
atusoft
hewor
ker
sast
heyar
eupgr
aded
t
onewseniorr
ank
i
v.I
thelpswor
ker
stoi
ncr
easespeed,
prof
ici
encyandaccur
acyatt
he
j
obsit
e
v
.Itpr
omot
esandf
ost
ersj
obsecur
it
ytowor
ker
s
(
½mar
keachf
or4poi
nts:
2mar
ks)
c.At
tri
but
eofal
eader
:
i
.Abi
l
ityt
oinf
usedy
nami
sm andcour
agei
nthesubor
dinat
es
i
i
.Ahi
ghsenseofr
esponsi
bil
i
ty,
account
abi
l
ityanddedi
cat
ion
t
owar
dst
heteam
i
i
i.Abi
l
ityt
oint
eractandadj
ustt
othewor
kingcondi
ti
onsoft
hegr
oup
i
v.Abi
l
ityt
ocommandr
espect
v
.Goodl
i
steni
ngabi
l
ity
v
i.Capaci
tyoff
ri
endl
i
ness
v
ii
.Wi
l
li
ngnesst
oref
rai
nfr
om domi
nat
ingot
her
s
vi
ii
.Gif
tofcheer
ful
ness (
½mar
keachf
or6
poi
nts:3marks)
d.Causesofj
obdi
ssat
isf
act
ioni
nanor
gani
zat
ion:
i
.Inef
fi
cientadmi ni
str
ati
on:Peopl
eli
ket
owor
kforanadmi
nist
rat
ion
t
hatisbotheffi
cientandeff
ecti
ve
i
i
.Incompetentsupervi
sion:Peopl
eexpectsuper
visor
stobe
t
echnical
l
ycompet ent
,soundandskil
led
i
ii
.Poorint
erpersonalr
elat
ionshi
p:Peopl
eoughtt
obet r
eat
edfai
rl
y,
poorhumanrelati
onbetweenmanagementandwor ker
sdet
erpeopl
e
fr
om worki
nghar dandgivi
ngthei
rbest
i
v.I
nadequat
epay(
poorRemuner
ati
on)
v
.Badwor
kingcondi
ti
on
v
i.Per
sonalqual
it
iesoft
hel
eader(
Ateam l
eaderoraboss)
(
½mar
keachf
or6poi
nts:
3
 mar
ks)
7a.Ef
fect
ivesofi
mpr
operbudget
ingi
nPr
imar
yHeal
thCar
eincl
ude:
i
.Inadequat
eequi
pment
i
i
.St
affmaygoonst
ri
ke
i
i
i.Fai
l
uret
oachi
evesetobj
ect
ives
i
v.Cl
i
ent
sandpat
ient
smayst
oppat
roni
zi
ngt
heheal
thf
aci
l
ity
v
.Inadequat
epay
mentofst
affwages
v
i.Shor
tageofdr
ugsi
nthecl
i
nic
v
ii
.Mi
spl
acementofpr
ior
it
ies
v
ii
i.I
tgi
vesr
oom f
orf
raudul
entact
sinnosmal
lmeasur
es
i
x.Maycausesdi
ssat
isf
act
ion (
½mar
keach
f
or8point
s:4marks)

b.Obj
ect
ivesofHeal
thManagementI
nfor
mat
ionSy
stem
i
.Tosetpr
ior
it
iesatal
ll
evel
s
i
i
.Toi
dent
if
ymaj
orheal
thpr
obl
ems
i
i
i.Topr
ov i
dei
nformati
onwhi
chcanbeusedasamanagementt
ool
f
ordeci
sionmaking.
i
v.Toassesst
hest
ateofheal
thoft
hepopul
ati
on
v.Tomonit
orthepr
ogr
esst
owar
dsst
art
edgoal
sandt
arget
soft
he
heal
thser
vices
v
i.Topr
ovi
dei
ndi
ctor
sforev
a1ut
ingt
heper
for
manceoft
heheal
th
ser
vices/pr
ogr
amme
v
ii
.Toprov
idei
nfor
mat
iont
othepol
i
cymaker
s/t
hosewhoneedt
o
t
akeact
ion
vi
ii
.Toassesst
heimpactofheal
thser
vices/pr
ogr
ammeont
he
heal
thst
atusoft
hepopulat
ion
(
½mar
keachf
or7poi
nts:
3½mar
ks)
c.For
mul
aasappl
iedi
nvi
talst
ati
sti
cs:
i
.Fer
ti
li
tyRat
e:
Tot
alNumberofBi
rt
hinay
earx1000
Numberofwomenaged15-
49y
ear
s
i
i
.Neonat
alMor
tal
it
yRat
e:
Numberofdeat
hsi
ninf
ant
sunder1mont
hofagex1000
Numberofl
i
vebi
rt
hsdur
ingt
hey
ear
i
i
i.St
il
lBi
rt
hRat
e:
Numberoff
oet
aldeat
hsof28weeksormor
eweeksofgest
ati
on
x1000
Numberofl
i
vebi
rt
hsandst
il
lbi
rt
h
i
v.Pr
eval
enceRat
e:
Numberofaper
sonwhoar
esi
ckatagi
vent
imex1000
Av
eragenumberofper
sonexposedt
ori
sk
v
.CaseFat
ali
tyRat
e:
Numberofdeat
hsascr
ibedt
ospeci
fi
cdi
seasesx1000
Numberofr
epor
tedcasesoft
hespeci
fi
cdi
seases
 (½mar
keachf
or5poi
nts:
2½
mar
ks)

MODELANSWERS
1a.Si
x(6)way
sofpr
otect
ingsour
cesofwat
ersuppl
y
 Keepi
ngwast
edi
sposal
awayf
rom wat
ersour
ces
 Keepi
ng peopl
e and ani
mal
s away f
rom cont
ami
nat
ion of
sour
ces
I
nst
all
i
ng f
ence orot
hermeans t
o pr
eventcont
ami
nat
ion of
sour
ces
I
nst
all
i
ngpar
apet
teatl
east90cm abov
egr
oundl
evel
I
nst
all
i
ngconcr
eteori
mper
vioust
hewel
lapr
onbyconst
ruct
ing
pr
operdr
ainage
 Educat
ingt
hecommuni
ti
esonuseoft
wobucket
ssy
stem t
o
f
etchwat
erf
rom t
hewel
l
.
 Tr
aini
ngVHW onmet
hodsofpr
otect
ingwat
ersour
ces
 Act
ingasr
esour
cesper
sont
otheVHWsandpr
ovi
dingt
echni
cal
adv
iceonpr
otect
ion
 ofwat
err
esour
ces.
 Obt
aini
ngr
andom sampl
eofwat
erf
oranal
ysi
susi
ngspeci
aldi
p
andst
eri
.cont
ainer
s.Col
l
ect
ingr
esul
tsofwat
eranal
ysi
sfr
om
t
hewar
dlabor
ator
y.
 Di
scussi
ng r
esul
ts ofwat
eranal
ysi
s wi
th VHW and Vi
l
lage
Dev
elopmentCommi
tt
ee
 Adv
isi
ngonappr
opr
iat
eact
iont
otake.(
‘/
2mar
keach—3mar
ks,
1b. Fact
orsaf
fect
ingmet
hodsofr
efusedi
sposal
 Lev
elofdev
elopmentoft
hecommuni
ty
 Topogr
aphy
,especi
all
ythepr
esenceofl
ow-
ly
inggr
oundand
pi
ttobef
il
led.
 Theoccupat
ionoft
hemaj
ori
tyoft
hepeopl
east
heor
gani
c
wast
escanbet
ransf
ormedi
ntomanur
e.
 Resour
cesav
ail
abl
etot
hepeopl
e. (
1/2 mar
k
each-2mar
ks
1c. Per
sonalf
act
orst
hati
nfl
uence f
requency ofacci
denti
n
i
ndust
ry
I
gnor
ance— ani
l
li
ter
atewor
kercanbei
gnor
antbecausehe
cannotr
eadandunder
stand
i
nst
ruct
ionandsi
gnsgi
venont
hemachi
newi
thwhi
chhewor
ks.
 Tr
aini
ngandExper
ience—Lackoft
rai
ningandexper
iencei
nthe
pr
operhandl
i
ngmachi
necani
ncr
easet
hef
requencyofacci
dent
s.
I
llheal
th Def
ect
s and Di
sabi
l
iti
es — acci
denthazar
ds ar
e
 i
ncr
easedbyi
l
lnessdi
sabi
l
iti
es(
e.g.hear
ingorv
isual
def
ect
s)
 Fat
igue orSl
eepl
essness — Pr
eci
sion and abi
l
ityt
orepor
t
pr
ompt
lyt
ost
imul
icanbe
r
educedbyf
ati
gueorl
ackofsl
eep.
 Al
coholanddr
ugs— al
coholanddr
ugscanl
eadt
oimpai
red
at
tent
ionandj
udgment
.
 Age — y
ounger wor
ker
s ar
e mor
e pr
one t
han ol
der
exper
ienced.
(’
/zmar
kseach—3mar
ks)
l
d. Occupat
ionaldi
seaseswhi
choccur
rencemustbenot
if
iedor
r
epor
tedi
nNi
ger
ia
 Leadpoi
soni
ng
 Phosphor
ouspoi
soni
ng
 Mer
cur
ypoi
soni
ng
 Manganesepoi
soni
ng
 Ar
seni
cpoi
soni
ng
 Ani
l
inepoi
soni
ng
 Car
bonBi
sul
phi
depoi
soni
ng
 Benzenepoi
soni
ng
 Chr
oni
cUl
cer
ati
onofski
na
 Ant
hrax
I
oni
zi
ngr
adi
ati
on
 Toxi
cjui
ces
  Toxi
canaemi
a.-
 Absest
osi (
1/2mar
keach—2mar
ks)
2a.Condi
ti
ont
hatr
equi
rei
mmedi
ater
efer
ral
-Abnor
malpr
esent
ati
one.
g.but
tocks(
breech)
,foot
,del
ayoft
he
head
-Ex
cessi
vebl
eedi
ngbef
oreandaf
terdel
i
ver
yofbi
rt
h
-Deept
earorcutoft
heper
ineum
-Mot
hert
ooweakandt
ir
edt
opushbabyorpl
acent
aout
.
-Cor
dpr
olapsedorcor
dpr
esent
ati
on
-Pr
olongedobst
ruct
edl
abour (
1/2mar
keach—3mar
ks)
2b.St
rat
egi
esofPr
event
ionofMot
her
-t
o-chi
ldTr
ansmi
ssi
onofWV
(
PMTCT)
-Pr
imar
ypr
event
ionofHI
Vinf
ect
ioni
nwomenofr
epr
oduct
ion
ageandt
hei
rsexual
par
tner
s.
-Pr
event
ion ofuni
ntended pr
egnanci
es among HI
V posi
ti
ve
women
-Pr
event
ionofHI
Vtr
ansmi
ssi
onf
rom i
nfect
edpr
egnantwomen
t
othei
rchi
l
dren
-Tr
eat
mentcar
eand suppor
tforHI
Vinf
ect
ed women,t
hei
r
chi
l
drenandf
ami
l
ies
2c.Women who cannot t
ake pr
ogest
in onl
y i
nject
abl
e
cont
racept
ives.
-Womenwhohav
eacut
edeepv
eint
hrombosi
s
 -Womenwhohav
eli
vet
umour-
-Womenwhoar
ebr
east
feedi
ngupt
osi
xweekspost
par
tum
-Womenwhohav
ebl
oodpr
essur
e160/
l00m Hgandabov
e.
-Womenwhohav
edi
abet
eswi
thv
ascul
arcompl
i
cat
ion
- Women who hav
e unexpl
ained v
agi
nalbl
eedi
ng (
bef
ore
ev
aluat
ion)
-Women who hav
e mul
ti
pler
isk f
act
orf
orcar
diov
ascul
ar
di
seases
-Womenwhohav
ecur
rentorhi
stor
yofst
rokeori
schaemi
c
hear
tdi
seases
-Womenwhohav
enot
icedt
lt
rmi
grai
neswi
thaur
aget
ti
ngwor
se
whi
l
etaki
ngpr
ogest
inonl
yinj
ect
abl
e
- Women who hav
e r
heumat
ic di
sease such as l
upus
er
ythemat
osus wi
th posi
ti
ve or unknown ant
iphoshol
i
pid
ant
ibodi
es.
-Womenwhohav
ehi
stor
yofbr
eastcancerandnoev
idenceof
cur
rentdi
seasef
or5y
ear
s.
(
1/2 mar
k each —.
3
mar
ks)
2d. Pr
event
ion of t
he pr
e-ecl
ampsi
a and Ecl
ampi
ainy
our
communi
ty.
-Ant
enat
alcar
eregul
arBPandur
inal
ysi
scheckup
-Ear
lyr
efer
ral
 -Ski
l
ledandmot
ivat
edheal
thper
sonnel
-Appr
opr
iat
edr
ugsandsuppor
ti
vecar
e
-I
dent
if
icat
ionofdangerorsi
gnPC
-Av
oiddel
aysi
nobst
etr
ics
-At
tachmentofmi
l
lenni
um Dev
elopmentGoal
s
-I
mpr
ovi
ngl
i
ter
acyl
evel
- Er
adi
cat
ing pov
ert
y and empower
ing women soci
o
economi
cal
l
y
-I
nvol
vementofot
herst
akehol
der(
communi
tyand r
eli
gious
l
eader
s)i
nthemanagementofpr
e-ecl
ampsi
aandecl
ampsi
a.
(
1/2mar
keach—2mar
ks)
3a. Char
act
eri
sti
csofagoodcompl
ementanyf
ood.
-Hi
ghener
gyandadequat
egoodqual
i
typr
otei
n,v
itami
nand
mi
ner
als
-Sof
tconsi
stencyt
oenabl
ethechi
l
dtoswal
l
owear
ly
-Lowdi
etar
ybul
k
-Need f
ormi
nimalpr
epar
ati
on pr
iort
ofeedi
ng and easy
di
gest
ibi
l
ity
-Noant
i-
nut
ri
ti
onal
fact
3rsandl
owi
ndi
gest
ibl
efi
bercont
ent
-Noar
ti
fi
cial
col
ourandf
lav
or. (
¼ mar
k each — 3
mar
ks)

3b. Dosesandr
out
esofadmi
nist
rat
ionofNPIv
acci
nes:
Cont
actMi
nimum Ty
pe ofDosage Rout
eof Si
te
Tar
get Vacci
ne Admi
nist
rat
ion
Age of
Chi
l
d
1st Atbi
rt
h BCG 0.
05ml I
ntr
ader
mal Ri
ght upper
ar
m
OPVO 2dr
ugs Or
al Mout
h
HBVO I
ntr
amuscul
ar
2nd 6 weeks Pent
aval
ent0,
5ml Or
al Ant
erol
ater
al
ofage 1(
DP.
HBV aspect
s of
andHi
b) hi
gh
OPVI 2dr
ops I
ntr
amuscul
ar Mout
h
3r
d 10weeks Pent
aval
ent0,
5ml Or
al Ant
erol
ater
al
ofage 2 aspect
s of
(
DPT.
HBV hi
gh
andHAI
B)
OPV 2 2dr
ops I
ntr
amuscul
ar Mout
h
4t
h 14weeks Pent
aval
ent0.
5ml Or
al Ant
erol
ater
al
ofage 3 (
DPT. aspect
s of
HBV and hi
gh
Hi
b)
OPV3 2dr
ops Subcut
aneous Mout
h
5t
h 9mont
hs Measl
es 0.
5ml Subcut
aneous Lef
t upper
ar
m
Yel
l
ow 0.
5ml Lef
t upper
f
ever ar
m
(
1/4mar
kforeachpoi
nt–5mar
ks)
.
3c. Fact
orst
hatpr
omot
espl
aguer
etent
ion:
1.Cr
ackedt
eet
h
2.Ov
erhangi
ngedgesonf
il
li
ng
3.Poor
lycont
ainedt
eet
hfi
l
li
ng
4.Somet
ypesofpar
ti
aldent
ine
5.Cal
cul
ushar
dened(
plaque)(
‘/
2mar
keach—2mar
ks)
4a. Def
ini
ti
onofPuer
per
alPsy
chosi
s:
Puer
per
alpsy
chosi
sal
soapost
per
tur
epsy
chosi
sisat
ermt
hat
cov
eragr
oupofment
ali
l
lnesswi
thasuddenonsetofpsy
chot
ic
sy
mpt
omsf
oll
owi
ngchi
l
dbi
rt
h,t
heonseti
sabr
upt
,andsy
mpt
om
r
api
dlyr
eachacl
i
maxofsev
eri
ty,mostof
tenwi
thi
nfi
rstf
ourweeks
postpor
tum. The most si
gni
fi
cant r
isk f
act
ors f
or puer
per
ial
psy
chosi
sar
caper
sonalorf
ami
l
yhi
stor
yofbi
col
ordi
sor
derora
pr
evi
ouspsy
chot
icepi
sode
4b. CausesofPuer
per
alPsy
chosi
s:
i
.Thephy
sicalst
rai
nofdel
i
ver
y,mat
ernalexhaust
ion,
whi
chmay
bemadewetbysur
gical
int
erv
ent
ion
i
i
.Anyi
nfect
ioncausi
nghi
ghf
everandaddi
ti
onal
str
ain
 i
i
i. Loss of bl
ood ant
epar
tum haem6r
rhage or post
par
tumhaemor
rhage
i
v.Reabsor
pti
onofhaemat
omaorot
herpr
otei
ncont
aini
ngf
lui
ds,
al
l
ergi
creact
ion
v
.Endocr
inol
ogi
cal
dist
urbancef
oll
owi
ngdel
i
ver
y
v
i.Psy
chol
ogi
ca1 t
ressesofpr
egnancyand l
abour
,incl
udi
ng
emot
ional
str
essespr
egnancyandmot
her
hood.
v
ii
.Possi
blyher
edi
tar
yfact
ors. (½ mar
keach—3
½ mar
ks)
4c. Ar
east
ocov
eri
nthephy
sicalexami
nat
ionofaschoolchi
l
d:
i
.Ey
est
est— f
oract
ivi
tyofv
isi
on,exami
nat
ionf
ordef
ecte.
g.
squi
nt,exami
nef
ordi
seasee.
g.Vi
tami
nAdef
ici
ency
,Tr
achoma,
Conduct
ivi
ti
eset
c.exami
nef
oranaemi
a.
i
i
.Teet
h—l
ookf
orcar
ri
es,
spongy
,bl
eedi
nggum,
pyor
rheaet
c.
i
i
i.Thr
oat—l
ookf
orenl
argedi
nfl
amedt
onsi
l
s
i
v.Ear
s—t
estf
orhear
ing,
lookf
or&di
schar
ge
v
.Chest—Auscul
atehear
tandl
umps
v
i.Abdomen— Pl
apat
eenl
argementofl
i
verorspl
een.L9okf
or
def
ect
s and pr
esence of l
ump or hi
nder
ness, l
ook f
or
undescendedt
est
is.
v
ii
.Li
mpsandspi
ne—t
estf
orr
esi
dualpar
aly
sis,
lookf
ordef
ect
s
e.
g.ky
phosi
s,cl
ubf
ootet
c.l
ooki
1orsi
gnsofr
icket
s
v
ii
i.Ski
nandhai
r—Lookf
orr
edorhy
popi
gment
edpat
cheswi
th
 l
ossofsensat
ion,l
ookf
orul
cer
s,boxes,r
ingwor
m,orscabi
es,
l
ookf
orpr
esencesofl
i
ce
i
x.I
fthechi
l
dhasami
nori
l
lment
,adv
icet
het
eacherorpar
ent
whatt
reat
menti
stobegi
ven.
(
½ mar
kach—3mar
ks)
4d. Rol
esofCHEW i
nSchoolHeal
thSer
vices:
1. Heal
th super
visi
on i
ncl
udes such act
ivi
ti
es Of heal
th
assessment
,vi
sion and hear
ing scr
eeni
ng and heal
th def
ici
t
i
dent
if
icat
ion..
2.Heal
thCounsel
i
ngi
nvol
vepr
ovi
dingi
nter
pret
ati
onr
egar
ding
heal
thbehav
iorandr
ecommendat
ionsr
egar
dingi
ndi
vi
dualand
gr
oupheal
thcondi
ti
on
3. Heal
th Educat
ion r
efer
s t
o pl
anni
ng, pr
omot
ing and
i
mpl
ement
ingheal
thi
nst
ruct
ionaswel
laspr
ovi
dingconsul
tat
ion
ser
vicesi
nheal
thr
elat
emat
ter
.
5a.i
.Inf
ect
ionsAgent— Ebol
avi
rusi
scausedbyv
irusoft
hef
ami
l
y
f
il
ovi
ri
dae,genus,Ebol
avi
rus.Fi
vesubspeci
esexi
sts,hamel
y:Ebol
a
v
irus(
Zai
reebol
avi
rus)Sudanv
irus(
sudanEbol
avi
rus)
;TaiFor
est
Vi
rus (
Taif
orestebol
avi
rus)
;Bundi
bugy
ovi
rus (
Bundi
bugy
oebol
a
v
irus)andRest
onVi
rus(
Rest
onebol
avi
rus) (
1mar
k)
i
i
.ModeofTr
ansmi
ssi
on—di
rectcont
actwi
tht
hebl
oodorsecr
eti
ons
ofani
nfect
edper
son.Exposur
etoobj
ect(
suchasneedl
es)t
hathav
e
beencont
ami
nat
edwi
thi
nfect
edsecr
eti
ons. (
1mar
k)
i
i
i.Si
gnsandsy
mpt
oms— Fev
er,headache,j
ointandmuscl
eaches,
weakness,di
arr
hea,(
1dmi
ti
ng,st
omachpai
nandl
ackofappet
it
e.
Ot
her
sincl
ude:Rashes,r
edey
es,hi
ccups,cough,cor
ethr
oatchest
pai
n,di
ff
icul
tybr
eat
hing,di
ff
icul
tyswal
l
owi
ng,bl
eedi
ng (
int
ernal&
ext
ernal
). (
2mar
ks)
i
v.Pr
event
ion-Bar
ri
ernur
singt
echni
quesi
ncl
ude:
-Wear
ingofpr
otect
ivecl
othi
ng(
suchasmasks,gl
oves,gowns,and
googl
es)
-Theuseofi
nfect
ioncont
rol
measur
es
-I
sol
ati
onofpat
ient
s.(
1‘/
2mar
ks)
5b. Char
act
eri
sti
csofNon-
Communi
cabl
eDi
seases(
NCD)
:
i
.Thecausei
slar
gel
yunknown
i
i
.Manyf
act
orscont
ri
but
etot
hei
rdev
elopment
i
i
i.Thedi
seasesdev
elopsl
owl
yov
eraper
iodofy
ear
s
i
v.Theycanbecont
rol
l
edort
reat
edi
fdet
ect
edi
r.ear
lyst
ates
v
.Cer
tai
nli
fest
ylehabi
tsormodesofl
i
vingi
ncr
easest
her
iskof
pr
emat
uredev
elopmentofNCD
v
i.Ri
sk r
educt
ion and pr
event
ive measur
e can del
ay t
he
dev
elopmentofNCDandr
educedi
sabi
l
ityordi
scomf
ort(
½mar
k
each—2½mar
ks)
5c. Pr
event
ivemeasur
esofHy
per
tensi
on:
1.Av
oidt
oomuchi
ntakeofsal
t
2.Av
oidorr
educemeal
sthatar
ehi
ghsi
nfat
sandchol
est
erol
 i
ncl
udi
ngf
ri
edf
oods.
3.Av
oidov
ereat
ingandr
educewei
ghti
fyouar
eobese
4.Av
oidt
oom4chsugari
nyourf
ood
5,Ex
erci
ser
egul
arl
y,byj
oggi
ng gent
ly,br
iskwal
ki
ng,pl
ayi
ng
t
enni
s.
6.Cont
rol
str
essandgetadequat
esl
eepandr
est
7.Checky
ourbl
oodpr
essur
eregul
arl
y
8.Av
oidexcessi
vei
ntakeofdi
arypr
oduct
ssuchsmi
l
k,eggy
ork,
but
ter
,et
c
(
½ mar
k each -
2 ½
mar
ks)
6a. Adv
icet
opar
ent
swi
tha°hear
ingi
mpar
edchi
ld:
i
.Lett
hechi
l
dseey
ourf
acewheny
ouspeakt
ohi
m
i
i
.Makesur
ether
eisgoodl
i
ghtf
ort
hechi
l
dtoseey
ourf
ace
i
i
i.Gett
hechi
l
d’sat
tent
ionbef
orey
ouspeakt
ohi
m
i
v.Decr
easeot
herdi
str
act
ion—especi
all
yloudnoi
ses
v
.Encour
agehar
dofhear
ingdi
sor
der
schi
l
drent
oli
stenand
di
scr
imi
nat
eduf
fsoundsespeci
all
yifhei
susi
ngahear
ingai
d.
v
i.St
andcl
oset
othechi
l
dwheny
ouspeak
v
ii
.Speakcl
ear
lyandmor
esl
owl
y
v
ii
i.Don’
tshoutanexagger
atemov
ement
i
x.Repeatwor
dsandi
nst
ruct
ionsmanyt
imes
x.Usegest
ures,
drawi
ng,
pai
nti
ng—poi
ntatt
hings
 xi
.Encour
agel
i
preadi
ng
xi
i
.Don’
teatorchewwhi
l
etal
ki
ngt
othechi
l
d
xi
i
i.Donotov
erpr
otectt
hechi
l
d
xi
v.I
fthechi
l
dhasahear
ingai
dhe/
shemustusei
t.
6c. Pr
ocedur
eformeasur
ingdi
stancev
isi
onusi
ngsnel
lenchar
t:
i
.Det
ermi
net
hedi
stancebet
ween t
hepat
ientand t
hechar
t
whi
chmustnotl
i
pmet
ersor20f
eet
.
i
i
.Expl
aint
hepr
ocedur
etopat
ientandsi
tthepat
ientcomf
ort
abl
y
i
i
i.Testt
her
ightey
efi
rst
,cov
erl
eftey
ewi
thoccl
ude.Besur
e
t
hatpat
ienti
sus4ey
e.
i
v.Testv
isi
onsbyst
art
ingwi
tht
hel
argel
ett
ersf
ir
st,pr
oceed
downt
hechar
ttot
hel
ett
erst
hepat
ientcansee.I
tisadv
isabl
eto
ski
pli
nessoast
oident
if
ythesmal
l
estt
hepat
ientcanr
ead.
v
.Recor
dthesmal
l
estl
i
nei
nwhi
cht
hepat
ientcanseeatl
east
hal
fofehl
ett
ers.
v
i.Repeatt
het
estwi
thl
eftey
e
v
ii
.Repeatt
het
estwi
thpat
ientwear
inghi
scor
rect
ivel
enses
v
ii
i.I
fpat
ientcannotseel
argestl
ett
ers,
thenadoptot
hermet
hod
e.
g.count
ingf
inger
.
7a. Obj
ect
iveoft
hecar
eoft
hehandi
capped:
i
.Ident
if
ythecommoncauseofhandi
capi
nthecommuni
ty
i
i
.Car
ry outact
ivi
ti
es ai
med atpr
event
ing handi
cap i
nthe
communi
ty.
 i
i
i.Pr
ovi
decar
efort
hehandi
cap
i
v. Rehabi
l
itat
ion (
medi
cal
l
y, ment
all
y and soci
all
y) ev
ery
handi
capper
soni
ncommuni
ty
v
.Mobi
l
izet
hecommuni
tyt
opar
ti
cipat
eint
heabov
e.(
½ mar
k
each— 2½mar
k)
7b. Act
ivi
ti
est
obecar
ri
edt
opr
omot
ecar
eoft
heel
der
lyi
nyour
communi
ty.
1.Car
eoft
heel
der
lyi
sther
esponsi
bil
i
tyoft
hef
ami
l
yand
communi
tyt
her
efor
edi
scour
aget
heest
abl
i
shmentofmor
eol
d
peopl
e’
shome
2.A daycent
reequi
ppedwi
thadequat
erecr
eat
ionalf
aci
l
iti
es
shoul
d-bepr
ovi
dedf
oreachcommuni
ty.
3.Or
gani
zei
nter
stat
ebus/
trai
nexcur
sionf
ort
heel
der
ly.(
½mar
k
each—4mar
ks)
7c. Gol
denr
ulesofFi
rstAi
d:
i
.Dof
ir
stt
hingf
ir
st,
qui
ckl
yandwi
thoutf
ussorpani
c
i
i
.Gi
vear
ti
fi
cial& r
espi
rat
ion i
fbr
eat
hing hasst
opped ev
ery
secondcount
s
i
i
i.St
opanybl
eedi
ng
i
v.Guar
dagai
nstort
reatf
orshockbymov
ingt
hecasual
tyas
l
i
ttl
easpossi
bleandhandl
i
nghi
m gent
ly.
v
.Donotat
temptt
oomuch— dot
hemi
nimum t
hati
sessent
ial
t
osav
eli
feandpr
eventt
hecondi
ti
onf
rom wor
seni
ng
 v
i.Reassur
est
hecasual
tyandt
hosear
oundal
sot
ohel
plessen
anxi
ety
v
ii
.Donotal
l
owpeopl
etocr
ownr
oundasf
reshai
risessent
ial
v
ii
i.Donotr
emov
ecl
othesunnecessar
il
y
i
x.Ar
rangef
ort
her
emov
aloft
hecasual
tyt
othecar
eofdoct
or
orhospi
tal
assoonaspossi
ble.(
1/2mar
keach-3½ mar
ks)

