Full marks: 100
Number of questions: 50
Pass marks: 40
Time: 45 Minutes

1. HEALTH, DISEASE, EPIDEMIOLOGY AND VITAL STATISTICS (4 Questions)

1.1. Health and Disease

1.1.1. Concept and definition of health and disease
1.1.2. Dimension and spectrum of health; Ways of achieving optimum health
1.1.3. Determinants of health; Disease process (Agent, Host and Environment)

1.2. Epidemiology

1.2.1. Concept, definition, aim, objectives and history of epidemiology
1.2.2. Basic measurement in epidemiology
1.2.3. Application of epidemiology
1.2.4. Dynamics of disease transmission: Source and Reservoir; Modes of Transmission; Susceptible Host and host defense
1.2.5. Disease Prevention and Control
1.2.6. Steps of Epidemics; Management of Epidemics

1.3. Vital Health Statistics

1.3.1. Concept of Rate, Ratio, Proportion, Incidence and Prevalence
1.3.2. Measurement of Health Indicator (Fertility, Morbidity and Mortality)
1.3.3. Source of Vital Health Information, Tabulation Analysis Interpretation and Presentation of Data
1.3.4. Sample and Sampling size
1.3.5.Mean, Median and Mode
1.3.6. Demography:National Population Policy, Population Process, Population Size, Growth and Composition

2. PRIMARY HEALTH CARE (PHC), ESSENTIAL HEALTH CARE SERVICES AND PUBLIC HEALTH (2 Questions)

2.1. Primary Health Care Services

2.1.1.Historical background, Concept, Element/Components and Principles of PHC
2.2. Essential Heath Care Services (EHCS)
2.2.1.Concepts of EHCS, Elements / Components and Principle of EHCS

2.3. Public Health

2.3.1.Concept, Definition, Objective and Principles of Public Health
2.3.2.Public Health Programs of Nepal

3. COMMUNICABLE AND NON-COMMUNICABLE DISEASES (6 Questions)

3.1. Communicable Disease

3.1.1. Diarrhea, Dysentery, Malaria, Leprosy, Japanese Encephalitis, Kala-azar, HIV/AIDS, STD, ARI, Dengue, Filariasis, Rabies
3.1.2. Vaccine Preventable Diseases – Tuberculosis, Measles, Diphtheria, Pertussis, Tetanus, Poliomyelitis, Hepatitis B, Meningitis, Typhoid, Influenza, Food Poisoning, Amoebiasis, Cholera, Trachoma and intestinal parasites induced diseases
3.2. Non- Communicable Diseases
3.2.1.Diabetes, Cancers, Arthritis, Asthma, Obesity, Blindness, Accident and Injury
3.2.2.Heart Diseases – Hypertension, Stroke, RH and Coronary HD

4. COMMUNITY HEALTH DIAGNOSIS, COMMUNITY ORGANIZATION, COMMUNITY PARTICIPATION AND COMMUNITY DEVELOPMENT (3 Questions)

4.1. Community Health Diagnosis

4.1.1.Concept and Definition of Community Diagnosis
4.1.2.Process, Methods techniques and tools of Community Diagnosis
4.1.3.Community Mobilization, Social Mobilization

4.2. Community Organization and Community Participation

4.2.1. Concept of Community organization
4.2.2. Techniques and Procedure of Community Organization
4.2.3. Concept of Community Participation
4.2.4. Methods and Process of Community Participation

4.3. Community Development

4.3.1. Concept of Community Development
4.3.2.Approaches of Community Development : External Agent Approach, Multiple Agent Approach, Internal Resource Mobilization Approach

5. HEALTH PROMOTION AND EDUCATION (8 Questions)

5.1. Health Promotion

5.1.1. Historical Background Health Promotion
5.1.2. Ottawa, Jakarta and Helsinki Health Promotion Declarations
5.1.3. Concept and Definition Health Promotion
5.1.4. Strategies and Action Area of Health Promotion
5.1.5. Setting Approaches of Health Promotion : Family Setting, Community Setting, Educational setting, Occupational Setting , Health Facility Setting
5.1.6. Approaches of Health Promotion

