MAHARASHTRA STATE BOARD OF NURSING AND
PARAMEDICAL EDUCATION, MUMBAI

EXAMINATION IN AUXILIARY NURSING AND MIDWIFERY
SECOND YEAR-PAPER II

HEALTH CENTRE MANAGEMENT
WEDNESDAY, 3RD JULY 2019

Duration: 3 Hours Max.Marks:75

I. Select the most appropriate answer from the following and complete the
statement : 1×5=5
(i) Head Quarter of W.H.O. is at …………….

(a) London (b) Geneva (c) Uganda (d) Delhi.
(ii) Environmental Day is celebrated on……………

(a) 5th June (c) 8th March (b) 10th June (d) 7th September.
(iii) Annual report is submitted by health center in ……………. month.

(a) March (b) April (c) August (d) September.
(iv) For districtwise transfer application is send through ………………..

(a) Medical Officer (b) District Health Officer (c) Taluka Medical Officer (d) Chief Executive
Officer.

(v) ANC Registration is done in ……………….. register.
(a) R-12 (b) R-14 (e) R-15 (d) R-16.

1. Headquarters of W.H.O. is at:
   (b) Geneva
2. Environmental Day is celebrated on:
   (a) 5th June
3. Annual report is submitted by health center in:
   (b) April
4. For district-wise transfer, the application is sent through:
   (b) District Health Officer
5. ANC Registration is done in:
   (a) R-12 register

II. Match the following 1×5=5
‘A’ Group ‘B’ Group
(i) Collect Information (a) Problem Solving
(ii) R.K.S. (b) IFA
(iii) Counselling (c) Malaria Control
(iv) Guppi Fish (d) B.P.L. Patient
(v) Anaemia (e) Survey.

‘A’ Group | ‘B’ Group
(i) Collect Information | (e) Survey
(ii) R.K.S. | (d) B.P.L. Patient
(iii) Counselling | (a) Problem Solving
(iv) Guppi Fish | (c) Malaria Control
(v) Anaemia | (b) IFA

III. State true or false 1×5=5
(i) All mothers are eligible for benefits under J.S.Y.
(ii) Referral services should not be given to suspected patient.
(iii) It is not necessary to update Dead Stock Register.
(iv) In home visit services should be provided to only ANC mother.
(v) To start nursing profession registration is needed.

(i) All mothers are eligible for benefits under J.S.Y.
False (Only eligible mothers based on criteria like BPL status or specific rural/urban areas are covered under
JSY.)

(ii) Referral services should not be given to suspected patient.
False (Referral services are critical for suspected patients to ensure timely treatment.)

(iii) It is not necessary to update Dead Stock Register.
False (It is necessary to update the Dead Stock Register to maintain accurate records.)

(iv) In home visit services should be provided to only ANC mother.
False (Home visit services should also include other beneficiaries like newborns, postnatal mothers, and
high-risk cases.)

(v) To start nursing profession registration is needed.
True (Registration with the nursing council is mandatory to practice as a nurse.)

IV. Define the following (any five) 2X5=10
(a) Eligible Couple
(b) Inservice Education
(c) Health Team
(d) Communication
(c) Target
(f) Neonatal Mortality

(a) Eligible Couple:
An eligible couple refers to a married couple in the reproductive age group (15–49 years) where the wife is
capable of conceiving. These couples are often targeted for family planning and reproductive health
services.

(b) In-service Education:
In-service education is a continuous training program designed for professionals to enhance their
knowledge, skills, and competencies while they are actively working in their field.

(c) Health Team:
A health team is a group of healthcare professionals, such as doctors, nurses, community health workers, and
other support staff, who work collaboratively to provide comprehensive healthcare services to the
community.

(d) Communication:
Communication is the process of sharing information, ideas, or messages between individuals or groups
through verbal, non-verbal, or written methods to achieve mutual understanding.

(e) Target:
In public health, a target refers to a specific goal or objective set for a particular health program or

intervention, such as immunization coverage, reduction in disease prevalence, or improved healthcare
access.

(f) Neonatal Mortality:
Neonatal mortality is the number of deaths of newborns within the first 28 days of life per 1,000 live births
in a given population during a specific time period.

V. Write short notes (any four) 4×5=20
(α) M.L.S.
(b) Mission Indradhanush
(c) Planning of Immunization Session
(d) Responsibilities of ANM in Malaria Programme
(e) Principle of Management.

