CM16.1-5 | Health Planning and Management — Practice Quiz

Correct. Health planning operates at the community/programme level; prescribing individual treatment protocols belongs to clinical medicine, not health planning.

Health planning (Park) focuses on population-level problem definition, resource assessment, and priority-setting — not individual clinical management. It translates priorities into administrative action through feasible, acceptable goals.

Review Park's definition of health planning. It is a community-level process encompassing needs assessment, resource inventory, priority-setting, and programme implementation — not individual patient care.

Correct. Reviewing coverage data, conducting surveys, and resource mapping are all elements of situation analysis — the first phase of the six-phase health planning cycle.

Phase 1 of the planning cycle — situation analysis — involves data collection on health burden, unmet needs, and existing resources. This is the foundation for all subsequent phases.

The activity described involves data collection and needs assessment, which maps to Phase 1 (situation analysis), not later phases such as plan formulation or implementation.

Correct. The Logframe's 4×4 matrix structures programme logic vertically (goal to activities) and horizontally (narrative summary, OVIs, means of verification, assumptions). It is widely used in NHM's SPIP process.

The Logframe (4×4 matrix) organises programme logic: goal → purpose/outcome → outputs → activities, each with objectively verifiable indicators (OVIs) and means of verification. It is the standard planning tool for donor-funded and NHM programmes.

The Logframe is specifically the 4×4 goal-to-activity matrix with indicators. Horizontal bar charts are Gantt charts; network diagrams are PERT/CPM; NPV calculation is cost-benefit analysis.

Correct. Testing a change in one PHC, reviewing results, and deciding on scale-up is the classic PDSA cycle used in health quality improvement.

The Plan-Do-Study-Act (PDSA) cycle is the core quality improvement method: plan a small-scale change, implement (do), study results, then act (standardise or revise). Its 'small test' discipline prevents system-wide failure from untested changes.

PDSA is the quality improvement cycle: Plan (design the change) → Do (pilot in small setting) → Study (analyse results) → Act (scale up or modify). This is distinct from scheduling tools (Gantt, PERT) or economic analysis tools.

Correct. NHP 2017 targets 2.5% of GDP by 2025. This is a key policy number you are expected to cite accurately.

NHP 2017 set an aspirational target of raising government health expenditure from ~1.2% to 2.5% of GDP by 2025. As of 2023–24 India is at approximately 1.9% of GDP — progress but still below target. OOP expenditure remains ~48% of total health expenditure.

NHP 2017's headline financing target is 2.5% of GDP by 2025. India's current public health expenditure is approximately 1.9% of GDP — well below this target.

Correct. NITI Aayog is a policy think tank; it does not control fund flows, which are managed by the Finance Ministry and Finance Commission.

The Planning Commission could allocate plan funds directly to states. NITI Aayog (National Institution for Transforming India) is a policy advisory/think tank with no fund-allocation authority; resources flow via the Finance Commission and Ministry of Finance. Five-Year Plans were replaced by three-year action plans and a 15-year vision document.

NITI Aayog's key difference from the Planning Commission is the absence of fund-allocation power. It advises, strategises, and coordinates — fund disbursement is the Finance Commission/Ministry of Finance domain.

Correct. PM-JAY covers ~500 million people from the bottom 40% for inpatient secondary/tertiary care, cashless, up to ₹5 lakh/family/year — the world's largest government-funded health protection scheme.

PM-JAY targets approximately 107 million families (~500 million beneficiaries) from the lowest socio-economic deciles, identified via SECC 2011 data. It covers secondary and tertiary inpatient care (cashless) up to ₹5 lakh per family per year. It does NOT cover the 'missing middle' or outpatient costs.

PM-JAY is targeted at the economically vulnerable, not universal. It does not cover CGHS beneficiaries (who have their own scheme) or ESIC workers. Coverage is inpatient-only, not outpatient.

Correct. Comparing strategies by cost per DALY averted is cost-effectiveness analysis — a natural health outcome unit in the denominator, no monetary valuation of health.

CEA compares interventions on a single natural health outcome unit (cases averted, DALYs averted, lives saved). CUA uses preference-weighted outcomes (QALYs, DALYs); CBA converts health outcomes into monetary values. DALYs averted as the denominator is a CEA or CUA outcome — since the question says 'cost per DALY averted' without QALYs or monetary conversion, the closest match is CEA (DALY is a natural unit of disease burden). In Indian examination convention, cost/DALY averted is usually classified under CEA.

When outcomes are expressed in natural health units (DALYs averted, cases prevented), the analysis is CEA. If outcomes were converted to money (economic value of lives saved), it would be CBA. If QALYs were used, it would be CUA.

Correct. Sub-Centre: 5,000 population in plains areas. This is the smallest unit of India's rural health infrastructure, staffed by one ANM and one MPW (M).

IPHS norms (Indian Public Health Standards): SC = 5,000 population (plains) / 3,000 (hilly/tribal/difficult areas); PHC = 30,000 population (plains) / 20,000 (hilly); CHC = 1,20,000 population. The SC is the peripheral-most unit in the public health infrastructure.

IPHS population norms: SC = 5,000 (plains) / 3,000 (hilly); PHC = 30,000 (plains); CHC = 1,20,000. Memorise these as they are a standard examiner favourite.

Correct. India's OOP is ~48–50% of total health expenditure — one of the highest globally. NHP 2017 aims to reduce this to 30%. PM-JAY and Health and Wellness Centres are key instruments for this reduction.

India's OOP expenditure is approximately 48% of total health expenditure (NHE 2021-22 data), making it among the highest in the world. NHP 2017 targets reducing OOP to 30% of total health expenditure. This high OOP is a major driver of catastrophic health expenditure and medical impoverishment.

India's OOP (~48%) is significantly higher than the WHO-recommended threshold (<20% of total health expenditure). This is the factual baseline for health financing discussions in India.