5.2. Health Education

5.2.1.Concept and Definition of Health Education
5.2.2.Rational and Purpose of Health Education
5.2.3. Principles and Scope of Health Education
5.2.4.Concept, Definition and uses of perception in Health Education
5.2.5.Concept of learning and learning process
5.2.5.1.Methods of learning process (Learning by hearing, Learning by seeing, Learning by doing, Learning by Imitation, Learning by Repetition)
5.2.5.2.Theories of Learning Process
5.2.6. Concept and Definition of Motivation
5.2.6.1.Types of Motivation, Techniques of Motivation
5.2.6.2.Rational of Motivation in health education program
5.2.6.3.Theories of Motivation (Maslow theory of Motivation)
5.2.7.Methods of Health Education
5.2.7.1.Individual Method (Interview and Counselling)
5.2.7.2.Group Method (Group Discussion, Demonstration, Role Play, Symposium, Work Shop, Seminar, Brainstorming, Problem Solving, Case Study, Mini-Lecture Field Trip)
5.2.7.3.Mass Method (Lecture, Exhibition, Museum, Drama, Film and Documentary Show, Rally and Social Media)
5.2.8.Media of Health Education
5.2.8.1.Poster, Fillip Chart, Flash Cards
5.2.8.2.Models and real objects
5.2.8.3.Printing Materials (Journals, Book Booklets, Pamphlets, Brochures)
5.2.8.4.Email, Internet
5.2.9.Planning of Health Education Programme
5.2.9.1.Concept and Definition of Health Planning
5.2.9.2.Purpose and Rationale of Health Planning
5.2.9.3.Steps and Process of Health Planning : Identification of Health Planning, Prioritization of Health Problem, Target Group Setting, Determinants of Objectives, Identification of Resources, Selecting Health Education Contents, Deciding Methods and Media of Health Education Programme Planning, Implementation of Health Education Programme, Evaluation of Health Education Programme

6. ENVIRONMENTAL HEALTH AND OCCUPATIONAL HEALTH (4 Questions)

6.1. Environmental Health

6.1.1. Concept and Definitions of Environmental Health
6.1.2. Sources of Water, Water Purification in Small Scale (Household level)
6.1.3. Solid Waste and Its Management
6.1.4. Excreta Disposal and its Management (Community and Household Level)
6.1.5. Control of Fly, Rodents and Street Dogs
6.1.6. Air, Soil, Water and Noise Pollutions and its Management

6.2. Occupational Health

6.2.1. Definition, Occupational Health Hazards and Disease
6.2.2. Preventive Measures of Occupational Hazards
6.2.3. Social Abuses, its Effects, Prevention and Control (Tobacco, Drugs, Alcoholism)

7. SCHOOL HEALTH EDUCATION AND NUTRITION (3 Questions)

7.1. School Health

7.1.1.Concept, definition and objectives of school health program
7.1.2.Areas of school health program : School Health Services, School Health Instruction, School Health Environment, School Community Joint Activities
7.2. Nutrition and Malnutrition
7.2.1.Introduction of nutrition and nutritive values of food
7.2.2.Classification of Foods and its Sources; Nutrients and its type, function, effects
7.2.3.Nutritional Deficiency Diseases, Helminthic diseases and Malnutrition among school children

8. NATIONAL HEALTH SYSTEM, POLICY, STRATEGIES, PROGRAM PLANNING AND MANAGEMENT (5 Questions)

8.1. National Health Policy, 2014 (2071), (Main feature of New Policy)
8.2. Second Long Term Health Plan; Current 3 year Health Plan; Nepal Health Sector Strategy – II; Health Sector Implementation Plan
8.3. Sustainable Development Goals
8.4. National Health System of Nepal : Structure/ Organogram of Ministry of Health, Central, Regional, Zonal, District, Constituency, VDC and Community level
8.5. Function of DHO/DPHO, PHCC, and Health Post
8.6. Job description of DHO/DPHO, MO, HA, Staff Nurses, Health Education Technician, AHW/ANM, others Paramedics and FCHV
8.7. Role and Responsibilities of National Health Education Information and Communication Centre (NHEICC); National Health Promotion and Education Policies and Strategies, Program and Activities from Central to Periphery Levels, National Communication / IEC Strategies

8.8. National Health Program (3 Questions)

8.8.1. Child Health; Immunization; Integrated Management of Childhood Illness (IMCI), CDD, ARI, Measles, Malaria; Nutrition – IDD, Iron, Vitamin A, Deworming; Reproductive Health – Safe Motherhood Neonatal health, Family Planning, Adolescent RH, Care of elderly women, RTI/STD, Male Involvement, Infertility Management Comprehensive Abortion Services.