PAPERI
SECTI
ONB:EASYQUESTI
ONS(
70Mar
ks)
(
a)Expl
ainf
ive(
5)outoft
hecodesofconductf
orCommuni
tyHeal
th
Pr
act
it
ioner
s.(
5mar
ks)
1.Setahi
ghst
andar
d:Acommuni
tyheal
thpr
act
it
ionershal
lseta
‘
hi
ghst
andar
dandnotal
l
ow
hi
msel
f/her
sel
ftor
ecei
vegi
ft
s,f
avour
sorhospi
tal
i
tyf
rom a
cl
i
ent
/pat
ient
,orr
elat
ivesofa
cl
i
ent
/pat
ientwhoi
stobeorwhohasbeeni
nhi
sorhercar
e
2.I
ntr
a-pr
ofessi
onalobl
i
gat
ion:A communi
tyheal
th pr
act
it
ioner
shal
l mai
ntai
n f
ri
endl
yrel
ati
ons wi
th col
l
eagues and be
r
espect
ful
tot
heseni
orcol
l
eagues
3.Useofst
andi
ngor
der
s:A communi
tyheal
thpr
act
it
ionermust
usehi
s/herst
andi
ngor
der
sand
 ot
hermedi
calequi
pment
sin ar
ri
vi
ng atany di
agnoi
s and
managementofhi
/herpat
ient
4.Mai
ntenanceoft
wo-
wayr
efer
ralsy
stem:A communi
tyheal
th
pr
act
it
ionershal
lmai
ntai
nthe
r
efer
ralsy
stem byr
efer
ri
ngcasesbey
ondhi
s/herj
obdescr
ipt
ion
t
otheappr
opr
iat
elev
el
5.Admi
nist
eri
ng oft
reat
ment
:A communi
ty heal
th pr
act
it
ioner
shal
lnotadmi
nist
eranyt
reat
mentonapat
ientorhi
s/herr
elat
ion
i
nacaseofunconsci
ousorapat
ientwhocannotspeakf
or
hi
msel
f/her
sel
f
6.Pr
omptat
tent
ion:Acommuni
tyheal
thpr
act
it
ionershal
lensur
e
t
hesaf
etyofhi
s/herpat
ient
whet
hert
her
elat
ives,ar
ear
oundornotandusewhat
evert
he
r
elat
ivesar
ear
oundornotandusewhat
evermeansofhi
s/her
di
sposalt
o pr
eser
vel
i
fe whi
l
e awai
ti
ng r
elat
ion ar
ri
valand
assi
stance
7.Gi
vi
ngofev
idence:A communi
tyheal
thpr
act
it
ionershal
lsay
whathe/
sheknowsi
str
uewhengi
vi
ngev
idenceasanexper
t
wi
tness.‘
-
8.Useofuni
for
m:A communi
tyheal
thpr
act
it
ionermustal
way
s
appeari
nhi
s/heruni
for
m onceondut
yexceptdur
ingemer
gency
andcal
ldut
ieswhi
char
eout
sideof
fi
cial
wor
kinghour
s
9.Ant
i-
prof
essi
onalbehav
iour
s:A communi
tyheal
th pr
act
it
ioner
 hal
1 be member
s o?
the Nat
ionalassoci
ati
on ofcommuni
ty
heal
thpr
act
it
ioner
sofNi
ger
iabei
ngt
heonl
ylegal
l
yrecogni
zed
bodyt
o assi
stt
heboar
dinensur
ingpr
ofessi
onalsani
tyand
di
gni
tyi
nthecount
ry.Anycommuni
tyheal
thpr
act
it
ionert
hat
doesnotbel
ongt
otheassoci
ati
onwoul
dnotber
ecogni
zedby
t
heboar
d.
10. Absent
eei
sm:A communi
tyheal
thpr
act
it
ionershoul
dnot
absenthi
msel
f/her
sel
ffr
om dut
y
wi
thoutper
missi
on
(
b)Li
stsi
x(6)dut
iesofCommuni
tyHeal
thPr
act
it
ioner
s(3mar
ks)
I
.Car
ingf
ort
hesi
ckandi
njur
edconsi
der
ingt
her
esour
cesoft
he
pat
ient
,hi
sfami
l
y and env
ironmentand t
he ser
vices av
ail
abl
e,
i
ncor
por
ati
ngper
sonalneedst
ohi
s/herr
ecov
eryandr
ehabi
l
itat
ioni
n
accor
dancet
othef
indi
ngandact
ionsoft
hest
andi
ngor
der
s.
I
I.Hel
pingt
hei
ndi
vi
dualandt
hef
ami
l
ytot
akeposi
ti
veact
ioni
nrel
i
ef
ofi
l
lnessi
mpr
ovementofhi
s/heri
ndi
vi
dualf
ami
l
yandcommuni
ty
needs
I
II
.Tr
aini
ngot
her
stof
unct
ionasmember
soft
heheal
tht
eam.
I
V. Adopt
ing communi
ty heal
th ser
vices t
o cor
respond wi
th
r
esponsi
blepl
anni
ngar
thor
it
ati
cinemer
gencyl
i
kedi
sast
ers,
out
break
andwar
s
V.Ev
aluat
ingandconduct
ingr
esear
cht
oimpr
oveheal
thcar
eand
adequat
elymeetsoci
etyneeds
VI
.Shar
ingwi
thot
her
sint
hedi
ssemi
nat
ionofheal
thi
nfor
mat
iont
o
i
ndi
vi
dual
sandi
tcommuni
ty
(
c)Li
stf
our(
4)Dut
ies oft
he Communi
ty Heal
th Pr
act
it
ioner
s
Regi
str
ati
onBoar
dofNi
ger
ia(
CHPRBN)
. (
2mar
ks)

a.Det
ermi
ning whatst
andar
d,knowl
edge and ski
l
lar
eto be
at
tai
ned by a per
son seeki
ng become member
s of t
he
communi
tyheal
thandi
mpr
ovi
ngt
hosest
andar
dsf
rom t
unet
of
ci
rcumst
ancesmayper
mit
.
b.Boar
d assess and accr
edi
ts communi
ty heal
th cour
se i
n
i
nst
it
uti
onsi
ncol
l
ege/
schoolofht
echnol
ogy
/schoolofhy
giene
andcommuni
tyheal
tht
rai
ningi
nst
it
uti
ons.
c.Secur
ing t
he mai
ntenance ofr
egi
ster
ed member
s undert
his
decr
eeasmember
sofIpr
ofessi
onandpubl
i
cat
ionf
rom t
imet
o
t
imel
i
stsoft
hemember
s.
d.Conduct
ing exami
nat
ions i
n t
he pr
ofessi
on and awar
ding
cer
ti
fi
cat
etosuccessf
ulcandi
dat
eappr
opr
iat
e.
e.her
eshal
lbeest
abl
i
shmentf
oradi
sci
pli
nar
ycommi
tt
eet
obe
known as “
the communi
ty Heal
th pr
act
it
ioner
s Di
sci
pli
nar
y
commi
tt
ee”whi
chshal
lbechar
gedwi
tht
hedut
yconsi
der
ingand
det
ermi
ninganycaser
efer
redt
oitbyt
hei
nvest
igat
ingpanel
(
sessi
on211decr
ee61of1992)
:
f
.CHPRBNsetst
andar
ds,
moni
toranddi
sci
pli
nemember
s.
 g.To ensur
ethe mai
ntenance oft
rai
ning st
andar
din or
dert
o
ensur
ethedel
i
ver
yofqual
i
tyheal
thser
vicesespeci
all
yatt
he
pr
imar
yheal
thcar
elev
el
2.(
a)Enumer
atef
ive(
5)t
ypesofTr
adi
ti
onalHeal
thCar
eDel
iv
ery
.
(
2½mar
ks)
a.Her
bal
i
st
b.Tr
adi
ti
onal
bir
that
tendant
s
c.Boneset
ter
s
d.Tr
adi
ti
onal
psy
chi
atr
istI
e.Spi
ri
tual
heal
ers
f
.Or
acl
emen/
women
g.Messenger
s
h.Gener
alpr
act
it
ioner
s
(
b)Li
stf
ive(
5)char
act
eri
sti
csofModem Medi
cine.
(2½ mar
ks)
1.Modem medi
ci
nei
ssci
ent
if
icbecausei
tisbasedonknowl
edge
der
ivedf
rom car
eful
andexper
iment
ati
on
2.Modem medi
cinei
steam wor
k:I
trequi
rest
heser
vicesofmany
pr
ofessi
onal
s who wor
k i
n col
l
abor
ati
on f
ort
he pr
oper
t
reat
mentofi
l
lnesses
3.Modem medi
cine pr
act
it
ioner
s make use ofchemot
eraphy
,
sur
ger
y,r
adi
oter
aphy
,di
eti
cs educat
ion ofpat
ient
s/cl
i
ent
sto
t
reatdi
sease.
4.Ther
ear
especi
ali
zat
ioni
nmoder
nmedi
cineandonemedi
cal
 pr
act
it
ionercannott
reatev
erysi
ckness
5.Modem medi
cinei
sst
andar
dizedwor
ldwi
dei
nthesenset
hat
onecanbet
rai
nedi
nonel
ocat
ionorpar
toft
hewor
ldand
pr
act
icesuccessf
ull
yinanot
herl
ocat
ionorpar
toft
hewor
ld
6.I
n Ni
ger
ia and el
sewher
e,t
he pr
act
ice ofmoder
n medi
cine
cont
rol
l
edbygov
ernmentpol
i
ciesandet
hicsoft
hepr
ofessi
on
i
nvol
ved
7.Modem medi
cinei
nNi
ger
iai
sor
gani
zedi
nthr
eel
evel
s,pr
imar
y
l
evel
,whi
chi
stheent
rypoi
nt,t
hesecondar
ylev
elandt
ert
iar
y
l
evel
.
8.Ref
err
ali
smadewhennecessar
yfr
om t
hepr
imar
ylev
elt
othe
secondar
ylev
elwher
especi
ali
zedser
vicei
sgi
venandf
inal
l
yto
t
het
ert
iar
ylev
elf
orhi
ghl
yspeci
ali
zedser
vice/
car
e
(
c)St
atet
het
wo(
2)t
ypesofemot
ion,gi
vi
ngt
wo(
2)exampl
eof
each.(
2mar
ks)
1.Emot
ionmaybepl
easantorposi
ti
vee.
g.Joy
,Lov
e,Happi
ness,
Smi
l
e,Laught
er,
Elect
ion,
Est
asy
,Amusement
,et
c.
2.Emot
ionmayal
sobeunpl
easantornegat
ivel
i
kef
ear
,sor
row,
di
sgust
,sur
pri
se,
jeal
ousy
,env
y,hat
redanger
,aggr
essi
on,
etc.
(
d)Enumer
atesi
x(6,
)fact
orst
hatmaycausef
orget
ti
ng. (
3mar
ks)
1.I
nter
fer
enceduet
omassi
ngofsi
mil
arl
ear
ningexper
iencesor
ov
erl
oadi
ngoft
hememor
y
 2.Fadi
nganddecayduet
olackofpr
act
iceandexer
cise
3.I
nsuf
fi
cientt
ime,whi
chl
eadst
oahast
ysear
choft
hememor
y
st
ore.
4.Repr
easi
onar
isi
ngf
rom st
rongemot
ionalat
tachmentorgui
l
t
f
eel
i
ngs
5.I
mper
fect
ionoft
hememor
ypr
ocess
6.Changeofcont
extorsur
roundi
ngsl
eadi
ngt
other
emov
alof
r
emi
nder
sandr
educt
ioni
ntheef
fect
ivenessofr
etr
ival
clues.
7.Fearoranxi
etyar
isi
ngf
rom l
ackofconf
idenceasexempl
i
fiedi
n
st
agef
ight
,ment
albl
ackoutorbr
ainwav
e
3.(
a)Br
ief
lyexpl
aint
hef
oll
owi
ngcommuni
cat
ionconcept
s
i
.Adv
ocacy (
1mar
k)
I
tist
hepr
ocessofcr
eat
ing•awar
enessconcer
ninganyheal
th
mat
teramongpol
i
cymaker
sinor
dert
o gett
oorgai
nthei
r
suppor
t.
i
i
)Soci
almobi
l
izat
ion (
1mar
k)
I
tisameansofencour
agi
ng,i
nspi
ri
ngandar
ousi
ngt
hei
nter
est
ofpeopl
eto maket
hem becomeact
ivel
yinv
olv
ed i
nfi
ndi
ng
sol
uti
ont
osomeoft
hei
rownpr
obl
emst
her
ebyl
eadi
ngt
osel
f
r
eli
ance&i
nit
iat
ives.
(
ii
i)Behav
iourchangecommuni
cat
ion(
l.mar
k)
I
tis a pr
ocess of under
standi
ng peopl
e’
s si
tuat
ions and
i
nfl
uences,dev
elopi
ngmessagest
hatr
espondt
otheconcer
ns
 wi
thi
nthosesi
tuat
ionsandusi
ngcommuni
cat
ionpr
ocessesand
medi
ato per
suade peopl
etoi
ncr
ease t
hei
rknowl
edge and
changet
hebehav
iour
sandpr
act
iceswhi
chpl
acet
hem atr
isk.
(
iv)I
nter
per
sonal
communi
cat
ion(
1mar
k).
I
tist
he f
ace t
oface v
erbaland non-
ver
balexchange of
i
nfor
mat
ion,
ideasorf
eel
i
ngsbet
weeni
ndi
vi
dual
sorgr
oups.
(
v)MassMedi
a (
1mar
k)
Thi
sist
hepr
ocessoft
ransmi
tt
ingmessagest
oal
argeaudi
ence
t
hrought
hemassmedi
asuchasTel
evi
sionar
idRadi
o
(
b)St
atef
ive(
5)way
sthr
oughwhi
chcommuni
ti
escancommuni
cat
e
heal
thmessages.(
2½ mar
ks)
 Rol
espl
ayi
ng
 St
oryt
ell
i
ng(
ver
bal
communi
cat
ion)
 Gr
oupdi
scussi
on
 Si
mul
ati
on
 SongsandDr
ama
 Demonst
rat
ion
 Counsel
l
ing
 Danci
ng
 Non-
ver
bal
communi
cat
ione.
g.gest
ures,
bodyl
anguages
(
c)Enumer
atef
ive(
5)qual
i
ties ofef
fect
ive communi
cat
ion (
2½
mar
ks)
i
. Speci
fi
cobj
ect
ives
 i
i
. Conci
seness--
i
i
i. Per
suasi
veness
i
v. Ti
mel
i
ness
v
. Cor
rect
ness
v
i. Compl
eteness
v
ii
. Feedback
v
ii
i. Mut
ual
i
x. I
nter
est
x. Appr
opr
iat
euseofl
anguage
xi
. Appr
opr
iat
euseofmedi
a
4.(
a)St
atef
ive(
5)ai
msoft
heBasi
cHeal
thSer
viceScheme(
BHSS)
(
5mar
ks)
1.Tocor
rectt
hei
mbal
ancescr
atedi
nthel
ocat
ionofheal
thcent
ers
t
her
ebyi
ncr
easi
ngt
hecov
erageofmedi
cal
ser
vices
2.Tocor
rectt
hei
mbal
ancesi
nthedi
str
ibut
ionofheal
thser
vices
3.Tot
rai
nanddev
elopmanpowerf
ort
heheal
thcar
eser
vices
4.To cor
rectt
he i
mbal
ances bet
ween pr
event
ive and cur
ati
ve
heal
thcar
e-ser
vices
5.To pr
ovi
de i
nfr
ast
ruct
uralf
aci
l
iti
esf
orpr
event
ive heal
th car
e
ser
vices
6.Theuseofsi
mpl
eandr
elev
antmedi
calt
echnol
ogyappr
opr
iat
e
t
oeachcommuni
ty
7.Toensur
ecommuni
tymobi
l
izat
ionandpar
ti
cipat
ioni
npr
ovi
ding
 heal
thser
vices
(
b)Enumer
atef
ive(
5)component
soft
heMi
nimum War
dHeal
th
Car
epackage.(
2½ mar
ks)
1.Er
adi
cat
eext
remepov
ert
yandhunger
2.Achi
eveuni
ver
sal
pri
mar
yeducat
ion
3.Pr
omot
egenderequal
i
tyandempowerwomen
4.Reducechi
l
dmor
tal
i
ty
5.I
mpr
ovemat
ernal
heal
th-
6.CombatHI
V/AI
DS,
mal
ari
aandot
herdi
seases
7.Ensur
eenv
ironment
alsust
ainabi
l
ity
8.Dev
elopgl
obal
par
tner
shi
pfordev
elopment
(
c)St
atef
ive(
5)r
easonsf
ort
hei
ntegr
ati
onofheal
thcar
eser
vice
del
i
ver
yinNi
ger
ia.(
2½mar
ks)
5.(
a)Di
scussf
ive(
5)const
rai
ntsy
oumayencount
eri
nconduct
ing
communi
tymobi
li
zat
ionpar
ti
cipat
ion.
(
5mar
ks)
(
b)St
atesi
x(6)Rat
ional
esf
orCommuni
tyMobi
li
zat
ion (
3mar
ks)
1.Tomakeupf
ort
hegr
ossi
nadequat
eofourheal
thmanpower
andequi
pment
,thesecoul
dbepr
ovi
dedbyt
hecommuni
tyand
f
ort
hei
rconsumpt
ionwher
egov
ernmenti
sincapabl
eal
lmeet
ing
t
heheal
thneedsofev
eri
ndi
vi
dual
inacommuni
ty.-
2.Toi
dent
if
ytheheal
thpr
obl
emsi
nthecommuni
ty,
thi
sisbecause
t
heheal
thneedsasI
dbyt
heheal
thwor
ker
smaybedi
ff
erent
 f
rom t
hef
eltneedsoft
hecommuni
ty.
3.Topl
ant
hei
rownsol
uti
onst
othei
rpr
obl
ems.
4.Tout
il
izet
hei
rownav
ail
abl
eresour
cest
osol
vet
hei
rneedsata
costt
heycanaf
for
d.
5.Tof
ost
ersel
f-
rel
i
ance.-
6.Tof
ost
erpr
omptat
tent
iont
opr
obl
ems
(
c)Li
stf
our(
4)Rol
esofSi
tuat
ionAnal
ysi
sinPHC. (
2mar
ks)
1.Todet
ermi
net
heef
fect
ivenessofheal
thcar
eser
vicesandt
o
r
espondt
othepr
obl
emschal
l
engesf
oundi
nthecommuni
tyor
l
ocal
gov
ernmentar
ea.
2.Topr
ovi
decompl
etei
nvent
oryofheal
thf
aci
l
iti
esi
nthel
ocal
gov
ernmentar
eaorcommuni
ty
3.Toi
dent
if
ythedi
str
ibut
ionofheal
thf
aci
l
iti
esi
nthecommuni
ty
4.Toi
dent
if
ycat
egor
yandnumberofper
sonnel
int
hef
aci
l
iti
es.
5.Topr
ovi
dei
nfor
mat
ionont
het
ypeandadequacyofser
vices
pr
ovi
dedi
nal
lthef
aci
l
iti
es
6.Topr
ovi
dei
nfor
mat
ionont
henumberofset
tl
ement
sineach
communi
tyorl
ocal
gov
ernmentar
ea.
7.Topr
ovi
deacompl
eteov
erv
iewofheal
thser
vices,
thei
rst
rengt
h
andweaknesses,
heal
thr
elat
edpr
obl
emsandi
nfr
ast
ruct
ure.
6.(
a)Enumer
atef
ive(
5)sour
cesofdr
ugs (
2½ mar
ks)
i
. Veget
abl
es-
i
i
. Mi
ner
alssour
ce,
i
i
i. Ani
mal
sour
ce
i
v. Sy
nthet
icsour
ce
v
. Ant
ibi
oti
csour
ce
(
b)St
atef
ive(
5)f
act
orsr
esponsi
blef
ort
hewast
ageofdr
ugsi
na
Heal
thCent
re.(
2½ mar
ks)
i
. Gi
vi
ngdr
ugswhen,
diagnosi
shasnotbeenmade
i
i
. Gi
vi
ngdr
ugst
opat
ient
swhodoesn’
tbel
i
evei
nthem
i
i
i. Or
der
ing dr
ugs mor
ethan necessar
y so t
hatsome expi
red
wi
thoutbei
ngused.
i
v. Notobser
vingFI
RSTI
NFI
RSTOUT(
FIFO)
v
. Notkeepi
ngt
othepr
inci
plesofcol
dchai
nmai
ntenancemakes
v
acci
net
olooset
hei
rpat
ience
v
i. Pi
l
fer
ing
v
ii
. Ov
erpr
escr
ipt
ionononepat
ient
v
ii
i. Poorst
oragef
aci
l
iti
es
(
c)I
dent
if
yfi
ve(
5)obj
ect
ives oft
he Nat
ionalEssent
ialDr
ugs
Pr
ogr
amme.(
2½ mar
ks)
i
. Tomakeessent
ialdr
ugseasi
l
yav
ail
abl
etot
heent
ir
epopul
ati
on
oncont
inuousbasi
s
i
i
. Tousedr
ugst
hatar
esaf
eandef
fect
ive
i
i
i. Tor
educet
hecostofdr
ugst
hroughacent
ralbul
kpur
chasi
ng
sy
stem usi
nggener
icnames
i
v. Topur
chaseonl
ynecessar
ydr
ugsf
ort
hesy
stem,t
hussav
ing
 f
orei
gnexchange
v
.Int
roduce a r
ati
onal
e sy
stem ofdr
ug sel
ect
ion,cal
cul
ati
on,
pr
ocur
ementanduse
v
i. Pr
ovi
de t
rai
ning f
ori
mpr
oved dr
ug managementand ski
l
lto
heal
thwor
ker
satal
ll
evel
s
v
ii
. Di
scour
age t
he pr
oduct
ion,mar
ket
ing and sue off
ake and
count
erf
eitdr
ugs.
(
d)St
ate(
5)f
act
orst
hati
nfl
uencet
hesel
ect
ionofEssent
ialDr
ugs.
(
2½ mar
ks)
7.(
a)St
atesi
x(6)r
easonsf
orr
efer
ralofaCl
ient
/Pat
ient
.
(
3mar
ks)
1.When t
he pat
ient
’s condi
ti
on i
srapi
dly get
ti
ng wor
se or
det
eri
orat
ing
2.Wheni
ndi
cat
edi
nthest
andi
ngor
der
s“REFER”
3.When pat
ient
’s condi
ti
on i
s notcov
ered orspel
touti
nthe
st
andi
ngor
der
s.
4.Whent
hepat
ientorhi
srel
ati
vesr
equestf
ort
her
efer
ral
5.Pat
ient
’scondi
ti
oni
snotr
espondi
ngt
other
apy
6.Whenheal
thwor
ker
sisi
ndoubtoft
hecasei
nvi
ew
7.Forspeci
ali
stsophi
sti
cat
edmanagement
8.Whent
her
eisnof
aci
l
iti
esandequi
pmentt
omanaget
hecase.
9.Whent
her
eisnoex
per
ttomanagesuchacasee.
g.i
nter
nal
bl
eedi
ngandbr
ainsur
ger
y
 10. Forcont
inui
tyofheal
thcar
e
11. Fordi
agnost
icpur
poses
(
b)Enumer
atef
our(
4)qual
it
iesofagoodr
efer
ralsy
stem. (
2mar
ks)
1.St
andar
dizedr
efer
ral
for
ms
2.Adequat
efeedbacksy
stem
3.Wi
l
li
ngnessofcl
i
ent
sandt
hei
rrel
ati
onst
oleav
ethei
rsecur
ed
env
ironment
soot
hernewcent
ers.
4.Abi
l
ityofcl
i
entandf
ami
l
ymember
stopayf
orheal
thcar
eand
t
ranspor
tfar
es
5.Goodr
oadnet
wor
kan4t
ranspor
tat
ion
6.Abi
l
ityofr
ecei
vi
ngheal
thf
aci
l
ityt
oabsor
bref
err
edcases.
7.Tr
ustamongheal
thpr
act
it
ioner
s
8.Adequat
eofdocument
ati
onofcar
epr
ovi
dedt
ocl
i
ent
(
c)Li
stf
ive(
5)ser
vicesr
ender
eddur
ingout
reachser
vices.(
2½
mar
ks)
i
. Heal
theducat
ion
i
i
. Ant
enat
alcar
e
i
i
i.I
mmuni
zat
ions
i
v. Cur
ati
vemedi
cine
v
. Mi
norsugar
y
v
i. Chi
l
d’swel
far
eser
vices
v
ii
. Ref
err
alser
vices
v
ii
i. Fami
l
ypl
anni
ng
i
x. Tr
eat
mentofmi
norai
l
ment
s
x. Dr
essi
ngofwounds
xi
. Nut
ri
ti
onal
assessment
xi
i. Fol
l
ow-
upser
vices
(
d)Expl
ainf
ive(
5)const
rai
ntsexper
ienceddur
ingout
reachser
vices.

