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

Correct. Feasibility anchors health planning goals to the reality of available resources and the socio-cultural environment — essential so plans are executed, not shelved.

Feasibility means setting goals that can realistically be achieved given the constraints of available human resources, finances, technology, and socio-cultural acceptability. Overambitious plans fail at implementation; underambitious plans underutilise capacity.

Feasibility in Park's framework means that planned goals are achievable within actual constraints — resources, technology, and sociocultural context. A 12-month timeframe, unanimous approval, or equal representation are not the defining criteria.

Correct. Plan formulation (Phase 3) follows priority-setting (Phase 2). Having decided WHAT to address, the planner now defines HOW — objectives, activities, resources, and timelines.

The six-phase cycle runs: (1) situation analysis → (2) priority-setting → (3) plan formulation → (4) implementation → (5) monitoring and evaluation → (6) re-planning. Plan formulation converts identified priorities into specific objectives, strategies, timelines, budgets, and responsibilities.

The correct sequence of the planning cycle places plan formulation after priority-setting. Situation analysis is Phase 1 (precedes priority-setting); M&E and re-planning occur after implementation.

Correct. PERT's defining advantage is critical-path analysis — identifying which tasks cannot be delayed without extending the whole project. Gantt charts cannot show this.

PERT/CPM uses a network diagram to map task dependencies and identifies the critical path — the longest chain of dependent tasks that determines minimum project duration. This capability is absent from the Gantt chart, which shows only activity duration, not dependencies. PERT is preferred for complex, multi-activity programmes where delays in one task cascade to others.

PERT is more complex than Gantt, not simpler. Its advantage is network-based critical-path analysis, enabling programme managers to prioritise tasks that are on the critical path.

Correct. 1983 → 2002 → 2017 is India's NHP timeline.

India has had three National Health Policies: NHP 1983 (primary health care, Health for All by 2000 inspired by Alma Ata 1978), NHP 2002 (measurable targets, private sector recognition, DOTS/RCH), and NHP 2017 (UHC, 2.5% GDP target, OOP reduction, Ayushman Bharat precursor). This sequence is a standard factual anchor.

India's three NHPs are: 1983, 2002, and 2017. No policy was issued in 1975, 1990, 1978, or 1995. These dates are fixed anchor points for CM exam preparation.

Correct. NHM (2013) = NRHM + NUHM. The urban component was newly added when NRHM was expanded into NHM.

NHM (2013) subsumed the National Rural Health Mission (NRHM, 2005) and the newly added National Urban Health Mission (NUHM, 2013), creating a unified mission covering both rural and urban health. RNTCP, JSSK, and RBSK are sub-programmes under NHM, not missions subsumed into it.

NHM subsumed NRHM (rural) and NUHM (urban). RNTCP is the TB programme (now National TB Elimination Programme — NTEP); JSSK is a beneficiary entitlement scheme; RBSK is the school health screening programme.

Correct. TQM is an organisation-wide quality philosophy and culture, not a single QI cycle. PDSA is the iterative operational tool used within TQM programmes.

TQM is an organisational philosophy (Deming/Juran) that permeates all levels of a health facility — culture, leadership, staff empowerment, customer focus — and is ongoing, not episodic. PDSA is the operational tool for testing specific changes within a QI cycle. TQM sets the culture; PDSA executes the improvement cycles within that culture.

PDSA tests one specific change iteratively. TQM is broader — a philosophy of quality culture involving ALL staff at ALL levels, continuous not episodic, organisation-wide not task-specific.

Correct. OOP (~48%) is the single largest source of health financing in India, driving catastrophic expenditure for vulnerable households.

Households bear ~48% of total health expenditure through OOP payments — the largest single source. Central + state government together contribute ~40%. Private insurance is ~5%. This dominance of OOP is the primary driver of catastrophic health expenditure and medical impoverishment affecting ~55 million Indians annually.

India's largest health expenditure source is out-of-pocket payments (~48% of THE). Central government transfers and state government together represent ~40%; private insurance is a small fraction.

Correct. Cost per maternal death averted is a natural health outcome — this is cost-effectiveness analysis. CEA is the standard decision tool for comparing health interventions when outcomes can be expressed in a common natural unit.

CEA uses a single natural health unit in the denominator (deaths averted, cases prevented, DALYs averted). The manager is comparing interventions on cost per maternal death averted — a natural health outcome — and selecting the most efficient option under budget constraints. This is the definition of CEA applied to priority-setting.

CEA uses natural health outcomes (deaths averted, cases prevented). CUA requires utility-weighted QALYs. CBA converts health outcomes into monetary values. Needs assessment describes burden, not efficiency comparison.

Correct. Equity in health planning means allocating resources according to need — greater burden or fewer existing resources justifies greater investment. This is vertical equity.

Equity (horizontal and vertical) is a core principle of health planning. Vertical equity means unequal treatment for unequal need — those with greater burden and fewer resources receive proportionally more. Equality (equal per-capita) is different from equity (need-based). IPHS norms adjust for geography (hilly areas get more facilities per population) as an equity mechanism.

Equity ≠ equality. Distributing equally (same per-capita spend) ignores different disease burdens. Equity requires allocating more to those with greater need — this is the vertical equity principle.

Correct. HWCs expand the primary care package beyond RMNCH+A to include NCDs (hypertension, diabetes, cancer screening), mental health, and palliative care — comprehensive primary health care.

Ayushman Bharat has two pillars: (1) Health and Wellness Centres (HWCs) — upgrading 150,000 sub-centres and PHCs to provide comprehensive primary health care including NCD screening, mental health, oral health, elderly care, and palliative care, which were absent from the traditional SC/PHC package focused on RMNCH+A; (2) PM-JAY — the hospitalisation insurance scheme for the bottom 40%.

HWCs are a primary care expansion, not a tertiary or specialist care addition. PM-JAY is the hospitalisation scheme; HWCs are the comprehensive primary care pillar. The key expansion is NCD screening, mental health, and palliative care at sub-centre level.