(a) M.L.S. (Minimum Laboratory Standards):
MLS refers to the essential standards and guidelines that laboratories must follow to ensure quality testing
and diagnostic services. It includes maintaining proper equipment, trained personnel, quality control
measures, and accurate record-keeping to provide reliable and safe health services.

(b) Mission Indradhanush:
Mission Indradhanush is a government initiative launched in 2014 to improve immunization coverage in
India. Its goal is to vaccinate all children under two years of age and pregnant women against preventable
diseases such as measles, polio, tetanus, and tuberculosis. The program focuses on high-risk and
underserved populations to achieve 90% immunization coverage.

(c) Planning of Immunization Session:
Planning an immunization session involves:

1. Identifying the target population, such as children under five and pregnant women.
2. Ensuring vaccine availability and proper storage in a cold chain.
3. Mobilizing beneficiaries and informing them about the session.
4. Arranging adequate logistics, like syringes, vaccination cards, and safety boxes.
5. Assigning roles to health workers and monitoring the session’s performance.

(d) Responsibilities of ANM in Malaria Programme:
The Auxiliary Nurse Midwife (ANM) plays a critical role in malaria control, including:

1. Identifying and reporting suspected malaria cases.
2. Collecting blood smears and sending them for testing.
3. Administering antimalarial drugs to confirmed cases.
4. Educating the community on malaria prevention, such as using insecticide-treated nets.
5. Monitoring and reporting vector control measures in the area.

(e) Principle of Management:
Management principles are the fundamental guidelines for efficient and effective administration of
resources. Key principles include:

1. Planning: Setting objectives and designing strategies to achieve them.
2. Organizing: Allocating resources and assigning tasks.
3. Leading: Guiding and motivating team members.
4. Controlling: Monitoring progress and making adjustments.
5. Coordination: Ensuring all activities work harmoniously towards common goals.

VI. Answer the following questions 5+5+5=15

(a) Define Meeting and write management of Meeting.
(b) Communication.
(c) Importance of Master File.
OR 5+5+5=15
You are appointed as ANM in one of the subcenter. Answer the following:-
(a) Define Survey. What are the advantages of survey?
(b) Functions of subcenter.
(c) How you will prepare action plan of subcenter?

Option 1:

(a) Define Meeting and Write Management of Meeting:
A meeting is a formal or informal gathering of individuals to discuss, deliberate, or make decisions on
specific topics or issues. Meetings facilitate communication, planning, and problem-solving among
participants.

Management of Meeting:

1. Preparation:
   o Define the purpose and objectives of the meeting.
   o Prepare an agenda and share it with participants beforehand.
   o Arrange a suitable venue and ensure necessary materials are available.
2. Execution:
   o Start the meeting on time.
   o Follow the agenda and keep discussions focused.
   o Encourage participation from all members.
3. Conclusion:
   o Summarize key points and decisions made.
   o Assign responsibilities and set deadlines for follow-up actions.
   o Document meeting minutes and share them with participants.

(b) Communication:
Communication is the process of exchanging information, ideas, or emotions between individuals or groups
through verbal, non-verbal, or written means. Effective communication is essential for building
relationships, conveying messages, and achieving organizational goals.

Types of Communication:

1. Verbal Communication (spoken words).
2. Non-verbal Communication (gestures, expressions).
3. Written Communication (emails, letters).
4. Visual Communication (charts, presentations).

Importance of Communication:

 Facilitates teamwork and collaboration.
 Ensures clarity in roles and responsibilities.
 Helps in conflict resolution and decision-making.

(c) Importance of Master File:
The master file is a centralized record containing comprehensive and up-to-date information about health
programs, target populations, resources, and activities of a health facility or organization.

Importance:

1. Data Accuracy: Ensures accurate and consolidated records for decision-making.
2. Monitoring and Evaluation: Helps track progress and assess outcomes of health programs.
3. Resource Allocation: Guides efficient use of resources based on needs.
4. Planning: Serves as a reference for preparing action plans and reports.

Option 2:

(a) Define Survey. What are the Advantages of Survey?
A survey is a systematic method of collecting data and information from a targeted population to study their
characteristics, behavior, or needs. Surveys can be conducted through questionnaires, interviews, or
observations.