i
. Pooraccessi
bil
i
tye.
g.badr
oads
i
i
.ii
.Host
il
it
ynonaccept
anceoft
heser
vicesbysomecommuni
ti
es
i
i
i.I
nsuf
fi
cientmanpowert
ocar
ryoutt
heser
vices
i
v.I
nsuf
fi
cientmat
eri
alsShor
tageofdr
ugs
v
. Languagebar
ri
er
v
i. Poorpl
anni
ngf
ort
heser
vices
v
ii
. Poorcommuni
tymobi
l
izat
ion
v
ii
i. Communi
ty’
s cul
tur
e bel
i
efs,t
aboos,r
eli
gions and adamant
dogman.
CHEW 2013PAPER11(
2)OBJECTI
VE
SECTI
ONB:ESSAYQUESTI
ONS(
70mar
ks)
AnswerALLQuest
ions
1.(
a)Enumer
atef
ive(
5)causesofNut
ri
ti
ondi
sor
der
sinchi
ldr
en
underf
ive. (
2½ mar
ks)
i
.Cul
tur
alf
oodt
aboosandf
oodr
est
ri
cti
on
i
i
.Loweconomi
cst
atus
i
i
i.Pov
ert
y
i
v.I
gnor
ance/
il
li
ter
acy
v
.Lackofi
nfor
mat
iononnut
ri
ti
onalv
alueofl
ocal
l
yav
ail
abl
efood
st
uff
s.
v
i.Poorweani
ngpr
act
ices
v
ii
.Lar
gef
ami
l
ysi
ze
v
ii
i.Wor
minf
est
ati
on
i
x.Repeat
edi
nfect
ions
x.Poorenv
ironment
alcondi
ti
ons
xi
.poormat
eri
alnut
ri
ti
on
(
b)St
atef
ive(
5)pr
event
ivemeasur
esofNut
ri
ti
onaldi
sor
der
sin
chi
ldr
enunderf
ive.
i
.Excl
usi
vebr
east
feedi
ng
i
i
.Encour
agehomegar
den
i
i
i.Dewor
ming
i
v.Goodweani
ngpr
act
ices
v
.Foodpr
epar
ati
onanddemonst
rat
ion
v
i.Fami
l
ypl
anni
ng.
(
c)Enumer
atef
our(
4)met
hodsoff
oodpr
eser
vat
ion
(
2mar
ks)
i
.Sal
ti
ng.
i
i
.Ref
uger
ati
ng
i
i
i.Canni
ngandBot
tl
ing
i
v.Sundr
ying
v
.Dehy
drat
ion
v
i.Pi
cki
ng
v
ii
.Fer
ment
ati
on.
v
ii
i.Theuseofchemi
cal
s
i
x.Osmot
icpr
eser
vat
ion
x..Pr
eser
vat
ionbygas
xi
.Pr
eser
vat
ionbyant
ibi
oti
cs
xi
i
.Cooki
ng
(
d)Fi
llt
het
abl
ebel
ow:
Foodcl
asses Nut
ri
ent
s Two(
2)exampl
es
1.
Ener
gygi
vi
ngf
ood Car
bohy
drat
e, f
ats Ri
ce, br
ead, y
am,
andoi
l
s mi
l
letet
c.
2.
Prot
ect
ivef
ood Mi
ner
als,
vit
ami
ns Fr
uit
s,v
eget
abl
es
3. Body bui
l
ding Pr
otei
n Egg, f
ish, meat
,
f
ood cheese,
beanset
c.
2.(
a)Usey
ourSt
andi
ngOr
dert
omanage:
A mot
herbr
oughthert
en(
10)y
earol
dchi
l
dtot
hecl
i
nicwi
tht
he
compl
aint
sofy
ell
owey
es,
fev
er,
nauseaandv
omi
ti
ng,abdomi
nalpai
n.00nexami
nat
ion,t
hef
oll
owi
ng
obser
vat
ionswer
emade;
yel
l
ow
ey
es,war
m t
otouch wi
tht
emper
atur
e 3 7.
5°C,abdomi
nalpai
n,
di
arr
hoea,
col
d.
Whati
syourcl
i
nical
judgmentandact
iont
otake.(
5mar
ks)
(
b)Enumer
atef
ive(
5)f
act
orst
obeconsi
der
edi
nani
nter
viewi
ng
env
ironment
.(2½mar
ks)
(
c)St
atef
ive(
5)condi
ti
onst
hatcanpr
eventt
aki
ngoft
emper
atur
e
or
all
y. (
2½mar
ks)
i
.Chi
l
drenwhoar
eunabl
eorunwi
l
li
ngt
ocooper
ate
i
i
.Del
i
rium
i
i
i.I
fthepat
ienti
sli
abl
etoconv
ulse
i
v.Unconsci
ouspat
ient
v
.Wher
ether
eisl
ocal
diseaseoft
hemout
he.
g.st
omat
it
is
v
i.I
mmedi
atel
yaf
tert
hepat
ienthashadahot
tercol
ddr
ink
v
ii
.Whent
hepat
ient
snosehasbeenpackedwi
thquaze
3.(
a)Enumer
atef
our(
4)f
act
orst
hataf
fecthosti
mmuni
ty.
(
2mar
ks)
i
.Age
i
i
.Gender(
sex)
i
i
i.Nut
ri
ti
on
i
v.Tr
aumaandf
ati
gue
v
.Pr
egnancy
v
i.Di
seaseandi
nfect
ion
v
ii
.Hor
mone
(
b)Li
stsi
x(6)non-
speci
fi
cdef
ensemechani
sms.
(
3mar
ks)
i
.Chr
oni
canddebi
l
itat
ingdi
seasese.
g.t
uber
cul
osi
s
i
i
.Genet
icf
act
ors
i
i
i.Pr
otect
ivecov
eri
ngoft
heski
n
i
v.Mucousmembr
ane
v
.Secr
eti
ons
v
i.Sal
i
va
v
ii
.Tear
s
v
ii
i.Cough
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x.Sneezi
ng
(
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ainf
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act
orst
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(
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ks)
i
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nut
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ti
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.Radi
ati
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i
i.Bl
oodsuppl
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v.St
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Whi
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atel
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stsev
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sofPl
asma.(
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ks)
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asmapr
otei
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ibr
inogen,
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ti
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ri
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vit
ami
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v.Or
gani
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alse.
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icaci
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ucagon
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g.oxy
gen,
car
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oxi
de,
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rogen
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g.pl
atel
etwhi
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oodcel
l
.
(
c)St
atef
ive(
5)f
unct
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heHumanSkel
eton.
(
2½ mar
ks)
(
d)Enumer
atef
ive(
5)f
act
orst
hatar
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ntenanceof
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i
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i
i
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i
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i.Wei
ght
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v.Exer
cisee
v
.Di
seaseandi
nfect
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v
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5.(
a)AsaCHEW,
Howdoy
oupl
anf
ort
het
rai
ningofJCHEW/
VVHW.
(
4mar
ks)
i
.Setbehav
iour
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ect
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v.Dev
elopat
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imat
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olocal
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v
ii
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ntur
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(
5mar
ks)
6.(
a)St
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ive(
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ff
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weencommer
cialandgov
ernment
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1 Pr
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b)St
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ive(
5)f
act
orst
hatmot
ivat
eempl
oyeei
nanor
gani
zat
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(
2½mar
ks)
I
.Regul
arpay
mentofsal
ary
i
i
.Regul
arpr
omot
ionofst
aff
i
i
i.St
afft
rai
ning
1i
v.Encour
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sonal
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andsel
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iodi
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oduct
ivi
ty
c)Enumer
atef
ive(
5)r
easonswhydel
egat
ionmayf
ail
.
(
2½mar
ks)
Par
ti
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ti
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7.(
a)St
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ect
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th Management
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nfor
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3mar
ks)
(
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ernmentLev
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oref
fect
iveheal
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nfor
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.
(
2mar
ks)
(
c)St
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(
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(
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qual
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14ngexami
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2013CHEW ESSAYQUESTI
ONS
PaperI
II
1.(
a)St
atef
ive(
5)qual
i
tiesofani
deal
lat
ri
ne (
2½ mar
ks)
1.Nocont
ami
nat
ionofsur
facesoi
l
2.Nohandl
i
ngoff
reshf
aeces
3.Nocont
ami
nat
ionofsur
facewat
er
4.Nocont
ami
nat
ionofunder
groundwat
er
5.Excr
etai
naccessi
blet
ofl
i
esorani
mal
6.Nounpl
easantodour
sorun-
sli
ght
lycondi
ti
ons
7.I
tshoul
dbesi
mpl
eandi
nexpensi
vei
nconst
ruct
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ati
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8.I
tshoul
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mpl
ement
edi
naccor
dancewi
tht
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 r
esour
cesoft
hecommuni
ty.
9.I
tshoul
dbecul
tur
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yaccept
abl
etot
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ty.
10. Shoul
dhav
easquat
ti
ngsl
ab,
11. Hundr
edmet
resawayf
rom asour
ceofwat
ersuppl
y
12. Roofpr
oper
ly
13. Adequat
elycement
ed
14. Pr
otect
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rom f
li
es
15. Li
nedwi
thbl
ocksandhav
ingaconcr
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loor
16. Hav
easupperst
ruct
uret
opr
ovi
def
orpr
ivacyoft
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s
17. Shoul
dbeconst
ruct
edofdur
abl
emat
eri
als.
(
b)AsaCHEW wor
kingi
nGodegodo communi
ty,expl
ainf
ive(
5)
f
eat
uresy
ouwi
l
lconsi
der
i
ntheconst
ruct
ionofasani
tar
ywel
l(2½ mar
ks)
1.l
.Locat
ion:Thef
ir
stst
epi
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lconst
ruct
ioni
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pr
opersi
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fbact
eri
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nat
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)fr
om l
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ces
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ir
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lshoul
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4.Thesi
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henear
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cesof
cont
ami
nat
ione.
g;t
oil
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tar
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lshoul
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eapl
atf
orm
 6.Ther
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ppedwi
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apetwal
lupt
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ghtofatl
east28
i
nchesabov
ethegr
ound
9.Per
manentbucketordr
awerwi
th a cl
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d be
pr
ovi
ded
10. Thephy
sical
,chemi
calandbact
eri
ologi
calqual
i
tyofwat
er
shoul
dconf
ormt
otheaccept
abl
est
andar
dsofqual
i
tyofsaf
e
andwhol
esomewat
er.
(
c)Enumer
atef
ive(
5)obj
ect
ivesofoccupat
ional
heal
th(
2½ mar
ks)
1.Thepr
event
ionamongwor
ker
sofdepar
tur
esf
rom heal
thcaused
byt
hei
rwor
kingcondi
ti
ons.
2.The pr
omot
ion and mai
ntenance oft
he hi
ghestdegr
ee of
phy
sical
, ment
al and soci
al wel
l
bei
ng of wor
ker
s i
n al
l
occupat
ions
3.The pr
otect
ion ofwor
ker
sint
hei
rempl
oymentf
rom r
isks
r
esul
ti
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rom f
act
orsadv
erset
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4.Thepl
aci
ngandmai
ntenanceoft
hewor
keri
nanoccupat
ional
env
ironmentadopt
edt
ohi
spsy
chol
ogi
calenv
ironment
;andt
o
summar
ize.
5.Theadapt
ati
onofwor
ktomanandofeachmant
ohi
sjob.
6.(
d)Ther
ehasbeenani
ncr
easei
nthei
nci
denceofsi
l
icosi
sin
y
ourcommuni
ty.AsaCHEW,st
atef
ive(
5)pr
event
ivemeasur
es
 t
haty
ouwi
l
ladoptt
oensur
ethecont
roloft
hedi
sease(
2½
mar
ks)
i
.Useofpr
otect
ivedev
ices
i
i
.Pr
e-empl
oymentandper
iodi
cmedi
cal
exami
nat
ion
i
i
i.Adequat
eli
ght
ingandv
ent
il
ati
on
2.(
a)St
atesev
en(
7)cat
egor
iesofwomenwhocanusepr
ogest
in-
onl
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ect
abl
econt
racept
iveswi
thoutr
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ri
cti
9naccor
dingt
oWHO
(
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2mar
ks)
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nedor
alcont
racept
ives(
COC)
becauseofest
rogenr
elat
edef
fect
s.
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deri
nject
abl
esmostcomf
ort
abl
e
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ati
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s
d.Womenwhohav
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rfami
l
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er35y
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.Womenwhol
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g.Womenwi
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ckl
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seasesMaydecr
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requentof
ar
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h.•Womenwhopr
eferamet
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equi
redai
l
y
act
ivi
ty.
(
b)Li
stt
hree(
3)causesofi
nfer
ti
li
tyi
nmal
es(
2½mar
ks)
i
. Poorqual
i
tyandquant
it
yofsper
m
i
i
. Mumpsdur
ingoraf
terpuber
ty
i
i
i.I
mmat
uresper
mat
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v. Bl
ockageoft
hev
asdef
erens
v
. Sl
uggi
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hesper
mat
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i.I
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l
ityt
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acul
ati
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v
ii
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est
icul
es
(
c)Expl
ainf
ive(
5)exampl
esofmenst
rualdi
sor
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s(2½mar
ks)
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rhea(
absenceofmenst
rual
per
iod)
2.Dy
smenor
rhoea
3.Menor
rhagi
a
4.Met
ror
rhagi
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5.Pol
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rhoea
6.Ol
i
gomenor
rhegi
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7.Anov
ulat
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fai
l
ureoft
heov
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orel
easeanegg)
(
d)Enumer
atef
ive(
5)component
sofr
epr
oduct
iveheal
th (
2 ½
mar
ks)
a.Fami
l
ypl
anni
ng
b.Saf
emot
her
hood,
incl
udi
ngbr
east
feedi
ng
c.Menopausal
/Andr
opausai
concept
s
d.Pr
event
ionandt
reat
mentofsexual
l
ytr
ansmi
tt
edi
nfect
ioas(
STI
s)
e.Adol
escentRepr
oduct
iveHeal
th
f
.Pr
event
ionandmanagc:
ncntoft
heconsequenceofabor
ti
on
g.pr
event
ionandappr
opr
iat
etr
eat
mentofi
nfer
ti
li
ty
h.Act
ivedi
scour
agementofhar
mful
pract
ices
i
.Genderequal
i
ty,
andwomenempower
ment
 j
.Scr
eeni
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orcancer(
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k.Communi
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l
.Basi
cemer
gencyobst
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icsa.
3.(
a)St
ateFi
ve(
5)Pr
event
iveMeasur
esOfPer
iodont
alDi
seases.(
2
½mar
ks)
1.Per
iodi
ccl
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ngoft
het
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hbyt
hedent
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alhy
giene(
regul
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4.Reduct
ioni
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-r
ichf
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s
5.I
ngest
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stanceaci
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cif
icat
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(
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atef
ive(
5)or
alheal
thpr
obl
ems(
2½mar
ks).
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alcar
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b.Gi
ngi
vi
ti
s
c.Per
iodont
it
is
d.Hal
i
tosi
s
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aque
f
.Dent
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omat
it
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(
c)Enumer
atesev
en(
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ldsur
viv
alst
rat
egi
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ks)
Adopt
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thesest
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ecal
l
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eedi
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l
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anni
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atet
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3)pr
ior
it
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ldhood nut
ri
ti
on i
nter
vent
ion
adopt
edi
nNi
ger
ia.(
1½ mar
k)

1.Excl
usi
vebr
east
feedi
ng
2.Adequat
ecompl
ement
arydi
et
3Vi
tami
nAsuppl
ement

4.(
a)Def
inet
hef
oll
owi
ngt
erms: (
1/2 mar
ks) each
=2½ mar
ks)
i
.Echol
ali
a
I
tist
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hol
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cal
inv
olunt
aryr
epet
it
ionofphr
asesorwor
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axi
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I
tist
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sofot
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ions.i
i
i.Hal
l
uci
nat
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alseper
cept
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Asensor
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ont
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ernal
sti
mul
ati
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i
v.Del
usi
on
Thef
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efhel
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chcannotbecor
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Ani
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ionorobj
ectt
hatt
he
pat
ientat
tempt
stoav
oid.
(
b)Enumer
atef
our(
4)t
ypesofpsy
chosi
s(2½ mar
ks)
a.Funct
ional
psy
chosi
s
b.Or
gani
cpsy
chosi
s
c.Puèper
alpsy
chosi
s
d.I
ndi
anhemppsy
chosi
s
e.Al
cohol
i
cpsy
chosi
s
f
.Rel
i
gionpsy
chosi
s
(
c)St
atesi
x(6)f
unct
ionsofschoolheal
thser
vices(
3mar
ks)
1.Topr
omot
eheal
thygr
owt
handdev
elopmenti
nal
school
chi
l
dren
2.Todet
ectanyphy
sicalandment
aldef
ectamongchi
l
drenwhi
ch
coul
daf
fectt
hei
rlear
ning abi
l
iti
esi
nschool
.
3.Tocont
rolt
hespr
eadofcommuni
cabl
edi
seaseamongschool
chi
l
dren.
4.Toi
nst
il
lpr
inci
pleofheal
thi
ntot
heschool
chi
l
dren
5.Topr
omot
eopt
imal
condi
ti
onsi
ntheschool
6.Topr
ovi
deemer
gencycar
etoschool
chi
l
dren
7.Toassi
stst
udenti
nacqui
ri
ng
8.Tocounselpupi
l
s,t
eacherandpar
entandot
herconcer
ningheal
th
pr
obl
ems.
9.To assi
sti
nthe i
dent
if
icat
ion and educat
ionalt
her
apy f
or:
handi
cappedchi
l
dren
10.Topr
omot
eandpr
otectt
heheal
thofschool
per
sonal
11.To co-
oper
ate wi
tht
he st
ate,l
ocalgov
ernmentand ot
her
communi
tyheal
thagenci
esi
nst
udentheal
thandwel
far
e
(
d)Expl
ainanyf
our(
4)way
syouwi
lladopti
nev
aluat
ing,School
Heal
thSer
vicesi
nyour
LocalGov
ernmentAr
ea (
2mar
ks)
1.Teacher
sint
erv
iew:ascer
tai
nfr
om t
het
eacher
sift
hechi
l
drenar
e
al
way
ssi
ck
2.School
abst
ent
ionr
ecor
d
3.School
att
endancer
ecor
d
4.Useofcasef
il
etof
indoutt
hecommondi
seasecondi
ti
onst
hat
chi
l
drenar
eal
way
sinf
ect
edwi
th
5.Obser
vat
ion:Obser
vet
hechi
l
dren dur
ing pl
ayi
ng t
o beabl
eto
det
ectsomef
orm ofpr
obl
ems/
chal
l
engesamongt
hem.
(
5)(
a)Enumer
atesi
x(6)sy
mpt
omsoft
uber
cul
osi
sinchi
ldr
en.
(
3mar
ks)
1.Per
sist
entcoughl
ast
ing
2.Fev
er,
Mal
aise,
lossofwei
ght
3.Gener
almor
eweeks
5.Chestpai
n
6.Coughi
ngupofbl
oodchaemopt
y
7.Hoar
seness
8.Shor
tnessofboa
(
b)Oneoft
hest
rat
egi
esi
nmal
9ri
acont
roli
stheuseofl
ongl
ast
ing
i
nsect
ici
dest
reat
ednet(
LLI
N).St
atef
our(
4)benef
it
sofl
ongl
ast
ing
i
nsect
ici
dest
reat
ednet
.
1.Pr
event
ionofi
nsect
-bor
nedi
sease
(
c)Li
stf
our(
4)t
ypesofcancerwhi
chcanoccuri
nyourcommuni
ty.
(
2mar
ks)
1.Br
eastcancer
2.Cer
vical
cancer
3.Ov
ari
ancancer
4.Ut
eri
necancer
5.Canceroft
het
est
is
6.Pr
ost
atecancer
(
d)St
atesi
x(6)modi
fi
abl
eRi
skf
act
orsassoci
atedwi
thcor
onar
y
hear
tdi
sease(
CHD)
a.Ci
gar
ett
esmoki
ng
b.Hy
per
tensi
on
c.Di
abet
esmel
l
itus
d.Obesi
ty
e.Excessi
veconsumpt
ionsoff
att
yfood
f
.Lackofexer
cise
g.Al
cohol
i
sm
h.Useofcor
ti
cost
eroi
dsdr
ugs
6.(
a)Enumer
atesi
x(6)si
gnsandsy
mpt
omsofswal
lowedpoi
son.
(
3mar
ks)
(
b)St
ateei
ght(
8)r
ulesoff
ir
stam.(
4mar
ks)
(
c)Li
stsi
x(6)si
gnsandsy
mpt
om ofsi
nusi
ti
s.(
3mar
ks)
a.Faci
alpai
n
b.Pur
ulentnasal
dischar
ge
c.PostNasal
dri
p
d.Di
sor
der
sofsmel
l
e.Headache
f
.Nasal
tur
binat
eengor
gement
g.Swel
l
ingoft
heupperey
eli
d
h.Tender
nessov
ert
heant
eri
orwal
loft
hewal
lov
ert
hei
ndi
vi
dual
si
nus
7(
a)Enumer
ateei
ght(
8)way
swhi
cht
hecommuni
tymember
scan
suppor
tpeopl
ewi
thhandi
cappi
ngcondi
ti
on. (
4mar
ks)
1.Educat
ing pat
ient
s orguar
dians on how t
otake car
e oft
hei
r
handi
cappedchi
l
d
2.Fi
nanci
alsuppor
tbyt
hecommuni
tyt
ohandi
cappedper
sonand(
or
car
etakerofhandi
cappedchi
l
dren)
.
3.Pr
ovi
sionofspeci
aleducat
ionf
aci
l
ityi
nthecommuni
ty
4.Est
abl
i
shmentofr
ehabi
l
itat
ioncent
ersf
ort
hehandi
capped
5.Pr
ovi
sionofadequat
ehospi
tal
car
e
6.Counsel
i
ng
7.Communi
tymobi
l
izat
ionf
orsuppor
tofhandi
capped
(
b)Li
stsev
en(
7)commoncausesofbl
i
ndnessi
nourcommuni
ty.(
3
½ mar
ks)
Gl
aucoma
Tr
achoma
Cat
aract
Onchocer
ciasi
s
Di
abet
esmel
l
itus.
Vi
tami
nAdef
ici
ency
Measl
esi
nfect
ion
Conj
unct
ivi
ti
s
Acci
dentgonor
rheaandsy
phi
l
is
(
c)Enumer
atef
ive(
5)obj
ect
ivesoft
heNat
ionalPol
i
cyoncar
eoft
he
el
der
ly.(
3½ mar
ks)

PAPER1
SECTI
ONB:ESSAYANSWERS(
70MARKS)
1.(
a)Def
ineHeal
thTer
m Accor
dingt
oWHO:
A gr
oup ofper
son who shar
e a common heal
th goaland
commonobj
ect
ivesdet
ermi
nedbycommuni
tyneedandt
owar
dst
he
achi
evementofwi
th each member
s oft
he t
eam cont
ri
but
es i
n
accor
dancewi
thhi
s/hercompet
enceandski
l
lsandr
espect
ingt
he
f
unct
ionoft
heot
her
s.
(
1mar
k)
(
b)Enumer
atesi
x(6)char
act
eri
sti
csofaHeal
thTeam:
-Co-
oper
ati
onamongmember
s
-Hav
ingcl
ear
-l
ineofcommuni
cat
ion
-Hav
ingacommongoal
-Regul
armeet
ingofmember
s
-Team spi
ri
tfort
hepr
imar
yheal
thcar
eser
vices
-Agr
eedwor
kingpr
ocedur
e
-Respectf
orev
erymemberandt
hei
rwor
k
-Al
lmember
smustt
rusteachot
her
-Member
smustbecompat
ibl
e
-Thet
ypeofj
oborwor
kmustper
mitt
eam wor
k(3mar
ks)

(
c)Out
li
neei
ght(
8)Heal
thser
vicesbasedonPr
imar
yHeal
thCar
e:
o Heal
thEducat
ionconcer
ningpr
evai
l
ingheal
thpr
obl
emsand
t
hemet
hodsofpr
event
ingandcont
rol
l
ingt
hem.
o Pr
omot
ionoff
oodsuppl
yandpr
opernut
ri
ti
on
o Adequat
esuppl
yofsaf
ewat
erandbasi
csani
tat
ion
o Mat
ernal
andchi
l
dheal
thcar
e,i
ncl
udi
ngf
ami
l
ypl
anni
ng
 oI
mmuni
zat
ionagai
nstmaj
ori
nfect
iousdi
seases
o Pr
event
ionandcont
rol
ofl
ocal
l
yendemi
cdi
sease
o Appr
opr
iat
etr
eat
mentofcommondi
seasesandi
njur
ies
o Pr
ovi
sionofessent
ial
drug
o Communi
tyMent
alHeal
thcar
e
o Or
alHeal
th—pr
imar
yey
ecar
e (
4
mar
ks)
(
d)St
atef
our(
4)pr
imar
yheal
thcar
eappr
oachesoft
heNi
ger
ia
Heal
thSy
stem
-Down-
up-
Appr
oach
-Emphasi
sonpr
event
ion
-CostRecov
ery
-Qual
i
tyAssur
ance
2.(
a)St
atesi
x(6)basi
cpr
inci
pleofef
fect
iveHeal
thEducat
ion
1.Respectf
orcul
tur
alandt
radi
ti
onal
views
2.Cl
ari
ty
3.Si
mpl
i
cit
y
4.Adapt
abi
l
ity
5.Ensur
anceofunder
standi
ng
6.Ef
fect
ivecommuni
cat
ion
7.Under
standi
ngoft
het
opi
c
8.Accept
abi
l
ity (
3mar
ks)
(
b)Di
scusst
het
hree(
3)mai
nty
pesofI
ECmedi
a
(
1) Audi
o: These ar
e sound pr
oduci
ng mat
eri
als wi
th whi
ch
communi
cat
ioncoul
dbeef
fect
ed.Theyar
ethet
eachi
ngai
dst
hat
appealt
othe sense or
gan ofhear
ing e.
g.t
ape r
ecor
ding,r
adi
o.
gr
amophone.
(
2)Vi
sual
s:Thesear
eteachi
ngai
dst
hatappealt
othesenseor
ganof
si
ghti
.e.t
heey
es.I
tgi
vespi
ctor
ialdescr
ipt
ion ofan obj
ecte.
g.
post
ers.l
eaf
let
s,f
lannel
graphs,
etc.
(
3)Audi
o-Vi
sual
s:I
tincl
udesal
lteachi
ngai
dst
hatappeal
stobot
hthe
sensesofhear
ingandsi
ghte.
g.t
elev
isi
on,
video,
soundf
il
ms
(
3mar
ks)
(
c) Enumer
atef
our (
4) adv
ant
ages each of or
aland wr
it
ten
communi
cat
ion:
4(
four
)adv
ant
agesofor
alcommuni
cat
ion
4(
four
)adv
ant
agesofwr
it
tencommuni
cat
ion
3.(
a)St
atesi
x(6)r
easonswhyi
tisnecessar
yfort
heCHEW t
ocar
ry
outAdv
ocacy
(
1)Toacquai
ntpol
i
cymaker
soft
hei
rrol
esandr
esponsi
bil
i
tiesi
n
r
elat
iont
oident
if
iedheal
thgoal
s.
(
2)To cr
eat
e a conduci
ve env
ironmentwhi
ch act
ivi
ti
es wi
l
lbe
or
gani
zed.
(
b)Enumer
atesi
x(6)-ar
easi
nwhi
chi
nfor
mat
ioncoul
dhecol
lect
ed
f
orconduct
ingsi
tuat
ionanal
ysi
sinacommuni
ty.
(
I)Number
sofset
tl
ementi
nthel
ocal
gov
ernmentar
ea
(
2)Funct
ioni
ngheal
thf
aci
l
iti
eswi
thi
ntheL-
.G.
A.
(
3)Heal
thper
sonnel
dist
ri
but
ionbyt
ype
(
4)Ty
peandv
olumeofser
vicespr
ovi
dedi
nal
ltheheal
thf
aci
l
iti
es.
(
5)LGAl
ogi
sti
cssuppor
t
(
6)LGAbudget
(
7)Basi
cinf
rast
ruct
ures t
hataf
fect
s heal
th e.
g.r
oad,el
ect
ri
cit
y,
t
elephone,
por
tabl
ewat
er.
(
8)Educat
ional
faci
l
iti
est
ypes
(
9)LGAi
nfor
mat
ionsy
stem. (
3
mar
ks)
(
c)St
atef
our(
4)r
esour
cesneededt
oconductHousenumber
ingi
na
communi
ty
I
ndel
i
blei
nk
 Br
ush
 Ladder
 Humanr
esour
ces
 Regi
ster
 Penandi
nk (
2mar
ks)
(
d)St
atef
our(
4)t
argetaudi
encef
orAdv
ocacyi
nyourcommuni
ty.
 Pol
i
cymaker
s
 Tr
adi
ti
onal
leader
s
 Di
str
icthead
 Communi
tyDev
elopmentCommi
tt
ees
 I
nfl
uent
ial
peopl
e
 Deci
sionmaker
s (
2mar
ks)
4.(
a)I
temi
sef
our(
4)char
act
eri
sti
csofper
sonal
it
y:
(
i)Ext
rav
ersi
on
(
ii
)Agr
eeabl
eness
(
ii
i)Consci
ent
iousness
(
iv)Neur
oti
cism
(
v)Openness(
2mar
ks)
(
b)Expl
ainf
our(
4)char
act
eri
sti
csofGoodmemor
y:
-Rapi
dRecal
l
-Ri
dRecogni
ti
on
-GoodRet
ent
ion
-Abi
l
ityt
olear
namat
eri
alr
api
dly
-Ut
il
it
yorser
viceabi
l
ity(
2mar
ks)
(
c)Ment
iont
hree(
3)met
hodsofl
ear
ning
1.Habi
torAssoci
ati
vel
ear
ning
2.Tr
ail
and.er
rorl
ear
ning
3.Soci
all
ear
ningi
nit
iat
ive
4.I
nsi
ghtonl
ear
ning
(
3mar
ks)
(
d)St
atet
hree(
3)behav
ior
sandat
ti
tudeexpect
edofaCHEW i
nthe
pr
act
iceofhi
s/herpr
ofessi
on
-Hav
eagener
all
yposi
ti
veat
ti
tudet
owar
dswor
kwi
thacheer
ful
per
sonal
i
ty.Mostoft
hecl
i
ent
s/pat
ient
sval
uet
heposi
ti
veper
sonal
i
ty
f
rom t
heheal
thcar
epr
ovi
der
-Bewar
m andat
tent
ive,
thi
shel
pst
oreassur
ethecl
i
ent
/pat
ientandi
s
asi
gnal
ofdesi
ret
ohel
p
-Pr
ovi
deappr
opr
iat
epr
ivacyt
ohi
s/hercl
i
ent
s/pat
ient
s
-
.Of
ferexpl
anat
iont
opat
ient
sonchar
gesf
orser
vicesi
nanhonest
manner
-Hav
eagenui
nedesi
ret
ohel
ppeopl
e;t
hisexpr
essedi
nthewayt
he
heal
thpr
act
it
ionercommuni
cat
eswi
thpeopl
ethr
oughspeechand
body l
anguage. These al
l
ays wor
ry and anxi
ety common i
n
pat
ient
s/cl
i
ent
swhocomei
ntot
heheal
thf
aci
l
ityf
ormanagement
adv
ice
(
3mar
ks)
5.(
a)I
nat
abul
arf
orm,
enumer
atef
ive(
5)di
seaseseachofAf
fl
uence
andPov
ert
y
(
b)Enumer
atesi
x(Sif
act
orst
hati
nfl
uencef
ami
lysi
ze:
-Sour
ceofi
ncome
-Lev
elofEducat
ion
-St
andar
dofl
i
ving (
3mar
ks)
(
c)Wr
it
eshor
tnot
esont
hef
oll
owi
ng:
i
..Nucl
earFami
l
y:
Thenucl
earf
ami
l
yisasmal
landsi
mpl
efami
l
yuni
torset
ti
ng
whi
chi
smadeupofpar
ent
sandt
hei
rchi
l
dren
i
i
.Si
ngl
ePar
entf
ami
l
y:
(
1mar
k)
6.(
a)St
atef
ive(
5)f
act
orst
hatar
eresponsi
blef
orwast
ageofdr
ugs
i
nvei
nHeal
thcent
re:
(
1)Ov
erpr
escr
ipt
ionofdr
ugs
(
2)Ov
erst
ocki
ngofdr
ugs
(
3)Gi
vi
ngofdr
ugst
opat
ient
ssi
mpl
eondemand
(
4)Gi
vi
ngl
argerdosest
hannecessar
y
(
5)Or
der
ingmor
edr
ugst
hanneededsot
hatsomedr
ugsexpi
redi
n
t
heshel
f
(
6)Exposi
ngofdr
ugst
oheat
,dampnessorl
i
ght
(
7)Gi
vi
ngdr
ugst
opat
ient
swhodonotbel
i
evei
nthem andwhot
hrow
awayt
hedr
ugsorf
orgett
otakei
t
(
8)Usi
ngdr
ugswi
thoutdi
agnosi
s.
(
9)Notusi
ngr
efr
iger
ator
sforv
acci
nesandt
hev
acci
neswi
l
lnev
erbe
ef
fect
iveanyl
onger
(
10)Ref
err
ing
(
11)Notobser
vingf
eed.
(
b)Enumer
atef
ive5cl
assi
fi
cat
ionsofdr
ugsaccor
dingt
odosage
f
orm andgi
veoneexampl
eeach:
(
1)Anal
gesi
cs—Par
acet
amol
tab/
syr
up,
Acet
y/Si
ti
cyl
i
cAspi
ri
n
(
2)Anaest
het
ics—Li
docai
net
opi
cal
/i
nject
ion
(
3)Ant
iconv
ulsant
s—Par
aldehy
dai
nject
ion
(
4)Ant
iMal
ari
a-Ar
temet
her+Luf
ement
ri
ne
(
5)Ant
ihel
mint
hs—Mehendazol
etab
(
6)Ant
ibact
eri
al—Benzy
lpeni
cil
l
ini
nject
ion
(
7)Ant
ifi
l
ari
al—Cal
ami
nel
oti
rn (
5
mar
ks)
(
c)Out
li
net
hecr
it
eri
ainv
olv
edi
ndr
ugsel
ect
ion:
(
1)The choi
ce ofdr
ugsmustbe based on t
he heal
th pr
obl
ems
commoni
nthecommuni
ty.
(
2)Choosi
ngt
hedr
ugsadequat
eandsuf
fi
cientt
oeachpr
obl
em by
t
hei
rgener
icnamesi
ntoconsi
pleset
ion
(
3)Rev
iewi
ngt
hel
i
stannual
l
y,t
aki
ngaccountofnewcommonheal
th
pr
obl
ems
(
4)Soci
o-cul
tur
alf
act
ors
(
5)Thedr
ugsmusthav
eNAPFDACr
egi
str
ati
onnumber
(
6)Mustbedr
ugswi
thcer
ti
fi
cat
edqual
i
tywhi
chcanbeobt
ained
easi
l
yfr
om l
ocal
inst
it
uti
onort
hrought
heWHO.
(
2½ mar
ks)
7.(
a)St
atesi
x(6)f
act
ors/
const
rai
ntst
hatcoul
dhi
nderef
fect
ive
r
efer
ralsy
stem:
(
1)Poort
ranspor
tat
ion
(
2)Lackoff
undsf
rom t
hepat
ent
s
(
3)Nonaccept
anceathi
gherl
evel
4)Nof
eedbackf
rom hi
gherl
evel
,aut
hor
it
y
(
5) Unwi
l
li
ngness of pat
ient
s/r
elat
ives t
o l
eav
e one’
s secur
ed
env
ironment
(
6)Ther
e maybe nepot
ism,f
avor
it
ism pr
efer
ent
ialt
reat
mentf
or
r
elat
ivesr
athert
hant
hosewhoneedi
tmost
.
(
7) I
nadequat
e pr
epar
ati
on of hospi
tal phy
sici
ans f
or r
efer
ral
t
echnol
ogy
(
8)I
nadequat
ecapaci
tyt
otakeal
lref
err
edcaset
ohi
gherl
evel
.
(
3Mar
ks)
(
b)St
atet
hef
ive(
5)l
evel
sofHeal
thcar
edel
iv
eryi
dent
if
iedi
nthe
pr
imar
yheal
thcar
eref
err
alpat
h
(
1)Hospi
tal
andDi
agnost
icser
vices.
(
2)Compr
ehensi
veHeal
thCent
re(
CHC)
(
3)Pr
imar
yHeal
thCar
e(PHC)
(
4)Heal
thPast
s/Mobi
l
eHeal
thcar
e
(
5)Heal
thcl
i
nics(
2¼mar
ks)
(
c)Li
stf
our(
4)way
sthecommuni
tycansuppor
tout
reachser
vices:
(
1)Pr
ovi
sionofl
ogi
sti
cse.
g.v
ehi
cle,
drugs.
(
2)Ther
eshoul
dbegoodr
appor
tbet
weent
hecommuni
tyandheal
th
(
2mar
ks)‘
(
d)St
atef
ive(
5)Heat
hSer
vicest
hatar
erender
eddur
ingout
reach
ser
vices:
-Heal
thEducat
ion
-I
mmuni
zat
ion
-Chi
l
dWel
far
eCl
i
nic
-Ant
e-Nat
alcar
e-
-Mi
norSur
ger
y
-Ref
err
alSer
vices
-Gener
alOut
pat
ientser
vices-
-Tr
eat
mentofmi
norai
l
ment
s.

SECTI
ONB:ESSAYANSWERS
1.(
a)Out
li
net
en(
10)char
act
eri
sti
csofaheal
thyhouse:
-Aheal
thyhouseshoul
dhav
easat
isf
act
oryl
i
ght
ingandv
ent
il
ati
on
-Adequat
epot
abl
ewat
ersuppl
y
-Adequat
esani
tar
yfaci
l
iti
ese.
g.bat
hroom,
toi
l
et,
kit
chen
-Adequat
eref
usecol
l
ect
ionanddi
sposal
faci
l
iti
es
-I
tshoul
dbesi
tedonawel
ldr
ainedsoi
l
.
-I
tshoul
dbef
reef
rom v
ermi
nsandpest
s.
-Adequat
espacet
oal
l
owt
reeci
rcul
ati
onoff
leshai
r
-Adequat
eopenspacef
orr
ecr
eat
ionalact
ivi
ti
esandr
elaxat
ionf
or
ment
alst
imul
ati
on
-Separ
ater
ooms f
orl
i
ving and sl
eepi
ng whi
ch shoul
d meett
he
r
ecommended ai
rspacecapaci
typr
escr
ibed byt
hel
aw ofheal
th
aut
hor
it
y.
-Separ
ater
oomsf
orbot
hchi
l
drenofdi
ff
erentsexest
hatar
eabov
e10
y
ear
sofage.
-Musthav
eadequat
espacet
oav
oidov
ercr
owdi
ng
-I
tshoul
dbesi
tedawayf
rom anysour
ceofpol
l
uti
on
-I
tshoul
dhav
eanappr
ovedbui
l
dingpal
n.
(
b)Di
scussf
ive(
5)cl
assi
fi
cat
ionofheal
thpr
obl
emsofagr
icul
tur
al
wor
ker
s
(
1)Phy
sicalhazar
ds,e.
g.noi
se,l
i
ght
,heat
,radi
ati
on,v
ibr
ati
on,hi
gh
pr
essur
e
(
2)“
Biol
ogi
cal
hazar
ds,
e.g.bact
eri
a,f
ungi
,vi
ruses,
ricket
tsi
a
(
3)Chemi
calhazar
ds:e.
g.gases,l
ead,mer
cur
y,’v
apour
,aci
ds,dust
s,
pest
ici
de,
her
bici
des,
rodent
ici
des,
etc.
(
4)Mechani
calhazar
ds:e.
g.f
aul
tymachi
nes,moi
stur
eofequi
pment
,
l
ackofmai
ntenance
(
5)Soci
alhazar
d:st
ress
Di
seasesaf
fect
ingt
hem (
agr
icul
tur
alwor
ker
s)
-Phy
sical
—deaf
ness,
cat
aract
,Ar
thr
it
is
-Chemi
cal
—pr
euni
oconi
osi
s,bums,
poi
soni
ng
-Bi
ologi
cal
—HI
V/AI
DS,
Hel
mint
heasi
s,Tet
anus,
Ant
hrax
-Soci
al—Neur
osi
s,Psy
chosi
s,Depr
essi
on
2.(
a)Li
stf
ive(
5)causesofpr
olongl
abour
:
-Cont
ract
edpel
vi
s
-Bi
gbaby
-Occi
pit
o-post
eri
orposi
ti
on
-Sl
owef
facementoft
hecer
vix
-Mul
ti
plebabi
es
-I
ncor
rectposi
ti
onoft
hebaby
-Psy
chol
ogi
cal
fact
orssuchaswor
ri
es,
str
ess
-Poorut
eri
necont
ract
ion
-Di
sor
der
edut
eri
neact
ione.
g.hy
pot
oni
cact
ion.Wi
thsl
ow cer
vical
di
l
atat
ion.
-Ni
ppi
ngoft
hear
ter
iorl
i
poft
hecer
vixbet
weent
heheadandt
he
publ
i
cbone(
24mar
ks)
(
b)Dur
ingl
abourt
her
ear
eindi
cat
ionswhi
cht
ell
sift
hemot
herort
he
babyi
sdi
str
ess.Enumer
atesi
x(6)si
gnsofdi
str
essi
nthemot
her
andf
our(
4)i
nthebaby
.
S/ MATERNALDI
STRESS FOETALDI
STRESS
N
1 Ther
e wi
l
lbe i
ncr
ease i
n pul
se Decr
easef
oet
almov
ementi
n
 r
ate(
Tar
chy
car
dia) t
he womb or excessi
ve or
i
nsuf
fi
cientmat
eri
alwasi
t

2 Ri
sei
nbodyt
emper
atur
e Abnor
mal r
esul
t of gam
cont
ract
ionst
resst
est
3 Sev
eredehy
drat
ion Abnor
mal
amni
oti
cfl
uidl
evel
4 Abdomi
nal
dist
ensi
on Abnor
mal r
esul
t of bi
o-
phy
sical
prof
il
e
5 Deat
h Vagi
nal
bleedi
ng
6 Dar
kvomi
ti
es Cr
ampi
ng
7 I
ncr
easei
nrespi
rat
oryr
ates Mat
ernal
highbl
oodpr
essur
e
8 WeaknessandSweat
ing

(
c)Enumer
atef
ive(
5)cont
rai
ndi
cat
ionsoft
hesur
gicalmet
hodof
cont
racept
ion:
-Pat
ienthav
ing act
ivei
nfect
ious e.
g.PI
D — Pel
vi
cInf
lammat
ory
Di
seases
-Pat
ientwi
thsev
erehear
torl
ungpr
obl
ems
-Pat
ientwi
thsuspect
edpr
egnancy
-Womenhav
ingmat
ernal
ori
nfantcompl
i
cat
ion
(
2½mar
ks)
3.(
a)St
atesi
x(6)benef
it
sofexcl
usi
vebr
eastf
eedi
ng
(
b)Out
li
nef
our(
4)di
seasest
arget
edi
nIMCIi
nter
vent
ion
-Acut
eRespi
rat
oryi
nfect
ion(
ARI
)
-Di
arr
hoea
-Measl
es
-Mal
ari
a
-Mal
nut
ri
ti
on(
2mar
ks)
(
c)St
atesi
x(6)el
ement
sthaty
ouwi
l
lconsi
deri
nini
ti
ati
ngaschool
heal
thpr
ogr
ammef
orpr
ivat
eschool
iny
ourcommuni
ty
-Medi
cal
inspect
ionofchi
l
dren
-Scr
eeni
ngf
ordef
ect
sinchi
l
dren
-Assessmentofhandi
cappedchi
l
drenf
orpr
omptr
efer
-Heal
thEducat
ionact
ivi
ti
es
-Env
ironment
alsani
tat
ionact
ivi
ti
es
-Cont
rol
ofcommuni
cabl
eDi
seasesbymeansofi
mmuni
zat
ion
-Nut
ri
ti
onpr
ogr
amme(
3mar
ks)
(
d)Li
stf
our(
4)scr
eeni
ngt
estper
for
medonschoolchi
ldr
en
-Vi
sionscr
eeni
ng
-Hear
ingt
est
-Mi
d-upperar
m ci
rcumf
erence(
MUAC)
-Wei
ght
,Hei
ghtmeasur
ement
.
(
2mar
ks)
4.(
a)St
atesi
x(6)compl
icat
ionsofsi
ckl
ecel
ldi
sease
-Gal
lst
one-
-Acut
echestsy
ndr
ome
-Pul
monar
yHy
per
tensi
on
-St
roke
-Legul
cert
hatdonotheal
-Ey
edamage
(
b)Li
stf
our(
4)r
iskf
act
orsi
ncor
onar
yhear
tdi
seasesi
nNi
ger
ia
-Ci
gar
ett
esmoki
ng
-Hy
per
tensi
on
-Di
abet
esMel
l
itus
-Obesi
ty
-Lackofexer
cise
-Excessi
veconsumpt
ionoff
att
yfoods;
e.g.f
att
ymeatl
i
kepor
k.
(
2mar
ks)
:
(
c)Di
scussLassaFev
erundert
hef
oll
owi
ngheadi
ngs:
i
.Def
ini
ti
on:
LassaFev
eri
sanacut
evi
rali
l
lnesswi
thdur
ati
onI— 4weeks.I
tis
wi
del
ytr
ansmi
tt
edov
erwestandcent
ralAf
ri
ca.Ther
eser
voi
riswi
l
d
r
odent
sIncubat
ionper
iodi
s6—21day
s.(
1mar
k)
i
i
.Modeoft
ransmi
ssi
on
I
tiscausedbyar
enav
iruscal
l
edt
heLassav
irus.Humanar
epr
imar
il
y
i
nfect
edf
oll
owi
ngexposi
ngoff
oodt
odust
,wheni
nfect
edr
atpasses
ur
ineorf
aeces. (
1mar
k)
i
i
i.Si
gnsandSy
mpt
oms:
-Fev
er
-Mal
ouse
-Muscl
epai
n
-Sev
ereheadache
-Cough-
-Chestpai
n
-Conj
unct
ivi
ti
s
-Phar
ynsi
ti
s,Tonsi
l
iti
s
i
v.Pr
event
ion/
Cont
rol
-Repor
ti
ngt
otheappr
opr
iat
eheal
thaut
hor
it
y
-Ear
lydi
agonal
spr
omptt
reat
ment
-I
sol
ati
onofsuspect
edcase
-Di
sinf
ect
ionofpat
ient
sexcr
ete,
secr
eti
ons,
blood,
sput
um
-Sur
vei
l
lance
-Rodentshoul
dnothav
eaccesst
ofoodst
uffbypr
operi
tems
-Rest
ruct
ionofmov
ement
.
5.(
a)Enumer
ate si
x(6)di
seasesand heal
th condi
ti
on t
hatar
e
bl
indnessi
nNi
ger
ia.
-Cat
aract
-Gl
aucoma
-Tr
achoma
-Onchocer
ciasi
s
-Vi
tami
nAdef
ici
ency
-Measl
esi
nfect
ion
-Di
abet
esmei
l
itus
-Conj
uct
ivi
ti
s
-Gonor
rhoeaandsy
phi
l
is(
3mar
ks)
(
b)St
atesi
x(6)i
nwhi
chhear
ingl
ossbepr
event
edi
nthecommuni
ty
-I
mmuni
zat
ion
-Heal
theducat
ion
-Genet
iccounsel
i
ng
-Av
oidanceofuseofant
ibi
oti
cse.
g.st
rept
ony
en
-Mot
hershoul
dbet
reat
edf
rom i
nfect
ious
-Av
oidancofal
cohol
andsmoki
ngdur
ingpr
egnancy
-GoodAnt
e-Nat
alcar
e
-Goodnut
ri
ti
on
-Ear
lydi
agnosi
sandpr
omptt
reat
ment
-Regul
arcl
i
nicat
tendance
-Goodper
sonal
hygi
enest
orageoff
oodassoci
ated.
wit
h
(
c)Out
li
nef
our(
4)f
unct
ionsoft
henose
-Respi
rat
ionThenosei
sforbr
eat
hing
-Ai
rcondi
ti
oni
ng
-Pr
otect
ion
-Ol
fact
ion:
prot
ect
ivev
alueagai
nstappr
oachi
ngdanger
s
-Resonance
-Ref
lexes
-Ai
rEqual
i
zat
ionper
for
medbyEust
achi
on
(
2mar
ks)
(
d)Li
stf
our(
4)di
seasecondi
ti
onsoft
het
hroat
-Lar
yngi
ti
s
-Phar
yngi
ti
s
-Tonsi
l
iti
s
-Sor
ethr
oat
-Toci
sil
ophar
yngi
ti
s
-I
nfect
ion
-For
eignbody
-Tumour
s (
2mar
ks)

6.(
a)St
atesi
x(6)changest
hatar
eassoci
atedwi
thagei
ng:
-Car
diov
ascul
arsy
stem
-Respi
rat
orysy
stem changes
-Gast
ro—i
ntest
inal
tract(
GIT)changes
-Changesi
nUr
inar
ysy
stem
-Changesi
nEndocr
inesy
stem
-Ner
voussy
stem changes
-Changesi
nrepr
oduct
ionsy
stems
-Muscul
o-skel
etal
syst
em changes(
3mar
ks)
(
b)Enumer
atesi
x(6)r
esour
ces/
faci
li
ti
esav
ail
abl
etot
heAgedi
nthe
communi
ty
-Fami
l
ymember
sandf
ri
ends
-Communi
tymember
s
-Associ
ati
onsi
nthecommuni
ty
-Vol
unt
aryagenci
es
-Gov
ernment
aland non-
gov
ernment
alor
gani
zat
ion,e.
g.Rd cr
oss
soci
ety
,Rot
arycl
ub,
etc.
-Heal
thv
isi
tor
s
-Hospi
tal
sandheal
thcent
res
-Soci
alandr
eli
giousgr
oups
-Nat
ional
Heal
thI
nsur
anceScheme(
NHI
S)(
3mar
ks)
(
c)I
dent
if
ysi
x(6)mai
ngr
oupsofdi
sabi
li
tyascat
egor
izedbyWHO
(
1)Per
sonswi
thf
it
s
(
2)Per
sonswi
thhear
ingpr
obl
ems
(
3)Per
sonswi
thl
ear
ningdi
ff
icul
ti
es
(
4)Per
sonswi
thdi
ff
icul
ti
esi
nmov
ing
(
5)Per
sonswi
thdi
ff
icul
ti
esi
nseei
ng
(
6)Per
sonswi
thst
rangebehav
ior
s(2½mar
ks)
(
d)I
temi
set
hree(
3)met
hodsy
oucanadopti
ncommuni
tywi
th
per
sonswi
thhear
ingandspeechpr
obl
ems
-Faci
algest
ures
-Useofsi
gnl
anguage
-Wr
it
ing
-Li
preadi
ng
-Fi
ngerspel
l
ing
-Manual
signs
-Audi
tor
ytr
aini
nge.
g.useofhear
ingai
d
-Languaget
rai
ning.(
1½ mar
ks)
7.(
a)St
atesi
x(6)condi
ti
ons/
fact
orsassoci
atedwi
tht
hef
ormat
ion
ofdent
alcar
es
-Fr
equencyconsumpt
ionofsugar
yandconf
ect
ionar
ysweet
s
-Pooror
alhy
giene
-Bact
eri
alsubst
rat
e
-Gr
ossr
educt
iont
heamountofSal
i
vasecr
eti
on
-Fai
l
uret
oobt
ainr
egul
ardent
alcheckup
-Fl
uor
idedef
ici
ency
-Vul
ner
abl
etoot
hsur
face
-Pr
egnancy(
duet
ore-
absor
pti
onofcal
cium f
ordent
it
ion)
-Nut
ri
ti
onal
def
ici
ency
.
(
b)Wr
it
eshor
tnot
esont
hef
oll
owi
ng:
(
i)Anxi
ety
:Thi
sisast
ateofgener
ali
zedper
vasi
vef
earwi
thaf
eel
i
ng
ofi
nnert
ensi
on.Anxi
etyt
hatf
oll
owsat
hreat
eni
ngsi
tuat
ioni
snor
mal
becausei
thel
pst
heor
gani
sm t
opr
epar
efordef
enceorf
li
ght
.
(
ii
)Depr
essi
on:i
sast
ateofpsy
chomot
orr
etar
dat
ionwher
ether
eis
phy
sicaland ment
alsl
owness char
act
eri
zed ofi
nter
est
,reduced
ener
gy,sui
cidalt
hought
s and sl
eep and appet
it
e di
stur
bance go
bey
ondnor
mal
changes.
(
ii
i)Psy
chosi
s:i
samaj
orment
ali
l
lnessandmor
eser
iousf
orm of
ment
ali
l
lnesst
hatof
tenr
equi
reaper
iodofhospi
tal
i
zat
ionwi
tht
otal
l
ossofcont
actwi
thr
eal
i
ty,noi
nsi
ghtandor
ient
ati
on,appear
ances
r
oughanddi
rt
y.
(
ii
)Acut
eAbdomen;Acut
eAbdomeni
sacondi
ti
onchar
act
eri
zed,by
t
heacut
eonsetofabdomi
nalpai
n,col
i
ckyorper
sist
entwhi
chmaybe
l
ocal
i
zed orgener
ali
zed and maybe associ
ated wi
th shock and
v
omi
ti
ng.
(
ii
i)Fi
rstAi
d:i
tcanbedef
inedast
hei
mmedi
atef
ir
stt
reat
mentgi
ven
t
oasi
ckori
njur
edper
sonbef
oret
hear
ri
valofamedi
calpr
act
it
ioner
orbef
oret
aki
nghi
m/hert
othehospi
tal
(
c)Enumer
atef
our(
4)posi
ti
ve ment
alheal
th habi
ts expect
ed
amongstmember
sofy
ourcommuni
ty
- Adequat
erestandsl
eep
- Adequat
enut
ri
ti
on
- Adequat
eexer
cise
- Recr
eat
ion
- Hol
i
day
s
- Posi
ti
vewayofhandl
i
ngst
resssi
tuat
ion
- Adequat
ehol
i
day
s