Advantages of Survey:

1. Data Collection: Gathers information from a large population.
2. Decision-making: Provides insights for planning and implementing programs.
3. Community Needs Assessment: Identifies issues and resources within the community.
4. Cost-effective: Efficient way to gather information compared to other methods.

(b) Functions of Subcenter:

1. Maternal and Child Health Services:
   o ANC and PNC care, immunization, and delivery assistance.
2. Family Planning Services:
   o Counseling and distribution of contraceptives.
3. Disease Prevention and Control:
   o Malaria, tuberculosis, and leprosy control activities.
4. Health Education:
   o Spreading awareness on nutrition, hygiene, and sanitation.
5. Basic Curative Services:
   o Treatment of minor illnesses and first aid.

(c) How You Will Prepare Action Plan of Subcenter:

1. Situation Analysis:
   o Assess the population, health indicators, and available resources.
2. Identify Priorities:
   o Focus on key health issues such as maternal health, immunization, and communicable diseases.
3. Set Objectives:
   o Define measurable and achievable goals, e.g., 90% immunization coverage.
4. Plan Activities:
   o Organize health camps, outreach sessions, and home visits.
5. Allocate Resources:
   o Assign staff, ensure supply of medicines, and maintain logistics.
6. Monitoring and Evaluation:
   o Regularly review progress and adjust the plan as needed.

VII. Answer the following questions: 5+5+5=15
a) To minimize the Maternal Mortality Rate in your area what action you will take?
(b) Write the role of ASHA in NRHM.
(c) Write medicine management of subcenter level.

(a) Actions to Minimize Maternal Mortality Rate (MMR):
To reduce MMR in the area, the following actions can be taken:

1. Antenatal Care (ANC):
   o Ensure timely ANC check-ups for all pregnant women.
   o Provide iron and folic acid supplements to prevent anemia.
   o Screen for high-risk pregnancies and refer them to higher facilities.
2. Skilled Birth Attendance:
   o Promote institutional deliveries.
   o Train healthcare workers and ensure the availability of skilled birth attendants.
3. Postnatal Care (PNC):
   o Provide follow-up care within 48 hours and subsequent visits during the postpartum period.
   o Monitor and manage complications like postpartum hemorrhage and infections.
4. Awareness and Health Education:
   o Educate women and families on danger signs during pregnancy and delivery.
   o Encourage family planning to prevent high-risk pregnancies.
5. Referral Services:
   o Strengthen referral systems for timely transport of emergency cases to higher centers.

(b) Role of ASHA in NRHM:
The Accredited Social Health Activist (ASHA) plays a vital role in the National Rural Health Mission
(NRHM):

1. Community Mobilization:
   o Create awareness about health services and programs.
   o Encourage institutional deliveries and immunization.
2. Linking Community to Health Services:
   o Assist in arranging transport for pregnant women under schemes like Janani Suraksha Yojana (JSY).
   o Ensure beneficiaries avail maternal and child health services.
3. Home-based Care:
   o Provide basic care for newborns and advice on breastfeeding and nutrition.
   o Educate families on hygiene and sanitation practices.
4. Disease Prevention and Management:
   o Identify and refer cases of TB, malaria, and other diseases to healthcare centers.
   o Distribute contraceptives and counsel couples on family planning.
5. Documentation and Reporting:
   o Maintain records of beneficiaries and health-related activities in the village.

(c) Medicine Management at Subcenter Level:
Effective medicine management ensures the availability of essential drugs at the subcenter level. The key
steps are:

1. Stock Maintenance:

o Maintain a proper stock register for medicines received, distributed, and in storage.
o Conduct periodic physical stock verification.

2. Storage:
   o Store medicines in a cool and dry place, ensuring compliance with storage guidelines (e.g.,

maintaining a cold chain for vaccines).

3. Indent and Supply:

o Prepare timely indents based on the population served and average consumption patterns.
o Coordinate with the primary health center (PHC) to ensure regular supply.

4. Distribution:
   o Dispense medicines as per guidelines during immunization sessions, ANC check-ups, and treatment

of minor ailments.

5. Monitoring and Expiry Management:

o Regularly check expiry dates and use medicines nearing expiry first (FIFO method).
o Dispose of expired or damaged medicines according to protocols.

6. Reporting:
   o Submit monthly reports on medicine usage and stock to the PHC or higher authorities.