CHEW 2011PAPER1
SECTI
ONB:ESSAYANSWER(
70mar
ks)
1a.ETI
QUETTE THAT A COMMUNI
TY HEALTH PRACTI
TIONER
SHOULDOBSERVEATWORK
i
. Hav
eagener
all
yposi
ti
veat
ti
tudet
owar
dswor
kwi
thacheer
ful
per
sonal
i
ty
i
i
.ii
.Of
ferexpl
anat
iont
opat
ient
sonchar
gesf
orser
vicesi
nan
honestmanner
i
i
i. Hav
eagenui
nedesi
ret
ohel
ppeopl
e;t
hisi
sexpr
essedi
ntheway
t
he heal
th pr
act
it
ioner communi
cat
es wi
th peopl
ethr
ough
speechandbodyl
anguage
i
v. Bewar
m andat
tent
ive,t
hishel
pst
oreassur
ethecl
i
ent
/pat
ient
andi
sasi
gnal
ofdesi
ret
ohel
p
v
. Li
steni
ngwi
that
tent
ioncommuni
cat
esaccept
anceoft
heper
son
v
i. Pr
ovi
deappr
opr
iat
epr
ivacyt
ohi
s/hercl
i
ent
s/pat
ient
s
v
ii
. Hav
e empat
hy al
way
s gi
ve uncondi
ti
onalposi
ti
ver
egar
dto
hi
s/herpat
ient
s and expr
ess appr
opr
iat
e empat
hy f
ort
hei
r
condi
ti
on.
v
ii
i. Est
abl
i
shagoodi
nter
per
sonalr
elat
ionshi
pwi
tht
hecl
i
ent
/pat
ient
f
oref
fect
ivei
nter
per
sonal
rel
ati
onshi
p
i
x. Show appr
opr
iat
ecour
tesyt
ocl
i
ent
s/pat
ient
satal
lti
mesand
underanci
rcumst
ances
x. Tr
eatal
lcl
i
ent
s/pat
ient
swi
tht
hesameamountofsy
mpat
hy,
concer
nandat
tent
ion’
xi
. Av
oidov
erf
ami
l
iar
it
ythr
oughl
essf
ormalt
one,t
hiswi
l
lmake
 cl
i
ent
/pat
ientf
eel
mor
ecomf
ort
abl
e
xi
i
. Av
oid smoki
ng and dr
inki
ng al
coholi
nthe heal
thf
aci
l
ity
env
ironment
xi
i
i. Dr
essdecent
lyal
way
s,whet
heratwor
koroutofwor
k
xi
v. Av
oidengagi
ngi
nmar
ket
ing,
adv
ert
isementorsel
lofi
temswhi
l
e
ondut
y
xv
. Av
oid gossi
ps, char
act
er assassi
nat
ion(
def
amat
ion) of
col
l
eagues,
pat
ient
sandr
elat
ions
xv
i. Av
oid pi
l
fer
ing orst
eal
i
ng heal
thf
aci
l
itypr
oper
tyl
i
ke dr
ugs,
equi
pment
,inst
rument
s,et
c.
b.DEFI
NITI
ONOFMEDI
CALSOCI
OLOGY
I
tisabr
anchi
nsoci
ologywhi
chi
sver
ymuchconcer
nedwi
thal
lthe
act
ionsandf
act
orsi
nil
l
nessi
nor
dert
obr
ingi
nthesi
ckper
son,hi
s
r
elat
ionandt
hemedi
calper
sonnelt
ounder
standhowt
omot
ivat
ethe
pat
ientt
oachi
ever
ecov
eryf
rom i
l
lnesswhi
chi
sthegoal
ofmedi
cine.
I
tist
hest
udyoft
heav
ail
abi
l
ityofmedi
cal
car
eandt
hesoci
ali
mpact
s
ofmedi
cal
prof
essi
ons
I
tisasub-
disci
pli
neofsoci
ologyt
hatst
udi
est
hesoci
alcausesand
consequencesofheal
thandi
l
lnessi
napopul
ati
on.
c.HARMFUL TRADI
TIONS AND CULTURAL HABI
TS THAT MAY
AFFECTHEALTH
i
. For
cef
eedi
ngofchi
l
dren,
i
i
.ii
.Femal
egeni
tal
mut
il
ati
on
i
i
i. Teenagepr
egnancy
i
v. Appl
i
cat
ionofcowdungaf
tercut
ti
ngumbi
l
ical
cor
dofachi
l
d
v
. Depr
ivi
ngchi
l
drenf
rom t
hei
rmot
herf
orweani
ngpur
pose
v
i. Cut
ti
ngofUmbi
l
ical
cor
dusi
nghotkni
feorol
drazorbl
ade
v
ii
. Dr
inki
ngbl
uef
orf
ami
l
ypl
anni
ng
v
ii
i. Tat
toomar
ks/
scar
if
icat
ion
i
x. Foodt
aboos
x. Bur
ningt
hef
eetofachi
l
ddur
ingepi
l
ept
icf
it
s
xi
. Ear
ly/
for
cedmar
ri
age
xi
i
. Sexual
viol
ence/r
apeagai
nstmar
ri
age
xi
i
i. Mal
tr
eat
mentofwi
dows
xi
v. Abr
uptweani
ng
xv
. Bat
hingofwomen’
sst
omachandpr
ivat
epar
twi
thv
eryhotwat
er
af
terchi
l
dbi
rt
h
2a.METHODS OF PASSI
NG HEALTH MESSAGES TO FAMI
LIES,
I
NDI
VIDUALAND
COMMUNI
TIES.
i
. Rol
epl
ayi
ng
i
i
.ii
.St
oryt
ell
i
ng(
ver
bal
communi
cat
ion)
i
i
i. Gr
oupdi
scussi
on‘
i
v. Si
mul
ati
onr
v
. SongsandDr
ama
v
i. Demonst
rat
ion
v
ii
. Counsel
i
ng
v
ii
i. Danci
ng
i
x. Non-
ver
bal
communi
cat
ionggest
ures,
bodyl
anguages
b.MAI
N GROUPSOFTEACHI
NG AI
D USED TN COMMUNI
CATI
ON
WI
THONEEXAMPLEEACH
(
1) Audi
o: These ar
e sound pr
oduci
ng mat
eri
als wi
th whi
ch
communi
cat
ioncoul
dbeef
fect
ed.Theyar
ethet
eachi
ngai
dst
hat
appealt
othe sense or
gan ofhear
ing e.
g.t
ape r
ecor
ding,r
adi
o,
gr
amaphone
(
2)Vi
sual
s:Thesear
eteachi
ngai
dst
hatappealt
othesenseor
ganof
si
ghti
.e.t
heey
es.I
tgi
vespi
ctor
ialdescr
ipt
ion ofan obj
ecte.
g.
post
ers,
leaf
let
s,f
lannel
graphs,
etc.
(
3)Audi
o-Vi
sual
s:I
tincl
udesal
lteachi
ngai
dst
hatappeal
stobot
hthe
sensesofhear
ing and si
ghte.
g.t
elev
isi
on,v
ideo,sound f
il
ms(
3
mar
ks)
c.ADVANTAGESOFWRI
TTENCOMMUNI
CATI
ON
i
. Easyt
opr
eser
ve
i
i
. Easypr
esent
ati
onofcompl
exmat
ter
i
i
i. Per
manentr
ecor
d
i
v. Pr
event
swast
ageoft
it
heandmoney
v
. Accur
atepr
esent
ati
on
v
i. Useasar
efer
ence
v
ii
. Del
egat
ionofaut
hor
it
yLongev
ity
v
ii
i. Ef
fect
ivecommuni
cat
ion
3a.PRI
MARYHEALTH CAREcanbedef
inedasanessent
ialheal
th
car
ebasedonpr
act
ical
,sci
ent
if
ical
l
ysoundandsoci
all
yaccept
abl
e
met
hodsandt
echnol
ogymadeuni
ver
sal
l
yaccessi
blet
oindi
vi
dual
s
andf
ami
l
iesi
nthecommuni
tyt
hrought
hei
rdev
elopmenti
nthespi
ri
t
ofsel
f-
rel
i
anceandsel
f-
det
ermi
nat
ion.
b.(
i)Pr
inci
pleofessent
ialser
vices:Thi
smeansessent
ialser
vice
whi
chpr
omot
esheal
thsuchaskeepi
ngacl
eanenv
ironment
,
goodwat
ersuppl
i
es,
car
eofmot
her
sdur
ingpr
egnancyandchi
l
d
bi
rt
h,Nut
ri
ti
on ofchi
l
dren,i
mmuni
zat
ion ear
lyt
reat
mentof
di
seases
(
ii
)Pr
inci
ple ofcommuni
ty par
ti
cipat
ion:The chal
l
enges att
he
Pr
imar
ylev
elofcar
ear
etoest
abl
i
shaheal
thcar
esy
stem t
hatwi
l
l
t
oucht
hel
i
vesofev
eryci
ti
zenandt
ackl
ethecondi
ti
onst
hatcauses
t
hehi
ghestmor
tal
i
tyandmor
bidi
tyt
hroughcommuni
typar
ti
cipat
ion.
(
ii
i)Pr
inci
pleofi
nter
sect
oralappr
oach(
Mul
tisect
oralcol
labor
ati
on)
:
PHCr
equi
rest
hecol
l
abor
ati
onofheal
thandot
herr
elat
edsect
orsf
or
i
tssuccess-
(
iv)Thespi
ri
tofsoci
alj
ust
icesandEqui
ty:PHCemphasi
zeanequi
ty,
equaldi
str
ibut
ion ofheal
thf
aci
l
iti
es,heal
th per
sonneland ot
her
suppl
i
erbet
weent
her
ural
andur
banar
ea.
(
v)Pr
inci
pleofsel
f-
rel
iance:I
tisnecessar
yforheal
tht
odev
elopski
l
ls
and st
rat
egy t
hey can r
ely on t
o sol
ve heal
th pr
obl
em i
n al
l
ci
rcumst
ancessoast
osust
ainpr
imar
yheal
thcar
e.
(
vi) Appr
opr
iat
e Technol
ogy
: PHC r
equi
res t
he dev
elopment
,
adapt
ati
on and appl
i
cat
ion ofsi
mpl
e equi
pment
,techni
ques and
met
hodt
hatpeopl
ecanaf
for
danduset
osol
veheal
thpr
obl
em.
(
vii
)Thepr
inci
pleofav
ail
abi
li
ty:Ef
for
tsshoul
dbemadet
omakePHC
av
ail
abl
eespeci
all
yessent
ialdr
ugsandot
hersuppl
i
esr
equi
redi
nthe
cent
erso t
hatcl
i
entwi
l
lachi
evet
hei
robj
ect
ivesofat
tendi
ngt
he
cent
er.
(
vii
i
)Pr
inci
pleofaccessi
bil
i
ty:PHCshoul
dbewi
thi
nther
eachoft
he
i
ndi
vi
dual
,fami
l
yandcommuni
tyt
hrougheasymeansofdel
i
ver
ing
ser
vices.
(
ix)Pr
inci
pleofPol
it
icalwi
ll
:Gov
ernmentappr
oacht
oP1-
ICshoul
dbe
i
n such a way as t
o commi
tresour
ces i
n money
,mat
eri
aland
manpowerf
ori
mpl
ement
ati
onofPHCpr
ogr
ammes.
(
x) Pr
inci
ple of i
ntegr
ated ser
vices:I
tis necessar
ythatPHC
r
esour
ces be coor
dinat
ed f
oref
fi
ciency and ef
fect
iveness.PHC
shoul
dbepr
ovi
dedi
nani
ntegr
atedandcompr
ehensi
vemannersuch
t
hatal
ltheser
vicesr
equi
redbyani
ndi
vi
dual
,fami
l
yandcommuni
ty
canbeobt
ainedt
oget
herassoonasanyonev
isi
ttoaheal
thf
aci
l
ity
.
(½mar
keachf
or2poi
nts:
1mar
ks)
c.
i
.Cul
tur
alf
act
ors
i
i
.Env
ironment
alf
act
ors
i
i
i.Per
sonal
fact
ors
i
v.Geogr
aphi
cal
fact
ors
d.i
.Cul
tur
alFact
ors:Cul
tur
eisawayofl
i
feofacommuni
tyofpeopl
&
whi
chhasbeenhandeddownf
rom onegener
ati
ont
oanot
herbyway
ofpr
act
iceorcommuni
cat
ion.
i
i.Env
ironment
alf
act
ors:Env
ironment can be def
ined as t
he
i
mmedi
ate and di
stant ci
rcumst
ances,obj
ect
s,condi
ti
ons and
sur
roundi
ngsofman,
plantandani
mal
s.
i
ii
.Soci
o Economi
cfact
ors:Thesear
eSoci
o-demogr
aphi
cfact
ors
t
hatcani
nfl
uencet
heheal
thst
atusoft
hepopul
ati
on
i
v.Per
sonalf
act
ors:Thest
ateofheal
thofani
ndi
vi
duali
sdet
ermi
ned
bycer
tai
ninper
sonal
fact
orst
hatmayaf
fecthi
s/herheal
th.
v
.Geogr
aphi
calf
act
ors:Thesei
ncl
ude;
a.Topogr
aphy
b.Deser
ts
c.Weat
her
d.For
estv
eget
ati
on
e.Dr
aught
s
f
.Ear
thquakes
g.Fl
oods,
etc.
4a.EMOTI
ONcanbedef
inedast
heout
war
dexpr
essi
onofani
nner
f
eel
i
ngoref
fect
,ast
ate
of ar
ousalchar
act
eri
zed by al
ter
ati
on of f
eel
i
ng t
one and by
phy
siol
ogi
cal
behav
ior
alchanges
b.TYPESOFEMOTI
ON
l
.Joy 9.Fear
2.Lov
e 10.Sor
row
3.Happi
ness 11.Di
sgust
4.Smi
l
e 12.Sur
pri
se
5.Laught
er 13.Jeal
ousy
6.El
ati
on 14.
Env
y
7.Ecst
asy 15.Hat
red
8.Amusement 16.Anger
17.Aggr
essi
on
c.i
.PHARMACOLOGY:I
tcanbedef
inedast
hesci
encewhi
chdeal
s
wi
tht
hest
udyofdr
ugsasi
trel
atest
othei
ror
igi
n,chemi
calst
ruct
ure,
pr
epar
ati
on,act
ion,admi
nist
rat
ion,modeofact
ionofdr
ugsi
nthe
bodybot
hinheal
thandi
l
lness,
incl
udi
ngt
hei
rnames,
met
abol
i
sm and
excr
eti
on.
i
i. PHARMACOVI
GILANCE: I
s known as dr
ug saf
ety
,is t
he
phar
macol
ogi
cal sci
ence r
elat
ing t
o t
he col
l
ect
ion, det
ent
ion,
assessment
,moni
tor
ing and pr
event
ion ofadv
erse ef
fect
s wi
th
phar
maceut
ical
product
s.
i
i
i.Dr
ugsar
echemi
calsubst
ancest
hathav
etheabi
l
ityt
orel
i
eve,
cur
e
orpr
eventanyabnor
mal
condi
ti
onoft
hebody
i
v.PHARMACOKI
NETJCS.
:Iti
sthest
udyoft
heconcent
rat
ionofa
dr
ug dur
ing t
he pr
ocesses of absor
pti
on, di
str
ibut
ion,
bi
otr
ansf
ormat
ionandexcr
eti
on.
v
.IDI
OSYNCRATI
C:Thi
sisanunexpect
edef
fectpr
oducedbyadr
ugi
n
agi
veni
ndi
vi
dual
.
5a.ROLESOFCOMMUNI
TYDI
AGNOSI
SINPHC
i
.Ident
if
yingheal
thandheal
thr
elat
edneedsoft
hecommuni
tyand
usedasbasi
sforpl
anni
ng.
.
i
i
.Ident
if
yingr
esour
ceswi
thi
nthecommuni
tyt
osol
vei
dent
if
ied
pr
obl
ems
i
i
i. Enhancesi
nter
act
ionbet
weent
hecommuni
tyandheal
thwor
ker
s.
i
v.I
dent
if
ying const
rai
ns whi
ch can t
hen be addr
essed i
nthe
pl
anni
ngpr
ocess
v
. Pr
ovi
desbasel
i
nef
orev
aluat
ionofi
nter
vent
ions.
v
i.I
tpr
ovi
desasol
i
dbasi
sformaki
ngpl
anst
osol
vet
heheal
th
pr
obl
emsandmeett
hei
dent
if
iedheal
thneeds
5b.Met
hodsusedi
ncommuni
tydi
agnosi
s
a.Obser
vat
ion
b.Quest
ionnai
re
c.I
nter
view
d.Gr
oupdi
scussi
on
e.Rev
iewofexi
ti
ngr
ecor
ds
5c.Si
tuat
ionAnal
ysi
sist
hepr
ocessoff
indi
ngoutt
heact
ualst
atusof
heal
thi
ngi
vencommuni
tysuchasi
nfor
mat
iononLGAPopul
ati
on,
LGAheal
thbudget
,Heal
thf
aci
l
itybyt
ypeandi
nfor
mat
ionsuppor
ts
5d.I
NSTRUMENTSUSEDI
NSI
TUATI
ONANALYSI
S
i
. For
m“H”—t
ocol
l
ecthousehol
dinf
ormat
ion
i
i
.For
m“C”—t
ocol
l
ectchi
l
dinf
ormat
ion-
i
i
i.For
m“F”— t
ocol
l
ecti
nfor
mat
ionOnf
emal
emar
ri
edandt
hose
under50y
ear
sincl
udi
ngwomenwhohav
enev
erbeenpr
egnant
6a.ESSENTI
ALDRUGSar
ethosebasi
cdr
ugst
hatsat
isf
ythebasi
c
heal
thneedsoft
hemaj
ori
tyoft
hepopul
ati
oni
nthecommuni
ty.
b. STEPS FOR THE MANAGEMENT OF ESSENTI
AL DRUGS
PROGRAMME
i
. Sel
ect
ingf
rom t
heessent
ialdr
ugsl
stt
hosedr
ugsneededatt
hat
speci
fi
cheal
thuni
t.
i
i
. Or
der
ingt
hedr
ugs
i
i
i. Recei
vi
ngandst
ori
ngt
hedr
ugs
i
v.I
ssui
ngandusi
ngt
hedr
ugs
c.STEPSFORORDERI
NGOFDRUGS
i
. Det
ermi
net
heor
der
ingi
nter
val
;i
.e.howof
tent
oor
der
i
i
.ii
.Li
stt
hedr
ugs
i
i
i. Cal
cul
atet
heamountofdr
ugsneededwi
thi
naspeci
fi
edor
der
ing
I
nter
valbased on l
ocal
l
yand seasonalusage (
e.g.measl
es
v
acci
nespr
iort
odr
yseason)
i
v. Compl
eteadr
ugr
equi
sit
ionf
orm
v
. Cal
cul
atet
hecostoft
hedr
ugsor
der
ed
v
i. For
war
dmoneyf
ordr
ugsor
der
edt
oget
herwi
tht
her
equi
sit
ion
f
orms
d.ADVANTAGESOFESSENTI
ALDRUGSPROGRAMME
i
.Iti
seconomi
cal
int
ermsofcost
i
i
.Iti
saf
for
dabl
eandaccessi
blemaj
ori
tyoft
hepopul
ati
oncan
af
for
dtopay
.
i
i
i.I
tenabl
essomeagenci
esr
elat
edt
odr
ugscont
rolt
oper
for
m
ef
fect
ivel
y
i
v. Dr
ugusagei
nourheal
thf
aci
l
iti
escaneasi
l
ybemanaged
v
.Itmakesdescr
ipt
ionofdr
ugsv
eryeasysi
ncet
hedr
ugsar
e
r
eadi
l
yav
ail
abl
e
v
i. The out
-of
-st
ock-
syndr
ome i
n ourheal
thf
aci
l
iti
es i
sreduced
dr
ast
ical
l
y
v
ii
. Ther
educt
ioni
nthenumberofdr
ugsusedi
ntheheal
thcar
e
sy
stem makespur
chasi
ngst
orageanddi
str
ibut
ioneasi
er.
ADVANTAGESOF2-
WAYREFERRALSYSTEM
I
tenhancescont
inui
tyofcar
e.
I
tpr
omot
esadequat
efol
l
owup
I
tensur
esf
eedback
I
tensur
escont
inui
tyofeducat
ion.
 CHEW 2011PAPER2
SECTI
ONB:ESSAYANSWERS(
70mar
ks)
l
a.EXCLUSI
VE BREASTFEEDI
NG:means i
nit
iat
ing br
east
feedi
ng
wi
thi
n30mi
nut
esaf
terbi
rt
handf
or6mont
hswi
thoutaddi
ngwat
er,
t
othebody
.

l
b.ADVANTAGESOFBREASTFEEDI
NGOVERARTI
FICI
ALFEEDI
NG
-Br
eastmi
l
kisal
way
scl
ean,
saf
e,f
reef
rom pat
hogeni
cor
gani
sm
-I
tisal
way
sav
ail
abl
e
-I
tisal
way
satcor
rectt
emper
atur
e
-Pr
otect
schi
l
dfr
om i
nfect
ionsbecausei
tcont
ainsant
ibodi
es
-Pr
event
smot
herf
rom br
eastcancerandov
ari
ancancer
-Pr
opergr
owt
handdev
elopmentoft
hechi
l
d
-Cr
eat
esbondbet
weenmot
herandchi
l
d
-Pr
event
schi
l
dfr
om di
arr
hea

1c.DI
RECTANDI
NDI
RECTMETHOD
 DI
RECTASSESSMENT
•Phy
sical
exami
nat
ione.
g.Head-
to-
toe
•Ant
hropomet
ri
cmeasur
emente.
g.Wei
ght
,Hei
ghtLabor
ator
ytest
•Ski
nfol
dthi
ckness
•Mi
d-upperar
m ci
rcumf
erence
I
NDI
RECTASSESSMENT
•Pat
ter
nofbr
east
feedi
ng
•Theot
herf
oods(
compl
ement
ary
)of
fer
edt
othebaby
•Thenumberoft
imeseachdayt
hechi
l
disf
ed
•Mot
her
’sknowl
edger
egar
dingdi
et
•Fami
l
yfoodbudget
.
d.Ni
ghtbl
i
ndness!xer
opht
hal
mia-LackofVi
tami
nA
Ber
iber
i -Lackofv
itami
nB
Kwashi
orkor -Lackofpr
otei
n
Ri
cket
s -Lackofv
itami
nD
Scur
vy -Lackofv
itami
nC
Goi
tr
e -LackofI
odi
ne
Mar
asmus -
Lackofpr
otei
nsandcal
ori
es
2.(
a)20y
earol
dIdr
iswasbi
tt
enbyast
raydogwhi
l
eret
urni
ngf
rom
school
.Managehi
scondi
ti
onwi
tht
heuseofSt
andi
ng Or
der
s(5
mar
ks)
b.DEFI
NITI
ONOFWOUND
Woundi
sabr
eaki
nthecont
inui
tyoft
heski
normucousmembr
ane
pav
ingway
sformi
croor
gani
smst
oinv
adet
heaf
fect
edpar
toft
he
body
c.TYPESOFWOUND
i
.Inci
sedwound:Thi
sisacl
eanwoundcutwi
thashar
pobj
ect
s,e.
g.
sur
gical
wounddur
ingoper
ati
on
i
i
i.Lacer
ated wound:The t
issue i
sfr
om r
esul
ti
ng i
nar
ugged
appear
ancee.
g.woundsust
ainedf
rom gl
assorbar
bwi
re.
i
v.Punct
uredwound:Thi
sisasmal
lper
for
ati
onofski
nusual
l
ycaused
byshar
pobj
ect
s,e.
g.bul
l
ets,
kni
fest
ab,
steppi
ngonnai
l
s,et
c.
v
.Cl
eanedwound:Cl
eaneduni
nfect
edwoundbecl
osedbysut
uri
ngt
o
ai
dheal
i
ng
v
i.Sept
ic wound:Thi
s cont
ains bact
eri
a and pus whi
ch maybe
ext
ract
edf
rom t
hewound.
3a.FACTORSAFFECTI
NGI
NDI
VIDUALRESI
STANCETODI
SEASES.
i
. Age
i
i
. Sex
i
i
i. Nut
ri
ti
on
i
v. Tr
aumaorf
ati
gue
v
. Pr
egnancy
v
i. Her
edi
ty
v
ii
. Di
seasesandi
nfect
ions
b.ROUTEOFADMI
NISSTERI
NGI
NJECTI
ONS
i
.Int
rader
mal
i
i
.Int
ramuscul
ar’
i
i
i.I
ntr
avenaus
i
v. Subcut
aneous
v
. Hy
poder
mic
v
i.I
ntr
athecal
4a.FUNCTI
ONSOFTHEBLOOD
1.Tr
anspor
tat
ionofOxy
genf
rom t
hel
ungst
othet
issues
2.Tr
anspor
tofcar
bondi
oxi
def
rom t
het
issuest
othel
ungs
3.Tr
anspor
tofnut
ri
entmat
eri
alsf
rom t
heal
i
ment
aryt
ractt
othe
t
issuesandcel
lwast
emat
eri
alst
otheexcr
etor
yor
gans,e.
g.
ki
dney
4.Tr
anspor
tofhor
monessecr
etedbyendocr
inegl
andst
othei
r
t
argetgl
andsandt
issues
5.Tr
anspor
tofheati
nact
ivet
issuest
oot
herl
essact
ivet
issues
6.Tr
anspor
tofpr
otect
ivesubst
ances,e.
g.ant
ibodi
es,t
oar
easof
i
nfect
iont
ofi
ghtt
hei
nfect
ion
7.Ar
rest
s haemor
rhage bypr
oduci
ng mat
eri
alst
hatcl
otbl
ood,
t
her
ebypr
event
ingi
tsl
ossf
rom ar
upt
uredbl
oodv
essel
8.Regul
ati
onofbodyt
emper
atur
e
9.Car
ri
esawaywast
epr
oductt
otheor
gans,whi
chexcr
etet
hem.
E.
g.CO2
10. Bl
oodhel
pst
ofi
ghtbact
eri
ali
nfect
iont
hroughwhi
tebl
ood
cel
l
sandant
ibodi
es
4b.FUNCTI
ONSOFTHESKI
N
1.I
tfor
msapr
otect
ivecov
eri
ngf
ort
hebody
2.I
tcont
ainst
heendor
gansoft
hesensor
yner
ves(
pai
n,t
ouchand
 t
emper
atur
e)
3.I
tsecr
etessebum,
whi
choi
l
sitandhai
rs
4.I
tiscapabl
eofabsor
bingsmal
lamount
sofoi
l
ysubst
ances
5.I
tgi
vesor
igi
ntot
hehai
randnai
l
s
6.Somedr
ugsar
eabsor
bedt
hrought
heski
n
7.I
tisanor
ganofsensat
ionorsenseor
gan
8.Excr
etor
yor
ganshel
psi
nther
emov
alofwast
epr
oduct
sfr
om
t
he bodyl
i
ke wat
erand sal
ts mai
nlyi
nthe f
orm,ofsweat
(
elect
rol
ytes)
9.Pl
aysani
mpor
tantr
olei
nther
egul
ati
onofbodyt
emper
atur
e.
Thet
emper
atur
eoft
hebodyr
emai
nsf
air
lyconst
antatabout
36.
8°C(
98.
4°E)
4c. SAFETY PRECAUTI
ONS I
N HANDLI
NG LABORATORY
EQUI
PMENT
1.Labor
ator
ycoatorapr
onmustbewor
n
2.Donoteat
,smokeordr
inki
nthel
abor
ator
y
3.Donotl
i
ckl
abel
s;i
nst
eaduset
apwat
er
4.Av
oidt
hehabi
tofhol
dingpenci
l
,pensandmar
ker
swi
thl
i
ps
5.Keept
hel
abor
ator
ybenchcl
eanandscr
upul
ousl
ycl
ean
6.Al
lthel
abor
ator
yequi
pmentshoul
dbehandl
edwi
thcar
ewheni
n
use
7.Whenhandl
i
ngspeci
mens,car
emustbet
akent
oav
oidv
ari
ous
di
seases
 8.Di
sinf
ect
ant
sshoul
dbeusedt
odi
sinf
ectanyi
nst
rumentbef
ore
andaf
teruse
9.Al
lthe speci
mens i
nvest
igat
ed shoul
d be r
ecor
ded i
nthe
pat
ient
’scar
dai
dint
her
ecor
dbook.
10. Remembert
owashandcl
eany
ourhandswi
thdet
ergent
s
bef
oreandaf
terl
eav
ingt
hel
abor
ator
y
11. I
ncul
cat
ingneedl
esandl
oopsshoul
dbef
lamedt
oredness
bef
oreandaf
teri
ncul
cat
ion
12. Cul
tur
esshoul
dnev
erbet
akenhomef
rom t
hel
abor
ator
y
13. Keept
estt
ubecul
tur
esi
ntest
_tuber
aceandnev
erl
ayon
t
hebencht
op
14. Av
oid exposi
ng y
ourey
es t
o ul
tr
a -l
etl
i
ghtused f
or
st
eri
l
izat
ion
15. Donotpi
pet
tecul
tur
esdi
rect
lybymout
h,i
nst
eaduser
obber
t
eat
sorpi
pet
tef
it
ter
s
16. Labelal
lcul
tur
esi
ncubat
edpr
oper
lywi
thy
ourname,t
he
nat
ureoft
hespeci
menanddat
e.
5a.STAFFTRAI
NINGNEEDSUSI
NGSI
MPLETRAI
NING
 ASSESSMENTMETHODS
1.Byaski
ngquest
ion
2.Obser
vat
ionofper
for
mance
3.Di
scussi
on‘
4.Feedback
 5.Rev
iewofpr
evi
ousknowl
edge
6.Cont
inuousassessment
7.Rev
iewofann3l
alper
for
mancer
ecor
d
5b.REASONSWHYSTAFFTRAI
NINGI
SNECESSARYI
NPHC
1.Tor
emov
eper
for
mancedef
ici
enci
es
2.To mat
ch empl
oyees abi
l
iti
es wi
th-
the j
ob r
equi
rement
s and
or
gani
zat
ional
needs
3.Toenhanceor
gani
zat
ional
viabi
l
ityandt
ransf
ormat
ionpr
ocess
4.Toi
mpr
ovet
hequal
i
tyandquant
it
yofwor
k
5.Somet
imest
rai
ningi
sunder
takent
oenhancet
heempl
oyee’
ssel
f
est
eem
6.Toenhancecer
tai
nbehav
iour
alchangei
ntheempl
oyees
7.Tor
educet
hecostofpr
oduct
ionandmi
nimi
ze‘
cost
8.Toi
ncr
easepr
oduct
ivi
tyandef
fi
ciency
5c.STEPSI
NCARRYI
NGOUTATRAI
NINGPROGRAME
-Setbehav
iour
all
ear
ningobj
ect
ives
-Chooset
rai
ningmet
hodst
omeetobj
ect
ives
-I
dent
if
yresour
ceper
sonst
oassi
sti
ntr
aini
ng
-Dev
elopat
rai
ningbudget
-I
dent
if
ybudgeti
temscor
rect
ly(
e.g.perdi
em,mat
eri
als,f
eedi
ng,
t
ranspor
t,suppor
tst
affet
c.)
-Est
imat
ereal
i
sti
ccost
ingf
oreachbudgeti
tem accor
dingt
olocal
si
tuat
ions
-Pr
epar
esi
mpl
epost
er,
char
tsandmodel
stohel
plear
ning.
-Deci
demet
hodst
oev
aluat
etr
aini
ngact
ivi
ti
es
-I
dent
if
yvar
iousassessmentmet
hods,i
ncl
udi
ng adv
ant
agesand
di
sadv
ant
agesofeach
-Sel
ectmet
hodsappr
opr
iat
etot
het
rai
neegr
oupandski
l
ltaught
-Conductt
rai
ningusi
ngpar
ti
cipat
oryadul
tlear
ningt
echni
ques
-Ev
aluat
etr
aini
ng
-Conducton-
the-
jobt
rai
ningdur
ingsuper
visor
yvi
sit
s.
6a.SI
X(6)FUNCTI
ONSOFMANAGEMENTBYOBJECTI
VE
-Pl
anni
ng
-
Organi
zi
ng
-St
aff
ing
-Di
rect
ing
-Cont
rol
l
ing
-Co-
ordi
nat
ing
-Repor
ti
ng
-Budget
ing
6b.QUALI
TIESOFAGOODSUPERVI
SION
1.Ti
mel
y
2.Regul
ar
3.Basedonsett
arget
4.Cul
tur
all
yaccept
abl
e
5.Notbehumi
l
iat
ing
6.Encour
agi
ng
7.Abl
etoof
fert
imel
yrewar
dforgoodper
for
mance
6c.ADVANTAGES/
MERI
TOFDELEGATI
ON
1.I
tmakest
hesuper
iorof
fi
cert
oat
tendt
omor
eimpor
tantdut
iesand
i
ncr
easepr
oduct
ivi
ty
2.I
tser
vesasani
ncent
ivet
othej
uni
orwor
kert
oinski
l
ls
3.I
tbr
ingsf
oodr
elat
ionshi
pamongwor
ker
s
4.I
tmakessuper
visi
oneasi
er
5.I
tpr
omot
essenseofbel
ongi
ng
6.I
t al
l
ows t
he subor
dinat
eto make deci
sions accor
ding t
o
ci
rcumst
ancessur
roundi
nghi
m/her
7.I
tpr
event
sdel
ayi
ndeci
sionmaki
ng
6d.I
MPLI
CATI
ONSOFI
MPROPERBUDGETI
NG
1.I
nadequat
eequi
pment
2.St
affmaygoonst
ri
ke
3.Fai
l
uret
oachi
evesetobj
ect
ives
4.Cl
i
ent
sandpat
ient
smayst
oppat
roni
zi
ngt
heheal
thf
aci
l
ity
5.I
nadequat
epay
mentofst
affwages
6.Shor
tageofdr
ugsi
nthecl
i
nic
7.Mi
spl
acementofpr
ior
it
ies
8.I
tgi
vesr
oom f
orf
raudul
entact
sinf
osmal
lmeasur
e
9.Maycausedi
ssat
isf
act
ion
7a.EVALAUTI
ON:I
tist
heper
iodi
cassessmentofpr
ogr
am t
oensur
e
t
hest
atedobj
ect
ivesar
ebei
ngmet
.Iti
soft
wot
ypes:For
mat
ive
ev
aluat
ionandsummat
iveev
aluat
ion.
b.Demogr
aphyi
sthest
udyoft
hepopul
ati
oni
nrel
ati
ont
oemi
grat
ion,
i
mmi
grat
ion,
language’
div
ersi
ty.
c.Heal
thst
ati
sti
cs:asy
stemat
icappr
oachf
orobt
aini
ng,or
gani
zi
ng
andanal
yzi
ngheal
thdat
a

CHEW 2O11PAPERI
II
SECTI
ONB:ESSAYANSWERS(
70mar
k(s)
l
a.PHYSI
CALENVI
RONMENT:I
tconsi
stsofnon-
li
vi
ngt
hingsand
ot
herf
act
ors.Someoft
hesef
act
orsi
ncl
udewat
er,ai
r,soi
l
,housi
ng,
wast
e,r
adi
ati
on,
cli
mat
icf
act
ors,
etc.
i
i.BI
OLOGI
CALENVI
RONMENT:I
tencompassesal
lli
vi
ngt
hingsbot
h
pl
ant
sandani
mal
s;f
ori
nst
anceman,goat
,pi
gs,bact
eri
a,v
iruses,
f
ungi
,pr
otozoa,
insect
s,r
odent
s,monkeyet
c.
i
ii
.SOCI
AL ENVI
RONMENT:I
tdeal
s wi
th ot
hersoci
alat
tri
but
es,
char
act
eri
sti
cs,f
act
ors and v
ari
abl
es ofman and t
oincl
ude hi
s
cust
oms, cul
tur
e, t
aboos, habi
ts, i
ncome, r
eli
gion, occupat
ion,
mar
ri
age,
div
orce,
housi
ng,
inher
it
ance,
eat
ingpat
ter
ns,
clot
hing,
etc.
b.METHODSOFSOLI
DWASTEDI
SPOSALI
NTHECOMMUNI
TY
1.Sani
tar
ylandf
il
lorcont
rol
led t
ippi
ng:Thi
sis a sy
stemat
ic
deposi
ti
onofr
efusei
nlow l
yi
nggr
ound,bur
row pi
tsorexcav
ati
ons
wi
tht
hei
deaoff
il
li
ngi
tupsani
tar
ytor
ecl
aimi
t.Thusmaki
ngusel
ess
l
andusef
ulagai
nforsomepur
poses.
2.I
nci
ner
ati
on:I
tisamet
hod’ofr
efusedi
sposalwher
ebyt
her
efuse
t
obedi
sposedorbur
nti
sfi
rstsor
tedoutanddr
iedonconcr
ete
pl
atf
orms;
thent
ins,
irons,
brokenbot
tl
es,
etc.ar
eremov
edandbur
ied,
whi
l
ethel
eftov
eri
ssani
tar
il
ybur
nti
nthei
nci
ner
ati
on.Thesy
stem
oper
atesbyl
oadi
ngt
hedr
iedr
efusei
ntot
hei
nci
ner
atorandf
ir
eisset
t
obur
ndownt
her
efusei
nthei
nci
ner
ator
.Vi
z:Barl
ess,openbar
,
baul
l
ewandbeehi
vear
ethef
ourt
ypesofi
nci
ner
ator
s.
3.Hogf
eedi
ng:I
tisamet
hodofr
efusedi
sposali
nwhi
chgar
bagei
s
ut
il
izedashogf
eedt
ofeedpi
gsorswi
ne.
4.Compost
ing:I
tisamet
hodwhi
chi
nvol
vesmi
xi
ngofhousehol
d
r
efuseandni
ghtsoi
l(excr
ete)wi
tht
heobj
ectofpr
ovi
dingmanur
e.
Sol
i
dwast
e(dr
yref
use)ar
emi
xedupwi
thexcr
eteandt
henl
oadedi
n
chamber
swhi
char
erect
angul
ari
nshape,measur
ing120cm deep,
180cm wi
deand600cm l
ong
5.Phy
ll
is’
s met
hod:Thi
sist
he met
hod ofsol
i
d wast
e di
sposal
wher
ebyr
efusei
sheat
edi
ntheabsenceofai
rtopr
oducegas,
oiland
coall
i
ker
esi
due.Thi
sisanew met
hodofr
efusedi
sposal
,whi
chi
s
bei
ngt
est
edt
oseei
fitcanbepr
act
ical
onal
argescal
e.
6.Pul
ver
izat
ion:Thi
sist
he met
hod t
hati
s most
ly pr
act
iced i
n
adv
ancedcount
ri
esandi
tinv
olv
esr
educi
ngt
hequant
it
yofr
efusei
nto
dustorf
inepowderandi
tisdonebyt
heusei
fspeci
almechani
cal
pl
ant
s.
7.Cr
udeTi
ppi
ngorOpenDumpi
ng:Thi
sisdonebydumpi
ngr
efusei
n
openl
andort
hrowi
ngt
her
efusei
ntoascr
ipt
ingpi
toropenspacei
na
di
sor
der
lymanner
.Dumpi
ngoft
hiski
ndr
equi
renoorl
i
ttl
epl
anni
ng
mi
dmai
ntenanceandunski
l
ledper
sonnel
8.Py
rol
ysi
s:Thi
sisanot
hermet
hodofwast
edi
sposalbywhi
chr
efuse
i
sneat
edi
ntheabsenceofai
rtopr
oducegas,
oil
andcoal
li
ker
esi
due.
Themet
hodr
educesr
efusei
ntogas,oi
landcoall
i
kemat
eri
als.The
met
hodi
sver
ycost
ly.

1c.PREVENTI
VEMEASURESOFI
NDUSTRI
ALACCI
DENT
1.Pr
ovi
sionofpr
otect
iveequi
pmentanddev
ices
2.I
ndust
ri
alHeal
theducat
iononacci
dent
sandsaf
etyst
rat
egi
es
3.Pr
e-empl
oymentandper
iodi
cmedi
cal
exami
nat
ions2c.
4.Regul
arsuper
visi
on and i
nspect
ion off
act
ory ment
alheal
th
i
mpl
i
cat
ionofoccupat
ions
5.Or
gani
zer
esour
cesandf
aci
l
iti
esf
ort
rai
ningont
hej
ob
6.Ensur
eadequat
eli
ght
ing
7.Ensur
eadequat
event
il
ati
on
8.Goodhousekeepi
ng
9.Pr
opermai
ntenanceandr
epl
acementoff
aul
tymachi
nes3a.
10.Ensur
emot
ivat
ionandgoodhumanr
elat
ionshi
patpl
acesatwor
k
t
oreducest
ressandal
cohol
i
sm
11.Anadequat
eor
gani
zat
ionofsaf
etyandoper
ati
onalmeasur
esof
pol
i
cyf
oreachpl
antandi
ndust
ry.
12.Mai
ntenanceofacci
dentr
ecor
ds,i
njur
iesanddeat
hforf
utur
e
pl
anni
ng
13.Pr
oper const
ruct
ion and desi
gn of f
act
ory wi
th adequat
e
t
emper
atur
eandv
ent
il
ati
on
2a.MEDI
CAL/
OBSTERI
CCAUSESOFMATERNALMORTALI
TY
i
.Unsaf
eabor
ti
on
i
i
.Pr
olonged!Obst
ruct
edl
abour
i
i
i.Haemor
rhage
i
v.Peuper
alsepsi
s
v
.Hy
eper
tensi
vedi
sor
deri
npr
egnancy
v
i.Anaemi
a4a.
v
ii
.Post
-par
tum depr
essi
on
v
ii
i.Pr
egnancyr
elat
edi
nfect
ions
2b.Ty
pesofAbor
ti
on
a.Habi
tualorRecur
rentAbor
ti
on:Thet
erm habi
tualabor
ti
oni
sused
when a pat
ienthas had t
hree ormor
e consecut
ive spont
aneous
abor
ti
on.Of
tent
hecauseofsuchabor
ti
onsi
snotknown.
b.Mi
ssed Abor
ti
on:Thet
erm i
sused when t
hef
oet
usdi
esand
r
etai
nedi
ntheut
erus subsequent
ly,t
hesi
gnsi
fthr
eat
enedabor
ti
on
subsi
deex
ceptf
orsomebr
owni
sh di
schar
gewhi
chi
snotassoci
ated
wi
thpai
n.Theut
erusandt
hebr
east
sfai
ltogr
ow.
c.I
nev
itabl
eAbor
ti
on:I
nthi
sease,t
hepr
egnancycannotbesav
ed
becauseagood posi
ti
onoft
hepl
acent
ahas’beendet
achedandt
he
cer
vical
isdi
l
ati
ng.Thev
agi
nalbl
eedi
ngi
ssev
ereandsomecl
otsmay
ev
enbepassed.
d.Ther
apeut
icAbor
ti
on:I
tisev
acuat
ionoft
heut
erusdonebya
qual
i
fiedmedi
calpr
act
it
ioneri
nthei
nter
estoft
hemot
her
’sl
i
feorher
t
otalwel
l
-bei
ng.The i
ndi
cat
ions ar
e usual
l
y medi
calcondi
ti
ons
t
hreat
eni
ng t
he mot
her
’sl
i
fe or l
i
kel
yto cause gr
oss f
oet
al
abnor
mal
i
ties
e.Cr
imi
nalAbor
ti
on:I
tisanabor
ti
ont
hati
sil
l
egal
l
ypr
ocur
ed.Such
abor
ti
oni
sof
tendonebyunqual
i
fiedper
sonshav
ingl
i
ttl
eregar
dfor
t
he consequences.Ri
sks ofsepsi
s,ut
eri
ne per
for
ati
ons,cer
vical
l
acer
ati
onandhaemor
rhagear
eassoci
atedwi
thcr
imi
nalabor
ti
on.
Ot
herdanger
sar
esuddendeat
handacut
e-r
enal
fai
l
ure.
f
.Sept
icAbor
ti
on:I
tisusual
l
yasequelbfi
ncompl
eteabor
ti
on,of
ten
cr
imi
nal
l
yinduced.Thepat
ienti
susual
l
yanaemi
c.i
l
lwi
thahi
gh
t
emper
atur
e,r
api
dpul
se,headache,v
omi
ti
ngandl
owerabdomi
nal
pai
n.Thel
ochi
aar
epr
ofuseandof
fensi
ve.
2c.SI
GNSANDSYMPTOMSOFECTOPI
CPREGNANCY
i
. Nauseaandbr
eastsor
eness
i
i
. Shar
pwav
esofpai
nint
heabdomen,
pel
vi
s,shoul
derorneck
i
i
i. Sev
erepai
nthatoccur
sononesi
deoft
heabdomen
i
v. Li
ghtt
oheav
yvagi
nal
spot
ti
ngorbl
eedi
ng
v
. Di
zzi
nessorf
aint
ing
v
i. Rect
alpr
essur
e
3a.COMPONENTSOFSCHOOLHEALTHSERVI
CES
i
. School
Heal
thEducat
ion
i
i
.ii
.Heal
thf
ulSchool
li
vi
ng
i
i
i. School
heal
thcar
eser
vices
i
v. School
HomeandCommuni
ty
v
. b.NeedsofNewbor
n
v
i. Cl
ear
ingt
heai
rwayt
oav
oidai
rwayobst
ruct
ion
v
ii
. Assesst
heApgarScor
ing
v
ii
i. Pr
ovi
sionofwar
mth
i
x. Car
eoft
hecor
d
x. Car
eoft
heey
es
xi
. Car
eoft
heski
n
xi
i
. Mai
ntenanceofbodyt
emper
atur
etoav
oidhy
pot
her
mia
xi
i
i. Br
eastf
eedi
ng
4a.
NEUROSI
S PSYCHOSI
S
1.Mi
norment
ali
i
lne,
s Maj
orment
ali
l
lness
2.Hasi
nsi
ght
Lackofi
nsi
ght
3.Nohal
l
uci
nat
ion
4.Nodel
usj
on Pr
esenceofhal
l
uci
nat
ion
5.Per
sonal
i
tyi
sint
act Ther
eisdel
usi
on
6.Nodi
sor
ient
ati
onof
Per
sonal
i
tyi
snoti
ntact
t
ime,
placeandper
son
7.Appear
ancei
sfai
r Ther
eis di
sor
ient
ati
on oft
ime,
8.Thoughti
sint
act
9.Speechi
sfai
r
10.Moodi
sfai
r
 pl
aceandper
son

Appear
ancei
sroughanddi
rt
y
Thoughti
sdi
sor
der
ed
Ther
eisf
li
ghtofi
deas
Moodchangest
otal
l
y
Ther
eis‘
i
ll
usi
on
Ther
eisechol
ali
a

Ther
eisechopr
axi
a

4b.FI
RST(
1ST)DEGREEBURNS
Her
e,damagei
s1i
mit
dtot
heepi
der
mis(
i.
e.t
heout
erl
ayeroft
he
ski
n).
>Ther
eisr
edness,
tender
ness,
pai
n,heatandswel
l
ingoft
heaf
fect
ed
si
te
>Ther
eispai
n
SECOND(
2ND)DEGREEBURNS
•Thi
saf
fect
sbot
htheepi
der
mis(
out
er)andder
mis(
secondl
ayer
)of
t
heski
n
•Bot
hepi
der
misandder
misar
edest
roy
ed
•Ner
veendi
ngar
edest
roy
ed
•I
tisassoci
atedwi
thpai
n
THI
RD(
3RD)DEGREEBURNS
•Ful
lthi
cknessoft
heski
nloss
•Lookswaxyandbl
acken
•Pai
nless
4c.
i
.Fl
amesf
rom t
hef
ir
e
i
i
.Hotmet
als
i
i
i.El
ect
ri
corgasf
ir
esorcani
ngi
ncont
actwi
thl
i
veel
ect
ri
cwi
res
i
v.Li
ght
ing
v
.Fr
ict
ion
v
i.St
rongaci
dse.
g.HCL(
Hydr
ochl
ori
caci
d)andLy
sol
5a.i
.My
cobact
eri
um t
uber
cul
osi
s
I
tismai
nlycont
ract
edbydr
opl
eti
nfect
iont
hroughcoughi
ng,
spi
tt
ingandsneezi
ngbypat
ient
swi
thact
ivet
uber
cul
osi
sC
I
tcanal
sobecont
ract
edbyhandl
i
ngobj
ect
scont
ami
nat
edwi
th
t
hesal
i
vaorsput
um ofpat
ient
s.
I
tcanbet
ransmi
tt
edf
rom ani
mal
stohumansv
iacont
actwi
th
i
nfect
edani
mal
sort
hei
rpr
oduct
s
i
ii
.SI
GNSANDSYMPTOMS
•Per
sist
entcoughl
ast
ing3ormor
eweeks6b
•Somet
imesbl
oodst
ainedsput
um
•Chestpai
n;haemopt
ysi
s,hoar
senessandshor
tnessofbr
eat
h
•Lossofwei
ght
,fat
igue,
fev
erandgener
almal
aise
i
v.PREVENTI
ONANDCONTROL
 Massv
acci
nat
ionwi
thBCG
 Casef
indi
ngf
ornewpat
ient
 Tr
eat
mentofknowncases,
cont
actt
raci
ng
 Heal
thEducat
ion
 Pr
event
ionofmal
nut
ri
ti
onespeci
all
yinchi
l
dren
I
mpr
ovementofsoci
alcondi
ti
one.
g.ov
ercr
owdi
ng
 Forcont
act
sandi
nact
ivecases,
treatwi
thi
soni
azi
d
 BCGr
acci
nat
ionf
ort
heunaf
fect
ed
 Past
uri
sat
ionofmi
l
kandt
est
ingofdi
arycat
tl
e
b.
Car
dio-
vascul
ardi
sease(
CVD)Si
n
•Cancer
s
•Chr
oni
cRespi
rat
oryDi
sease(
CRD)
•Renal
diseases
•Di
abet
esmel
l
itus
6a.i
.GLAUCOMA:I
sacondi
ti
onoft
heey
ethatcausesdamaget
o
y
ourey
e’sopt
icner
veandgetwor
seov
ert
ime.I
tresul
tsf
rom t
heey
e
f
lui
dpr
essur
einsi
det
heey
e,nor
mal
l
ythef
lui
dcal
l
edAqueoushumour
f
lowsoutoft
heey
ethr
oughameshl
i
kechannel
.Ift
hischannelget
s
bl
ocked,t
hel
i
qui
d bui
l
d up t
hati
swhatcausesgl
aucor
ue.Ot
her
causesi
ncl
ude:
•Abl
unti
njur
ytoy
ourey
e
•
Traunat
otheey
e
•Sev
ereey
einf
ect
ion
•Enl
argecat
aract
s
•I
ntr
aocul
arhumor
i
i.CATARACT:Acat
aracti
sacl
oudi
ngoft
hel
ensi
ntheey
ewhi
ch
l
eadst
odecr
easei
nvi
sion
SYMPTOMSOFCATARACT
•Fadedcol
our
s
•Bl
urr
ingv
isi
on
•Hal
osar
oundt
heni
ght
Poorv
isi
oncausedbycat
aract
smayal
sor
esul
tinani
ncr
easedr
iskof
f
all
i
nganddepr
essi
on.Cat
aract
sar
ethecauseofhal
fofbl
i
ndness
and33%ofv
isual
impai
rmentwor
ldwi
de
i
ii
.STYE(
HORDELUM)
:Iti
sabact
eri
ali
nfect
ionofanoi
lgl
andi
nthe
ey
eli
d.Thi
sresul
tsi
nar
edt
enderbumpatt
heedgeoft
heey
eli
d.The
out
sideort
hei
nsi
deoft
heey
eli
dcar
tbeaf
fect
ed
i
v.TR.
ACHOMA:I
tisan i
nfect
iousdi
sease caused bybact
eri
um
chl
amy
di4t
rachor
nat
is.Thei
nfect
ion causesar
ougheni
ng oft
he
i
nnersur
faceoft
heey
eli
ds.Thi
srougheni
ngcanl
eadt
opai
nint
he
ey
es,br
eakdownoft
heout
ersur
faceorcor
neaoft
heey
esand
ev
ent
ual
bli
ndness
v
.PTRYGI
UM:I
tisal
soknownassur
fer
’sey
e.Themai
nsy
mpt
omsi
s
agr
owt
hofpi
nk,
fleshyt
issueont
heconj
unct
iva.Somept
ery
giagr
ow
sl
owl
ythr
oughoutaper
son’
sli
fe,whi
l
eot
her
sgr
owi
ngaf
teracer
tai
n
poi
nt.Pt
ery
giaar
emor
ecommoni
nsunnycl
i
mat
esandi
nthe20-
40
agegr
oup.I
tisapi
nki
sh,t
ri
angul
ar-
shaped t
issuegr
owt
hont
he
cor
nea
6b-Fi
rstAi
d Car
eyouwi
llgi
vet
o a10 y
earol
d boywi
thnose
bl
eedi
ng.
-Bl
eedi
ngf
rom t
henoseduet
oanycausewhi
chcoul
dbel
ocalor
sy
stemat
ic
-Makehi
mtosi
tcomf
ort
abl
y
-Expl
aint
hepr
ocedur
etohi
m
-Gent
lyputt
empor
arypr
essur
eov
ert
heal
aebypi
nchi
ngt
henose
whi
l
ethepat
ientsi
tsupr
ight
-Tel
lhi
mtoopent
hemout
htobr
eat
h
-I
nst
ructhi
mtospi
tanysecr
eti
ont
hatmayconi
ctot
hebackoft
he
nosei
ntoar
ecei
ver
-Pl
acei
ce-
cubesi
nsi
det
hegauzeandpl
aceov
erehbr
idgeoft
he
nosei
nanat
temptt
o’const
ri
ctt
hebl
eedi
ngv
essel
s
-Thi
smet
hodi
sdonef
or10mi
nut
es
-Usual
l
ymi
l
dbl
eedwi
l
lst
opaf
tert
hispr
ocedur
e
6c
Deaf
ness
Ot
it
isMedi
a
Si
nusi
ti
s
Rhi
nit
is‘
‘
Epi
staxi
s4
Lar
yngi
ti
s
Tonsi
l
iti
s
Phar
yngi
ti
s
Tonsi
l
o—phar
yngi
ti
s
7a.MEDI
ALCLASSI
FICATI
ONI
NUSEFORTHEAGED
-El
der
lyf
it
:Thoset
hatar
eabl
etomanaget
hei
rli
vesont
hei
rown
-El
der
lyi
nfi
rm:Those‘
wit
hsomephy
sicaldef
ect
spr
event
ingt
hem
f
rom managi
ngt
hei
rli
vesont
hei
rown
-El
der
lysi
ck:Thoseneedi
nghospi
tal
i
zat
ionf
rom ai
l
ment
spr
event
ing
f
rom managi
ngt
hei
rli
veswi
thoutanyhel
p
-El
der
lypsy
chi
atr
ic:Thosewi
thment
alpr
obl
emsandi
ncapabl
eof
bei
ngont
hei
rown
-Speci
algr
oup:Thi
sref
erst
otheel
der
lywhohav
esomedi
sabi
l
iti
es
suchasbei
ngbl
i
ndanddeafamongot
her
s
b.MEASURESFORREHABI
LITATI
NGTHEHANDI
CAPPED
•Recogni
zi
ng and t
aki
ng appr
opr
iat
e act
ions on env
ironment
al
hazar
dsasappl
i
cabl
etot
hedi
sabl
edper
sone.
g.wel
l
s,pool
sofwat
er,
pot
hol
es,
openf
if
e,et
c.
•Teachi
ngandwor
kingwi
thf
ami
l
iesoft
hehandi
cappedont
hecar
e
andr
ehabi
l
itat
ionofdi
sabl
edper
sonst
obei
ndependentandsel
f-
r
eli
ant
•Keepi
ngar
egi
sterofnames,
ages,
addr
essandact
ivi
ti
esofdi
sabl
ed
per
sonsi
nthecommuni
tydev
elopmentcommi
tt
eewor
kshopsf
ort
he
handi
cappedi
nthecommuni
ty
c.I
DENTI
FICATI
ONOFACHI
LDWI
THDI
FFI
CULTYI
NHEARI
NG
1.Notr
espondi
ngt
oorconf
usi
ngv
erbal
dir
ect
ions
2.Showi
ng no sur
pri
seorbei
ng st
art
led i
n si
tuat
ionst
hatwoul
d
nor
mal
l
yev
okesuchr
esponse
3.Rubbi
ngt
heear
sfr
equent
lyort
urni
ngt
heheadi
nonedi
rect
ionasi
f
t
ryi
ngt
olocat
easound
4.Compl
aini
ngofar
ingi
ngbuzzi
ngsoundi
ntheear
,
5.Notr
espondi
ngwhencal
l
edf
rom adi
stance
6.Request
ingaper
sonspeaki
ngt
ohi
mtor
epeatwhathehassai
d;or
bei
ngsl
owi
nanswer
ingasi
mpl
equest
ion
7.Compl
aini
ngofdi
schar
gef
rom t
heear
8.Fl
owi
ngorbendi
ngf
orwar
dinor
dert
ohearorunder
standwhati
s
sai
dtohi
m
9.Gazi
ngatt
hel
i
psofaper
sonspeaki
ngt
ohi
m i
nst
eadoft
he
per
son’
sey
e
10.Mi
sar
ti
cul
ati
ngsi
mpl
ewor
ds
11.Compl
aini
ngt
hatanor
mal
soundornoi
sei
stool
oud
12.Av
oidi
ngsi
tuat
ionst
hatmayr
equi
rehi
mtol
i
stenort
alk
13.Speaki
ngi
nabnor
mal
l
ylow,
highorl
oudv
oice
14.Maki
ng ar
esponseonl
ywhenheseest
hespeaker
’sf
aceor
gest
ure

COMMUNI
TYHEALTHEXTENSI
ONWORKERS
PAPERI
ESSAY
(
a)Def
inet
hef
oll
owi
ngt
erms:
i
.Et
hics.
I
sasy
stem (
awr
it
tendocumentorr
ules)obser
vedwi
thav
eryhi
gh
st
andar
dofr
espect(
byapr
ofessi
on)whi
chgui
desandcont
rol
sthe
mor
albehav
iour
sandmani
fest
sint
hechar
act
erandmi
nd.
i
i.Et
iquet
te.
Meanscodeofmanner
s,behav
iorandact
ionswhi
char
eexpect
edof
a pr
ofessi
onalundercer
tai
n condi
ti
ons /ci
rcumst
ances and ar
e
obser
vedbyal
li
nthepr
ofessi
on.
i
ii
.Pr
ofessi
onalEt
hics. (
3mar
ks)
Ar
easetofr
ules,codeofconduct
sgov
erni
ngt
hegoodpr
act
iceof
communi
tyheal
thpr
ofessi
oni
nNi
ger
ia.
(
b)Li
stsev
en(
7)f
unct
ionsoft
heCommuni
tyHeal
thPr
act
it
ioner
s
Regi
str
ati
onBoar
dofNi
ger
ia(
CHPRBN)
.
(
7mar
ks)
a.Det
ermi
ningwhatst
andar
d,knowl
edgeandski
l
lar
etobeat
tai
ned
byaper
sonseeki
ngt
obecomemember
soft
hecommuni
tyheal
th
andi
mpr
ovi
ngt
hosest
andar
dsf
rom t
imet
oti
measci
rcumst
ances
mayper
mit
.
b.Theest
abl
i
shmentandmai
ntenanceof
’ar
egi
sterofper
sonsas
memberoft
hepr
ofessi
on.
c.Conduct
ingexami
nat
ionsi
nthepr
ofessi
onandawar
dingcer
ti
fi
cat
e
t
osuccessf
ulcandi
dat
esasappr
opr
iat
e.
d.I
ndexi
ngt
rai
neesf
orv
ari
ousCommuni
tyHeal
thcour
se.
e.I
nspect
ionofschool
sandi
nst
it
uti
onswher
eCommuni
tyHeal
th
Pr
act
it
ioner
sar
etr
ained.
f
.Accr
edi
tat
ionofschool
sandCommuni
tyHeal
thCour
sesi
ntr
aini
ng
i
nst
it
uti
ons.
g. Dev
elopment of t
rai
ning cur
ri
cul
a f
or Communi
ty Heal
th
Pr
act
it
ioner
s.
h.Pr
int
ingandsal
esofSt
andi
ngOr
der
s,Cur
ri
cul
um andot
herr
elev
ant
publ
i
cat
ions.
i
.Or
gani
seandconductst
udi
es,semi
nar
sandwor
kshopst
oupgr
ade
knowl
edgeandski
l
lsofpr
act
it
ioner
s.
j
.Regul
ati
onoft
hepr
ofessi
onal
conduct
.
k.Mai
ntenanceofdi
sci
pli
neamongmember
soft
hepr
ofessi
on.
2.(
a)Whati
sHeal
thEducat
ion? (
1
mar
k)
Heal
th educat
ion adopt
ed byWHO i
s concer
ned wi
th char
ges i
n
knowl
edge,f
eel
i
ngs and behav
ioroft
he peopl
e and such heal
th
pr
act
icesar
ebel
i
evedt
obr
ingaboutt
hebestpossi
blest
atesofwel
l
-
bei
ng.I
tgoali
stoenabl
epeopl
etopr
act
iceheal
thbehav
iori
naway
t
hati
scul
tur
all
yaccept
abl
e.
OR
Heal
th educat
ion i
stheactorsci
enceofgi
vi
ng si
mpl
eaccur
ate
sci
ent
if
ici
nfor
mat
ioni
nawayt
hati
twi
l
lbeunder
stood,accept
ed,
bel
i
evedandputi
ntopr
act
ice.
OR
I
sapr
ocessofhel
ping i
ndi
vi
dual
sand gr
oup orcommuni
ti
est
o
acqui
rer
elev
antknowl
edgeandski
l
lsonheal
thi
nsuchawayt
hat
t
heyv
olunt
ari
l
yadaptt
oposi
ti
vechangei
nbehav
iorwhi
chaf
fectt
hei
r
heal
th.
OR
I
sapr
ocessbywhi
chheal
thi
nfor
mat
ioni
ssuccessf
ull
yimpar
tedi
n
such a wayt
hatt
he r
eci
pienti
s mot
ivat
ed t
o make use oft
he
i
nfor
mat
ion f
or t
he pr
omot
ion,pr
otect
ion and mai
ntenance or
r
est
orat
ionofaf
ami
l
yorcommuni
tyheal
th.
(
b)Out
li
nef
ive(
5)qual
it
iesofaGoodHeal
thEducat
or.
(
5mar
ks)
 Musthav
efactand adequat
eknowl
edgeofheal
thi
ssuesi
n
quest
ion.
 Musthav
egoodcommuni
cat
ionski
l
ls
 Mustbeabl
etosendhi
s/hermessageacr
osst
otheaudi
encev
ia
massmedi
aori
nter
-per
sonal
communi
cat
ion.
 Mustunder
standcul
tur
alpat
ter
nsornor
msoft
hecommuni
ty
andr
elat
etot
hepeopl
eusatt
hei
rownl
evel
.
 Mustbeagoodandsy
mpat
het
icl
i
stener
.
 Shoul
dbeabl
etocr
eat
eawar
enessandencour
agepeopl
eto
changebehav
iour
stowar
dsheal
th
 Shoul
dknowhowt
omot
ivat
epeopl
eandbr
ingaboutbehav
iour
al
change.
 Mustbepat
ientandt
oler
ant
.
 Musthav
etheabi
l
ityt
oev
aluat
ethr
oughaski
ngquest
ionsand
al
l
owi
ngcl
i
ent
s/pat
ient
stogi
veaf
eedback
 Hav
etheabi
l
ityt
ochooset
her
ightt
opi
cfort
het
argetgr
oup.
 Shoul
dbecheer
ful
andneat‘
i
nappear
anceex
 Mustnotbeboast
ful
butsi
mpl
e.
(
c)Di
scussei
ght(
8)Bar
ri
erst
oGoodCommuni
cat
ion.
(
4mar
ks)
1.Per
sonal
i
ty-(
e.g.host
il
eper
sonal
i
ty,
etc.
)ad:
2.Soci
o-economi
cdi
ff
erence.
3.I
nadequat
eknowl
edgeoft
het
opi
c.
4.Poorl
i
steni
ng
5.Noi
se—(
i.
e.Noi
syenv
ironment
,di
str
act
ion,
etc.
)
6.Di
ff
erencei
nat
ti
tudeandper
cept
ion
7.Emot
ions.
8.Ageandsexdi
ff
erences,
3.(
a)Def
ineAdv
ocacy
. (
1mar
k)
Adv
ocacyi
sapr
ocessofcr
eat
ingawar
enessamongpol
i
cymaker
s
concer
ninganyheal
thmat
teri
nor
dert
ogett
hei
rsuppor
t.
Apr
ocessofsensi
ti
zi
ngwi
thsubsequentf
oll
ow upofpol
i
cymaker
s
t
oar
ouset
hei
rint
erestandcommi
tmenti
nPHCpr
ogr
amme.
OR
(
b)AsaCHEW,expl
aint
hei
mpor
tanceofAdv
ocacyt
o anewl
y
post
edJCHEW t
oyourHeal
thFaci
li
ty.
(
4mar
ks)
I
tadv
ancescommuni
tyheal
thpol
i
cies
I
tshapest
hedebat
eoncommuni
tyheal
thi
ssuesi
\.
I
tset
stheagendaonheal
thi
ssues.
I
tempower
sthecommuni
tyt
ospeakf
ori
tsel
fabouti
tsheal
th
pr
obl
ems.
 Af
easi
blesol
uti
oni
sachi
eved
I
tbui
l
dsCommuni
tyagr
eementt
hatani
ssuei
sapr
ior
it
yfor
act
ionandt
hatt
hepr
oposedsol
uti
onsar
eaccept
abl
e.
(
e)St
atef
ive(
5)Focalper
sons/
groupsf
orsuccessf
ulAdv
ocacy
(
5mar
ks)
1.Thechai
rmanofal
ocal
gov
ernmentcounci
l
.
2.Thecounci
l
’ssecr
etar
y
3.Thev
il
lagehead/
clanhead
4.Thesuper
visorf
orheal
th.6
5.Thel
ocal
gov
ernmentpr
imar
yheal
thcar
eco-
ordi
nat
or
6.Thel
ocal
areapr
imar
yheal
thcar
ecommi
tt
ee.
7.Di
str
ictheadorheadofat
radi
ti
onal
counci
l
8.Rel
i
giousl
eader
s.
9.Womenl
eader
s
10.Yout
hs.
4.a)Whati
sDr
ug? (
1nar
k)
Dr
ugi
ncl
udesanysubst
ancesormi
xtur
eofsubst
ancesmanuf
act
ured,
sol
doradv
ert
izedf
orusei
nthedi
agnosi
s,t
reat
ment
,mi
ti
gat
ionor
pr
event
ionofanydi
seasedi
sor
der
,abnor
malphy
sicalst
ate,ort
he
sy
mpt
omst
her
eof
,inmoni
tor
ingani
mal
s.
OR
Dr
ugi
samedi
cineorot
hersubst
anceswhi
chhasaphy
siol
ogi
cal
ef
fectwheni
ngest
edorot
her
wisei
ntr
oducedi
ntot
hebody
.
OR
Adr
ugi
sachemi
calsubst
ancewhi
chwhent
akenorgi
veni
nther
ight
quant
it
y ori
n appr
opr
iat
e dosage f
orms,al
l
evi
ate suf
fer
ing and
i
mpr
ovest
heheal
thandgener
alwel
l
-bei
ngoft
her
eci
pient
.
(
b)Expl
aint
he di
ff
erence bet
ween Pr
escr
ipt
ive Dr
ugs and Non-
pr
escr
ipt
iveDr
ugsgi
vi
ngexampl
eofeach.(
5mar
ks)
Pr
escr
ipt
ivedr
ugsar
edr
ugst
hatar
enotsaf
eforusewi
thoutmedi
cal
super
visi
on.Theyar
e onl
ydi
spensed byt
he or
derofa l
i
censed
medi
calpr
act
it
ionerwho i
s al
l
owed by l
aw t
o admi
nist
ert
hem.
Exampl
e—Lexot
an,
Val
i
um
Non-
prescr
ipt
ivedr
ugsar
edr
ugssol
dov
ert
hecount
erduet
othef
act
t
hatt
heycanbsol
dorsaf
elyusewi
thoutmedi
calsuper
visi
onor
di
rect
ion.Exampl
es—Fol
i
caci
d,Mul
ti
vi
te.
(
c)I
dent
if
ythedr
ugsl
i
stedi
ntabl
ebel
owbyt
hei
rGener
icNames:
BRANDName GENERI
CNames
 Phensi
c,Caf
enol
,
Aspr
in Acet
ysal
i
cyl
i
caci
d
 •Panadol
,Chemadel Par
acet
arnol
 •Val
i
um Di
azepam
 •Fl
agy
l Met
roni
dazol
e
 •Pi
ri
ton- Chl
orpher
nami
ne
 •Combant
ri
n Py
rant
el
 Sept
ri
n Co-
tr
imoxazol
e
.
Vit
ami
nC Ascor
bicAci
d
5.(
a)St
atef
ive(
5)r
easonsf
orRef
err
al. (
2 ½
mar
ks)
i
. Onpat
ientr
equest
 i
i
. Whenpat
ientcondi
ti
oni
srapi
dlyget
ti
ngwor
se
i
i
i. Wheni
ndi
cat
edbyt
hest
andi
ngor
der
i
v. Pat
ientcondi
ti
onnotr
espondi
ngt
otr
eat
ment
.
v
. Whenheal
thwor
keri
sindoubtofcasei
nvi
ew.
v
i. Whenheal
thwor
keri
sindoubtofcasei
nvi
ew
v
ii
. Forspeci
ali
st/
sophi
sti
cat
edmanagement
.
v
ii
i. Whent
her
eisnof
aci
l
ityandequi
pmentt
omanaget
hecase.
i
x. Condi
ti
onnotcov
eredbyt
hest
andi
ngor
der
x. Forcont
inui
tyofcar
e
xi
. Fordi
agnost
icpur
poses
(
b)Enumer
atef
ive(
5)const
rai
ntst
oRef
err
al (
2½
mar
ks)
-Poort
ranspor
tat
ion
-Lackoff
undf
rom t
hepat
ient
’send
-Ther
e maybe nepot
ism,egocent
ri
sm,f
avour
it
ism t
reat
mentf
or
r
elat
ivesr
athert
hant
hosewhoneedi
t
-Non-
accept
anceathi
gherl
evel
-Nof
eedbackf
rom hi
gherl
evel
/aut
hor
it
y
- Unwi
l
li
ngness of pat
ient
/rel
ati
ves t
o l
eav
e one’
s secur
ed
env
ironment
-I
nadequat
epr
epar
ati
onofhospi
tal
phy
sici
anf
orr
efer
ral
technol
ogy
-I
nthehi
gherl
evel
,thecapaci
tyt
otakeal
lref
err
edcasesmaynotbe
adequat
e.
(
c)Li
stt
en(
10)di
seasecondi
ti
onst
hataCHEW wi
llr
efer
.
(
5mar
ks)
i
.Acut
eappendi
cit
is
i
i
.Int
est
inal
obst
ruct
ion
i
i
i.St
rangul
atedher
nia
i
v.Acci
dentofal
lty
pe
v
.Chr
oni
cdi
seasee.
g.t
uber
cul
osi
s
v
i.Obst
etr
icEmer
gencycondi
ti
one.
g.Ant
e-par
tum hemor
rhage,post
-
par
tum
v
ii
.Sev
erebur
nsi
.e.2nd&3r
ddegr
ee
v
ii
i.Obst
ruct
edl
abour
i
x.Acut
eAst
hma
x.Cer
tai
ncondi
ti
one.
g.Di
abet
esmel
l
itus
xi
.Renal
fai
l
ure
xi
i
.Ment
aldi
sor
der
xi
i
i.Cancer
xi
v.Psy
chosi
s
xv
.Heal
thpr
obl
ems
6.a)AsaCHEW,enumer
atef
ive(
5)f
unct
ionseachofy
ourCl
ini
c
basedandCommuni
tyBasedf
unct
ions.
(
5mar
ks)
CLI
NICBASEDFUNCTI
ONSOFCHEW
1.Pr
ovi
dei
ntegr
atedpr
ir
r1ar
yHeal
thcar
eser
vices
2.Or
gani
zeandr
uni
ntegr
atedpr
imar
yheal
thcar
eser
viceswher
e
communi
tyheal
thof
fi
ceri
snotav
ail
abl
e.
3.Col
l
ectandcol
l
atemoni
tor
ingandev
aluat
iondat
afort
henat
ional
heal
thmanagementi
nfor
mat
ionsy
stem (
NHMI
S)f
rom t
hecommuni
ty
andheal
thf
aci
l
ityandf
orwar
dtot
hewar
dlev
el.
4.Car
ryoutwi
thcommuni
tyheal
thof
fi
cer(
wher
eav
ail
abl
e)t
heday
-to
dayadmi
nist
rat
ionofheal
thser
vicesi
nthet
argetpopul
ati
on.
5.I
mmuni
zat
ionser
vices.
6.Managel
ogi
sti
csandcol
dchai
nsy
stem
7.Tr
eatcommoncondi
ti
onusi
ngt
heSt
andi
ngor
der
s
8.Car
ryoutst
eri
l
izat
ionofequi
pment
9.Pr
omot
ement
alanddent
alheal
th
10.Per
for
m si
mpl
elabor
ator
yteste.
g.haemogl
obi
nest
imat
ion,st
ool
andur
inet
est
ing,
etc.

COMMUNI
TYBASEDFUNCTI
ONSOFCHEW
1.Expl
aint
othecommuni
tyt
hepr
imar
yheal
thcar
eappr
oachoft
he
Ni
ger
ianheal
thsy
stem andhi
srol
easamemberoft
heheal
tht
eam t
o
l
i
nkt
hecommuni
tywi
thheal
thcar
esy
stem.
2.Car
ryoutcommuni
tymobi
l
izat
ionf
orheal
thact
ion.
3.Fami
l
iar
izesel
fwi
tht
argetpopul
ati
onandheal
thser
viceswi
thi
nthe
communi
ty
4.I
nit
iat
ethef
ormat
ionandf
aci
l
itat
etheef
fect
ivef
unct
ioni
ngoft
he
dev
elopmentcommi
tt
ees.
5.At
tendcommuni
tyDev
elopmentcommi
tt
eesmeet
ingi
nrot
ati
onat
l
east2t
imesi
nay
ear
.
6.Par
ti
cipat
ein,andsuper
visepr
imar
yheal
thcar
ehousenumber
ing
andpl
acementofhome-
basedr
ecor
ds.
7.Teach t
he Juni
orcommuni
tyheal
th ext
ensi
on wor
ker
s si
mpl
e
met
hodsofdat
acol
l
ect
ionandanal
ysi
s.
8.Par
ti
cipat
eint
heanal
ysi
sofdat
acol
l
ect
ed.
(
b)Di
scussf
ive(
5)f
act
orst
hatcanaf
fectt
heheal
thofpeopl
eli
vi
ng
i
nal
ocalcommuni
ty.
1.Cul
tur
alf
act
ors:Cul
tur
eist
hewaypeopl
eli
vewhi
chhasev
olv
ed
ov
eral
ongper
iodoft
imeandgoesf
rom gener
ati
ont
ogener
ati
on.
Thecomponent
sorcul
tur
eandcust
om,bel
i
efsandpr
act
ices,t
aboos
andhabi
ts.Somecul
tur
esar
ebenef
ici
alwhi
l
eot
her
sar
ehar
mfult
o
heal
th.Har
mful
cul
tur
esshoul
dbedi
scour
age.
2.Soci
o-Economi
cFact
ors:Thi
sist
her
elat
ionshi
pofmanwi
thhi
s
env
ironmentandi
tembr
aces:
i
.pov
ert
y—l
owi
ncome
i
i
.educat
ion—l
i
ttl
eornoeducat
ioni
sver
ydanger
ous
3.I
gnor
ance—l
eadst
opoorhabi
ts
4.Poorcommuni
cat
ionnet
wor
k
5.Env
ironment
alf
act
orswhi
chi
ncl
udes:
i
.Ai
rpol
l
uti
on
i
i
.Inadequat
esaf
eorwhol
esomewat
ersuppl
y.
i
i
i.Thepr
esenceofwast
e—i
mpr
operdi
sposal
i
v.Poorr
oadnet
wor
k
v
.Inadequat
eexcr
etadi
sposal
.
6.Per
sonal
fact
orst
hataf
fectheal
thsuchas:
-Lackofper
sona]hy
giene
-Educat
ionl
evel
-At
ti
tudet
owar
dsheal
thsy
stem
-Awar
enessaboutheal
thmat
ter
s
-Genet
icorbi
ologi
cal
fact
ors.
7.Geogr
aphi
cal
fact
orsi
ncl
ude:
-Topogr
aphy
:nat
ureofsoi
l
,ri
ver
s,mount
ains,
etc.
-Deser
ts
-Weat
her
-Dr
aught
s
-Ear
thquakes
-Fl
oods,
etc.
7.(
a)Def
inet
het
erm St
ress.(
1mar
k)
St
ressi
syourbody
’swayofr
espondi
ngt
oanyki
ndofdemandor
t
hreat
.
OR
St
ressi
ssai
dtobeanyf
act
ort
hatt
hreat
enst
heheal
thoft
hebodyor
hasanadv
erseef
fectont
hef
unct
ioni
ng,suchasi
njur
y,di
seaseor
wor
ry.
Theexi
stenceofonef
orm ofst
resst
endst
odi
mini
shr
esi
stancet
o
anot
herf
orm.Const
antst
ressbr
ingsaboutchangesi
nthebal
anceof
hor
monesi
nthebody
.
(
b)Enumer
atef
our(
4)way
sani
ndi
vi
dualcancopewi
thSt
ress.
(
2mar
ks)
i
.Resol
veper
sonal
conf
li
ct
i
i
.Hav
eposi
ti
vebel
i
efsaboutl
i
fe
i
i
i.Hav
eadequat
esl
eepandr
est
i
v.Eatbal
anceddi
etwi
thpl
ent
yoff
rui
tsandv
eget
abl
es
v
.Acceptwhaty
oucannotchange
v
i.Ar
rangef
orhol
i
daywi
thy
ourwi
fe/
husband.
(
c)Li
stf
our(
4)commonDr
ugsAbusedbyy
out
hsi
nthecommuni
ty.
(
2mar
ks)
i
.Mar
ij
uana/I
ndi
ahemp
i
i
.Cocai
ne
i
i
i.Mor
phi
ne
i
v.Caf
fei
ne
v
.Anal
gesi
cs
v
i.Ant
ibi
oti
cs
v
ii
.Val
i
um /di
azepam
v
ii
i.Al
cohol
.
d)St
atet
hef
unct
ionsoft
heFami
lyasaSoci
alI
nst
it
uti
on.
(
3mar
ks)
i
.Iti
sthebasi
cuni
tofsoci
ali
zat
ion.
i
i
.Itpr
ovi
desmodeofbehav
iort
othey
oungones
i
i
i.I
tregul
atessexual
andpar
ent
albehav
ior
i
v.I
tpr
ovi
despr
oper
tyt
hatar
etobeshar
ed
v
.Itt
akescar
eofl
essunf
ort
unat
emember
s
v
i.I
tpr
ovi
desmeansofpr
opagat
ingf
ami
l
ynamest
ofut
uregener
ati
on
(
e)Di
sti
ngui
shbet
weenExt
endedandNucl
earFami
ly (
2mar
ks)
Ext
endedFami
l
y Nucl
earFami
l
y
I
tincl
udes a mar
ri
ed pai
rand Nucl
earf
ami
l
yisl
i
mit
edt
oa
t
hei
rof
fspr
ing. mar
ri
edpai
randt
hei
rchi
l
dren
I
tal
so i
ncl
udes one ormor
e
peopl
e
r
elat
edt
othosewhoar
eki
ns

COMMUNI
TYHEALTHEXTENSI
ONWORKERS(
CHEW)2
PAPERI
I
SECTI
ONB:ESSAYQUESTI
ONS
1.(
a)Whati
sanadequat
eDi
et? (
1
mar
k)
Anadequat
edi
eti
sadi
etwhi
chmeet
sal
lthenut
ri
ti
onalneedsoft
he
per
son.
(
b)Li
stf
our(
4)f
unct
ionseachoft
hef
oll
owi
ng:
(
i)Pr
otei
n. (
2mar
ks)
I
.For
mat
ionofenzy
mes,
hor
mones,
haemogi
obi
nandant
i-
toxi
ns.
2.Gr
owt
handdev
elopmentoft
issuecel
l
sfr
om bi
rt
handgr
owt
h
st
ops.
3.Repai
rand r
epl
acementoft
issue cel
l
s whi
ch i
s const
ant
ly
under
goi
ngwearandt
eare.
g.sol
esoft
hef
eet
,nai
l
sandski
n.
4.Ser
vesasant
ibodi
est
opr
otectt
hebodyagai
nsti
nvadi
ngmi
crobes
e.
g.(
gammmagl
obul
i
n).
5.Tr
anspor
tat
ion ofv
italsubst
ances t
hroughoutt
he body (
e.g.
haemogl
obi
nint
ranspor
tofoxy
genandcar
bondi
oxi
de)
.
(
ii
)Fat
sandOi
l. (
2mar
ks)
i
.Topr
oduceener
gyandheat
i
i
.Tosuppor
tcer
tai
nor
gansoft
hebodyf
ori
nst
ance,
theey
esandt
he
ki
dney
s.
i
i
i.Tot
ranspor
t/st
orageoff
at-
sol
ubl
evi
tami
nsA,
D,E,
K.
i
v,I
tisusedi
nthef
ormat
ionofchol
est
erol
andst
eroi
dhor
mones
(
ii
i)Car
bohy
drat
e. (
2mar
ks)
1.Pr
ovi
dest
hebodywi
thener
gy
2.I
tst
oresener
gy(
b
3.I
tsat
isf
yhunger
4.I
tpr
ovi
desf
oodf
ort
hef
oet
us
5.I
tpr
ovi
desf
oodt
othebr
aini
nfor
m ofgl
ucose
6.Hel
psi
nthecompl
exbur
ningoff
atsi
nthe.
body
.
(
c)St
atet
hedi
seasecondi
ti
onsassoci
atedwi
thdef
ici
encyoft
he
f
oll
owi
ng:
(
i)I
odi
ne.—Goi
tr
e
(
ii
)Vi
tami
nC.
—Scur
vy
(
ii
i)Vi
tami
nA.
-Ni
ghtbl
i
ndness/
xer
opht
hql
mia
(
iv)Vi
tami
nB12-Anaemi
a(Megal
obl
ast
icAnaemi
a)
(
v)Vi
tami
nB-Ber
iber
i
(
vi)Vi
tami
nD-
Ricket
s/Ost
eomal
aci
a
(
3mar
ks)
2.Labelt
hei
ndi
cat
edpar
tsoft
heOr
gansbel
ow.

(
b)St
atef
our(
4)f
unct
ionsoft
heSt
omach.
(
2mar
ks)
 i
.Itpr
oducesgast
ri
cjui
ce
i
i
.Itact
sasat
empor
aryr
eser
voi
rforf
ood
i
i
i. Absor
pti
onofi
ron
i
v.I
thel
psi
nbi
ndi
ngv
itami
nB12
v
. Wi
thgast
ri
cjui
ce.I
thel
psi
nthemi
xi
ngmechani
sm off
ood

(
c)St
atet
hree(
3)di
seasecondi
ti
onseachoft
hef
oll
owi
ngor
gans:
(
3mar
ks)
1.(
a)Def
inet
hef
oll
owi
ngt
erms:
(
i)I
mmuni
ty. (
1
mar
k)
I
mmuni
tyi
sthest
ateofr
esi
stancet
oinf
ect
ionconf
err
edbyt
he
pr
esence ofant
ibodi
es capabl
e ofcombi
ning wi
th ant
igens or
ant
it
oxi
nswhi
chneut
ral
i
zet
oxi
norot
herchemi
cal
s.
(
ii
)Immuni
zat
ion. (
1
mar
k)
I
sthepr
ocessofi
ntr
oduci
ngant
igeni
ntot
hebodyt
ost
imul
atet
he
bodyt
opr
oducespeci
fi
cbody
.
(
iv)Vacci
ne. (
1
mar
k)
Av
acci
nei
sani
mmune-
biol
ogi
calsubst
ancedesi
gnedt
opr
oduce
speci
fi
c pr
otect
ion agai
nst a gi
ven di
sease.I
t st
imul
ates t
he
pr
oduct
ionofant
ibody
.
(
iv)Ant
igen. (
1
mar
k)
Thi
sis a subst
ance (
vacci
ne/
ser
um)whi
ch i
ntr
oduce i
nto body
sy
stem underf
avor
abl
econdi
ti
onscanst
imul
atet
hepr
oduct
ionof
ant
ibody
.
(
v)Col
dChai
n. (
1mar
k)
Col
d chai
n sy
stem i
sthe pr
ocess ofst
orage,mai
ntenance and
di
str
ibut
ionofv
acci
nesi
napot
entf
rom manuf
act
urert
otheact
ual
v
acci
nat
ionsi
te.
(
b)AnAdul
twasbr
oughtt
oyourcent
rewi
tht
hecompl
aintofi
tchy
ski
nandswol
l
enr
ightl
egi
nthepastt
woweeks.
O/
ETher
ewasappear
anceofwhi
tet
hreadl
i
kesubst
anceandi
nabi
l
ity
t
omov
e.B/
Pl20/
8ommhg,
Temp.37.
5°C
(
5mar
ks)
Managehi
scondi
ti
onwi
thy
ourSt
andi
ngOr
der
s.
SuspectGui
neawor
m(Dr
ancont
iasi
s)
Nat
ional
standi
ngor
der
sforCommuni
tyHeal
thOf
fi
cer
s/CHEW’
s
Rev
isedEdi
ti
onPage267
Compl
aint Fi
ndi
ngson Cl
i
nical Act
ion
s Exami
nat
ion Judgment

Swel
l
ing Swel
l
ing of t
he Mi
l
d •
Testf
or
oft
hel
eg l
eg condi
ti
on Fi
l
ari
asi
s
Not pi
tt
ing on Suspect I
ver
mect
in12mg
pr
essur
e El
ephant
ias 4t
abl
ets, once Dai
l
y
i
s washi
ng and dr
ying of
af
fect
edl
i
mb.
Li
mbsshoul
dbeel
evat
ed
whensl
eepi
ng.
.
4.a)
Expl
aint
hef
oll
owi
ngt
ermsusedi
nSt
ati
sti
cs:
(
i)Mean.
Anav
erageofasetofv
alues.I
tist
hesum t
otalof
:obser
vat
ions
di
vi
dedbyt
henumberofobser
vat
ions.
(
ii
)Medi
an.
Themi
ddl
eval
uei
nasetofmeasur
ement
swhent
hev
aluesar
e
ar
rangedi
nanar
ray
.Iti
sthecent
ral
l
ylocat
edobser
vat
ionwhenal
lthe
obser
vat
ionshav
ebeenar
rangedi
nascendi
ngordescendi
ngor
der
.
(
ii
i)
Mode. (
3mar
k)
•Themostf
requent
lyoccur
ri
ngobser
vat
ion.I
tist
hescor
ewi
tht
he
hi
ghestf
requencyofoccur
rencei
napopul
ati
onordi
str
ibut
ion.
(
b)Cal
cul
atet
hemeanoft
heunder
-l
ist
edDat
a.
0,
1,
3,
4,
10,
20,
23,
3040,
44 ‘
(lmar
k)
Mean=0+1+3+4+10+20±23+30+40+44
10
=175
10
Mean=17.
5
(
c)Enumer
atef
our(
4)f
act
orseacht
hatcoul
daf
fectt
hef
oll
owi
ng:
(
i)Bl
oodPr
essur
e. (
2mar
ks)
—Ageofpat
ient
—Anxi
ety
!St
ress/emot
ional
stat
e
—Obesi
ty
—Cer
tai
nhear
tdi
seasese.
g.r
enal
condi
ti
on
—Endocr
inedi
sor
der
-Thy
roxi
cosi
s
—Smoki
ng,
alcohol
(
ii
)Pul
seRat
e. (
2mar
ks)
—Ageoft
hepat
ient
—Sex
—Posi
ti
onoft
hepat
ient
—Exer
cise
(
ii
i)Respi
rat
ion. (
2mar
ks)
Exer
cise
—Emot
ion
Age:
asy
ougr
owol
der
—Fat
igue
—Rest
ing
— Toxaemi
a — Dr
ugsi
ntakee.
g.mor
phi
ne,depr
essesr
espi
rat
ory
cent
re
5.(
a)Def
ineBudget
. (
1mar
k)
Abudgeti
saf
inanci
alpl
anf
oradef
inedper
iodoft
imeusual
l
yay
ear
.
(
b)St
atef
our(
4)ef
fect
seachofunder
-budget
ingandov
er-
budget
ing
i
nPHC (
4mar
ks)Ef
fect
sofunder
-budget
ing
I
nadequat
eequi
pment
 St
affmaygoonst
ri
keasar
esul
tofnon-
pay
mentofsal
ary
 Fai
l
uret
oachi
eveobj
ect
ives.
 Shor
tageofdr
ugsi
nthecl
i
nic
I
nadequat
est
afff
ort
heser
vice
I
nadequat
evacci
nest
opr
eventcommuni
cabl
edi
seases
 Lowpat
ronageoft
hef
aci
l
ity
 Causesdi
ssat
isf
act
ionamongwor
ker
sandl
owmor
ale
 Ef
fect
sofov
erbudget
ingi
nPHC
 Fr
aud
 Embezzl
ement
 Wast
ageofr
esour
ces
(
c)Wr
it
eshor
tnot
esi
nthef
oll
owi
ngf
unct
ionsofManagementi
n
PHC.
(
i)Pl
anni
ng.
Pl
anni
ngi
sdeci
dingi
nadv
anceWhatt
odo,
howt
odoi
t,whent
odoi
t
and who i
sto do i
t.Pl
anni
ng setst
andar
dsf
ormeasur
ementof
per
for
manceandseei
fobj
ect
ivesar
emetorachi
eved.
(
ii
)Impl
ement
ati
on.
I
mpl
ement
ati
oni
sther
eal
i
zat
ionofanappl
i
cat
ion,orexecut
ionofa
pl
an,
idea,
model
,desi
gnspeci
fi
cat
ion,
standar
dal
gor
it
hm,
orpol
i
cy.
(
ii
i)St
aff
ing..
The pr
ocess of hav
ing sui
tabl
e candi
dat
es accor
ding t
othei
r
knowl
edgeandski
l
lsi
nanor
gani
zat
ions-
(
iv)Co-
ordi
nat
ion.
Thi
sist
her
esul
ti
ngst
ateofwor
kingt
oget
her
.
(
v)Ev
aluat
ion. (
5mar
ks)
Thi
sisper
iodi
cassessmentofanyheal
thpr
ogr
ammet
oensur
ethat
setgoal
sandobj
ect
ivesar
eachi
eved.I
tisoft
wot
ypes:
i
.For
mat
iveev
aluat
iona
i
i
.Summat
iveev
aluat
ion
6.(
a)Def
inet
hef
oll
owi
ng:
(
i)Moni
tor
ing. (
1mar
k)
Thi
sist
hecont
inuouschecki
ngofpr
imar
yheal
thcar
epr
ogr
ammes
upt
otheachi
evement
sofobj
ect
ivesl
evel
(
ii
)Tar
getPopul
ati
on. (
1mar
k)
Apar
ti
cul
argr
oupofpeopl
ethati
sident
if
iedast
hei
ntendedr
eci
pient
ofanadv
ert
isement
,pr
oduct
,orcampai
gn.
(
ii
i)Heal
thI
ndi
cat
or. (
1mar
k)
I
tist
heassessmentt
hatuset
odet
ermi
net
heheal
thandheal
thcar
e
needofacommuni
tybutal
sot
ocompar
etheheal
thst
atusofone
communi
tyt
othatofanot
her
.
(
iv)Heal
thObj
ect
ive. (
1mar
k)
Can be v
iewed orseen as t
he st
atementofout
come ofPHC
pr
ogr
ammeaf
terI
mpl
ement
ati
onofsame.
(
b)Li
stt
heRecor
ds/
Dat
acol
lect
ion f
ormst
hatar
eav
ail
abl
efor
i
nfor
mat
ioni
nthef
oll
owi
ngl
evel
s:
(
i)Homel
evel
. (
2mar
ks)
•PHCchi
l
dheal
thchar
tandt
reat
mentcar
d(0-
5year
s)
•PHCper
sonal
heal
thcar
etr
eat
mentcar
dfor(
Adul
t)
(
ii
)Heal
thFaci
li
tyLev
el. (
4mar
ks)
•Cl
i
nicMast
erCar
d
•Moni
tor
ingandEv
aluat
ionFor
mse.
g
oBook1HF/
1-8:
DiseasecaseseenbyVVHWS/
TBAS
oBook2HF1-
3.:
Tracerdi
seaseandout
pat
ientat
tendance
oBook3H/
F1-
3:Pr
egnancyout
come
oBook4H/
F11-
3:Fami
l
yPl
anni
ngr
ecor
d
oBook5H/
Fl-
3:I
mmuni
zat
ioni
nheal
thf
aci
l
ity
oBook6H/
F1-
3:I
npat
ientcar
e
oBook7H/
F1-
3:Env
ironment
alheal
thsani
tat
ionact
ivi
ti
es
oBook8H/
F1-
3:Gr
owt
hmoni
tor
ing&pr
omot
ion.
7.(
a)AsaCHEW i
nchar
geofHeal
thFaci
li
ty,
howwoul
dyoui
dent
if
y
t
het
rai
ningneedsof
JCHEW wor
kingwi
thy
ou?- (
2mar
ks)
1.I
dent
if
ytr
aini
ngneedsofJCHEW,
VVHWs,
TBAs
2.Pr
ovi
deon-
the-
jobt
rai
ningasnecessar
y.
3.Teacht
heI
CHEW si
mpl
emet
hoddat
aanal
ysi
s
4.Col
l
abor
atei
nthe pl
anni
ng i
mpl
ement
ati
on and ev
aluat
ion of
t
rai
ningpr
ogr
ammesf
orJCHEW VVHWs,
TBAs
(
b)Li
stFour(
4)Cl
ini
c-Basedf
unct
ionsoft
heJCHEW.(
2mar
ks)
1.Regi
sternewcl
i
ent
s
2.Wei
ghcl
i
ent
sandr
ecor
dwei
ght
saccur
atel
y
3.Car
ry outheal
tht
alks on di
ff
erentheal
thr
elat
ed t
opi
cs as
schedul
ed
4.Est
imat
ehaemogl
obi
naccor
dingt
oest
abl
i
shedpr
ocedur
e
5.Measur
ebl
oodpr
essur
eaccor
dingt
oest
abl
i
shed/
procedur
e
6.Testur
inef
orsugar
,pr
otei
nandal
bumen.
(
c)Li
ghtEi
ght(
8)BooksofAccount
ingusedi
nPHC
(
4mar
ks)
 Ledger
 Cashbook
 Booksofor
igi
nal
ent
ry
I
mpr
estcashbook
 St
ockaccountbook
 Bal
ancesheet
 Voucher
s
I
nvoi
ces
(
d)Di
sti
ngui
shbet
ween“
def
act
o’popul
ati
onand‘
deJur
epopul
ati
on
(
2mar
ks)
“
Def
act
o”popul
ati
oni
saconceptunderwhi
chi
ndi
vi
dual
,orv
ital
ev
ent
sar
erecor
ded(
orar
eat
tri
but
ed)t
othegeogr
aphi
calar
eawher
e
t
heywer
epr
esentatkspeci
fi
cti
mewhi
l
e“Dej
ure”popul
ati
ona
conceptunderwhi
chi
ndi
vi
dual
s(orv
italev
ent
sar
erecor
dedt
oa
geogr
aphi
cal
areaont
hebasi
sofpl
aceofr
esi
dence.
Ty
pesofPr
obabi
li
tySampl
ingTechni
ques
I
.Si
mpl
eRandom sampl
i
ngTechni
que
2.St
rat
if
iedRandom sampl
i
ngt
echni
que
3.Sy
stemat
icr
andom sampl
i
ngt
echni
que
4.Mul
ti
stagesampl
i
ngpr
ocedur
e
5.Cl
ust
eror(
Area)sampl
i
ng,
6.Compr
ehensi
vesampl
i
ng.

COMMUNI
TYHEALTHEXTENSI
ONWORKERS(
CHEW)
PAPERI
II
SECTI
ONB:ESSAYQUESTI
ONS
AnswerALLquest
ions
1.(
a)Def
ineEnv
ironment
alHeal
th. (
2
mar
ks)
Env
ironment
al heal
th has been def
ined by t
he wor
ld heal
th
or
gani
zat
ionast
hecont
rolofal
lthosef
act
orsi
nman’
sphy
sical
,
bi
ologi
calandsoci
alenv
ironmentwhi
chmayexer
ciseadel
eter
ious
ef
fectonhi
sphy
sical
,ment
alandsoci
alwel
l
-bei
ng,dev
elopmentand
sur
viv
al.
(
b)St
ateei
ght(
8)component
sofEnv
ironment
alHeal
th
(
4mar
ks)
1.Foodhy
gieneandsaf
ety
.
2.Wast
emanagement
3.Vect
orandpestcont
rol
4.Housi
ngsani
tat
ion
5.Epi
demi
ologi
cal
studi
esandcont
rol
ofcommuni
cabl
edi
sease
6.Ai
rqual
i
tymanagementofmoni
tor
ing
7.Occupat
ional
heal
thandsaf
ety
8.Wat
err
esour
cesmanagement&sani
tat
ion
9.Noi
sepol
l
uti
onmoni
tor
ingandpr
event
ion
10.Cont
rol
off
ront
ier
s,ai
randseapor
tandbor
dercr
ossi
ng.
(
c)Li
stf
our(
4)wat
er-
bor
nedi
seases. (
2
mar
k)
1.Di
arr
hea
2.Chol
era
3.Dy
sent
arv
4.Ty
phoi
dfev
er
5.Sal
monel
l
aandcol
ii
nfect
ion
6.Campy
lobact
er
7.Legi
onel
l
osi
s
8.Lept
ospi
rosi
s
9.Bot
uli
sm
10.Pol
i
omy
eli
ti
s
(
d)Li
stf
our(
4)wat
ershor
tagedi
seases. (
2
mar
ks)
1.Scabi
es
2.Tr
achoma
3.Amebi
cdy
sent
ery
4.Chol
era
5.Ty
phoi
d
6.Gi
ardi
asi
s
7.Hepat
it
isAandE
8.Hookwor
m
9.Gui
neawor
m
2.(
a)Def
inePuer
per
alSepsi
s. (
1
mar
k)
Puer
per
alSepsi
s:Thi
sisani
nfect
ionoft
hegeni
talt
ractoccur
ri
ng
usual
l
ywi
thi
nthr
eeweeksaf
terabor
ti
onorchi
l
dbi
rt
h.
(
b)Li
stf
our(
4)si
gnsandsy
mpt
omsofPuer
per
alSepsi
s.
(
2mar
ks)
1.Pr
ofusel
ochi
a,whi
chhasof
fensi
veodour
2.Gener
almal
aise
3.Agener
alr
isei
nthebodyt
emper
atur
etoov
er38degr
eeCel
sius
4.I
ncr
easei
npul
ser
atet
oov
er90mi
nut
es
5.Sub-
inv
olut
ionandt
heut
erusi
stendert
otouch
(
c)Ei
ghtcondi
ti
onsi
nPr
egnancyt
hatr
equi
rei
mmedi
ater
efer
ral
.
(
4mar
ks)
1.Rai
sebl
oodpr
essur
e 279
2.Ecl
ampsi
a
3.Bl
eedi
ng
4.Pl
acent
apr
aev
ia‘
5,
Anaemi
a
6.Cephal
opel
vi
cdi
spr
opor
ti
on
7.Abnor
mal
present
ati
onoff
oet
us(
ii
i
8.Toxaemi
ainpr
egnancy
9.Mal
ari
ainpr
egnancy
10.Li
qui
ordr
ainage
(
d)Act
ivi
ti
esi
nvol
vedi
nest
abl
ishi
ngBr
eastf
eedi
ngi
nanewbor
n
baby
. (
3mar
ks)
1.Hav
eawr
it
tenbr
east
feedi
ngpol
i
cyt
hati
srout
inel
ycommuni
cat
ed
t
oal
lheal
thcar
est
aff
.
2.Tr
ainal
lheal
thcar
est
affi
nski
l
lsnecessar
ytoi
mpl
ement
sthi
s
pol
i
cy.
3.I
nfor
m al
lpr
egnantwomenaboutt
hebenef
it
sandmanagementof
br
east
feedi
ng
4.Hel
pmot
her
sini
ti
atebr
east
feedi
ngwi
thi
nahal
fhourofbi
rt
h
5.Show mot
her
show t
obr
east
feed,andhow t
omai
ntai
nlact
ati
on
ev
eni
ftheyshoul
dbesepar
atedf
rom t
hei
rinf
ant
s
6.Gi
venewbor
ninf
ant
snof
oodordr
inkot
hert
hanbr
eastmi
l
k,unl
ess
medi
cal
l
yindi
cat
ed.
7.Pr
act
icer
oomi
ng-
in-al
l
ow mot
her
sandi
nfant
stor
emai
ntoget
her
—24hour
saday
.
8.Encour
agebr
east
feedi
ngondemand
9.Gi
venoar
ti
fi
cial
teet
htobr
east
feedi
ngi
nfant
s
10.Fost
ert
heest
abl
i
shmentofbr
east
feedi
ngsuppor
tgr
oupsand
mot
her
stot
hem ondi
schar
ge
f
rom t
hehospi
tal
orcl
i
nic.
5.(
a)Whati
sCommuni
tyMent
alHeal
thCar
e?
(
1mar
k)
Communi
tyment
alheal
thcar
eref
erst
oal
lthosef
aci
l
iti
es,
apar
tfr
om
hospi
tal
car
e,whi
char
e
empl
oyedf
ort
reat
ingandr
ehabi
l
itat
ingment
all
yil
lpat
ient
sint
he
communi
ty.

(
b)Expl
aint
hei
mpor
tance/
benef
it
sofCommuni
tyMent
alHeal
tht
o
member
sofy
ourCommuni
ty
Dev
elopmentCommi
tt
ee. (
5
mar
ks)
1.I
tpr
omot
est
hespi
ri
tofpar
ti
cipat
ioni
nthecar
eofi
tsmember
s.
2.I
tst
rengt
hensf
ami
l
yti
es.Thef
ami
l
yisassi
stedt
ounder
standand
acceptt
hei
rmember
swhoi
s ment
all
yil
l
.
3.I
treduces expenses i
ncur
red by f
ami
l
y member
s and t
he
gov
ernment
.
4.Absenceofst
igmaanddi
scr
imi
nat
ion.
5.Rei
ntegr
ati
oni
ntot
hecommuni
tyandl
i
vinganor
mal
dai
l
yli
fe.
6.I
tbr
ingsment
alheal
thcar
eser
vicescl
osert
othedoor
stepsof
member
soft
hecommuni
ty.
7.I
tisaccessi
ble,accept
abl
e,av
ail
abl
eandaf
for
dabl
ebycommuni
ty
member
s.
8.pr
omptt
reat
mentofment
aldi
sor
der
s.
(
c)Descr
ibeei
ght(
8)f
eat
4rest
hatcoul
dassi
sty
oui
nident
if
ying
ment
all
yil
lper
soni
nthe
communi
ty. (
4mar
ks)
1.Appear
ance:.
Thepat
ientappear
snegl
ect
ed;l
ooksr
ough,di
rt
y,
scat
ter
edandmaygonaked.
2.MannerandAt
ti
tudes:
Abnor
mal
,vi
olent
,andmaybeaggr
essi
ve.
3.Or
ient
ati
on:
Disor
ient
ati
ont
oti
me,
per
son,
placeandt
hings.
4.Mood:
Dev
iat
ionf
rom nor
ms,
mut
e,y
ell
i
ng,
cry
ingorexci
ted.
5.Wi
thdr
awal
:Sol
i
tar
yfr
om t
hesoci
ety
,lonel
yandmayr
efuset
omi
x
upwi
thot
hernor
mal
per
sons.
6.Par
anoi
d:Suspi
cious
7.Uncoor
dinat
edspeech.
8.Negat
iver
eact
iont
onewenv
ironment
.
9.Noi
nsi
ghtandj
udgment
.
10.Hal
l
uci
nat
ion(
bot
hvi
sual
andaudi
tor
y)
11.Del
usi
on
6.(
a)Di
scussAI
Dsundert
hef
oll
owi
ngheadi
ngs:
(
i)Def
ini
ti
on. (
1mar
k)
H-Humani
nfect
inghumanbei
ngs
I
-Immunodef
ici
encydecr
easedorweakenedi
nthebodyabi
l
ityt
o
f
ighti
nfect
ionsandi
l
lness
V-Vi
rusapat
hogenhav
ingt
heabi
l
ityt
orepl
i
cat
eonl
yinsi
deal
i
ving
cel
l
.
(
ii
)Causat
iveAgent
. (
1mar
k)
HI
V-HumanI
mmunodef
ici
encyVi
rus
(
ii
i)ModeofTr
ansmi
ssi
on. (
2mar
ks)
1.Sexual
cont
act
2.Fr
om i
nfect
edmot
hert
oherchi
l
ddur
ingpr
egnancy
,labourdel
i
ver
y
andbr
east
feedi
ng
3.Tr
ansf
usi
onwi
thi
nfect
edbl
oodorbl
oodpr
oduct
s
4.I
ntr
avenousdr
uguser
s
5.Shar
ingofunst
eri
l
izedr
azor
sdur
ingt
radi
ti
onal
cir
cumci
sion.
(
iv)Si
gnsandsy
mpt
oms. (
3mar
ks)
a.Wei
ghtl
ossgr
eat
ert
han10%oft
hebodywei
ght
b.Unexpl
ainedchr
oni
cdi
arr
heagr
eat
ert
hanonemont
h
c.Unexpl
ainedper
sist
entf
evergr
eat
ert
hanonemont
h
d.Or
alcandi
dasi
s
e.Kaposi
Sar
coma
f
.Pneumoni
a
(
v)I
dent
if
ysi
x(6)v
ulner
abl
egr
oupst
oHI
VIAI
Ds. (
3
mar
ks)
1.SexWor
ker
s
2.Mul
ti
plesexpar
tner
s
3.HI
Vex
posedchi
l
dren
4.Menwhohav
esexwi
thmen(
MSM)
5.Per
sons who engage i
n unpr
otect
ed sexuali
nter
cour
se wi
th
i
nfect
edpar
tner
6.Pr
ospect
ivebl
oodr
eci
piente.
g.acci
dentcases
7.Longdi
stancedr
iver
s
8.Pr
isoner
s“
7.(
a)Def
ineDeaf
ness. (
1mar
k)
Deaf
nessi
mpl
i
est
otal
hear
ingl
osst
oapat
ient
(
b)St
ateei
ght(
8)possi
blecausesofDeaf
ness.(
4mar
ks)
1.Exposur
etol
oudnoi
se
2.Headt
rauma
3.Vi
ral
disease
4.Aut
oimmunei
nnereardi
sease
5.Hear
ingl
osst
hatr
unsi
nthef
ami
l
y
6.Agi
ng
7.Mal
for
mat
ionoft
hei
nnerear
8.Meni
ere’
sdi
sease
9.Acci
dent
10.Useofot
otoxi
cdr
ugsdur
ingpr
egnancy
(
c)Di
scusssi
x(6)Pr
event
ivemeasur
esf
orHear
ingLoss.
(
3mar
ks)
1.Av
oidr
ecei
vebl
owsi
ntheear
2.St
ayawayf
rom noi
se
3.Useofearpl
ugst
ocov
ery
oureari
nal
oudpl
ace
4.Donotuseshar
porpoi
ntedobj
ect
sincl
eani
ngt
heear
5.Heal
theducat
ion
6.Useofhear
ingai
d
7.Ear
lydi
agnosi
sandt
reat
mentofeari
nfect
ion
(
d)Li
stf
our(
4)di
seasescondi
ti
onst
hatcoul
dleadt
oBl
indness,
(
2mar
ks)
1.Cat
aract
s 3.Tr
achoma 4.Macul
ardegener
ati
on
2.Gl
aucoma 5.Di
abet
icRet
inopat
hy
Pastquest
ionsandanswer
s