8.8.2. Epidemiology and Disease Control (Malaria, Kala-azar, Encephalitis, Filariasis, Rabies); Tuberculosis Control Program; Leprosy Control Program; Eye and Oral Health Program; Health Training Program; Logistic Management; Health Management Information System (HMIS) Program; NHEICC Program; Disaster Management Program; Primary Health Care Program; Communicable and Non-Communicable Diseases program; Mental Health Program; Tobacco Control Program.

8.9. Health Planning and Management (2 Questions)

8.9.1. Health Planning: Definition and Rationale of Health Planning; Health Planning Cycle/ Process of Planning; Health Planning Steps; Types of Planning; Trends of Health Planning in Nepal

8.9.2. Health Management : Concept, Definition, Function and Principles of Health Management; Health Camp Management

9. HEALTH COMMUNICATION (2 Questions)

9.1. Concept and Definition of Health Communication
9.2. Elements and Components of Health Communication : Source (Communicator), Message, Channels, Audience, Feed – Back
9.3. Principles and Methods of Communication
9.4. Barriers of Communication
9.5. Needs of Communication Skill in Health sector
9.6. Behaviour Change Communication: Process Of Behavior Change; Method Of Behavior Change Communication

10. HEALTH TRAINING AND CURRICULUM (2 Questions)

10.1. Health Training : Concept and Definition of Health Training; Rational and purpose of Health Training; Training Needs Identification
10.2. Types of Training ; Pre-service, In-Service, Refresher and Orientation Training
10.3. Methods / Techniques of Training
10.4. Planning, Management and implementation of training Program for Various levels of Health Worker
10.5. Curriculum and Curriculum Development : Concept and Definition of Curriculum; Process of Curriculum Development; Implementation of Curriculum; Lesson Plan, Development and Testing Evaluation Tools; Monitoring, Supervision and Evaluation of Curriculum and Training Program

11. SUPERVISION AND MONITORING HEALTH ACTIVITIES (2 Questions)

11.1. Supervision : Concept and Definition of Supervision
11.2. Elements / Components of Supervision : Directing, Training, Counseling, Motivating, Communicating, Guiding / Facilitating, Evaluation
11.3. Types of Supervision : Institutional Supervision (Organization Focus), Personal supervision (Individual Health Worker Focus)
11.4. Tools of Supervision : Supervision Schedule, Personal Record / File, Checklist of Supervision (Skill Testing/Performance testing), Observation Checklists, Authority letter of Supervision
11.5. Monitoring : Concept, Purpose and Objectives of Monitoring
11.6. Different Between Supervision and Monitoring
11.7. Role of monitoring in Health Activities

12. LOGISTIC MANAGEMENT (2 Questions)

12.1. Concept and Rationale of logistic Management
12.2. Logistic Cycle/ logistic Right; Process of Logistic Management
12.3. Different Terminology used in logistic Management (FIFO, Stock level, ASL, EOP, VVM)
12.4. Demand and Supply of Health Service Equipment’s and Materials
12.5. Inventory Management; Store Keeping and Store management
12.6. Logistic Management information System(LMIS)
12.7. Role of Logistic Management Division in Health Services

13. HEALTH MANAGEMENT INFORMATION SYSTEM (HMIS) (2 Questions)

13.1. Historical Development, Concept and Definition of HMIS
13.2. Different Types of HMIS : Master Register (HMIS-1), Health Service Card (HMIS-2), OutPatient Register (HMIS-3), Referral Slip (HMIS-4), Discontinuation Tracing (HMIS-5)
13.3. Uses of HMIS in Health Services; Process of HMIS
13.4. Types of Recording and Reporting

14. NATIONAL AND INTERNATIONAL ORGANIZATION CONTRIBUTING HEALTH SECTOR (2 Questions)

14.1. National Organization : Nepal Red Cross Society; Family Planning Association of Nepal (FPAN); Nepal Heart Foundation; Lions Club of Nepal; Nepal Cancer Relief Society; Nepal Netra Jyoti Sangh; Nepal Jaycees; Mrigendra Samjhana Medical Trust; Nepal Disabled Association; Mother Club (Group)
14.2. International Organization : WHO, UNFPA, UNICEF, USAID, UNDP, WORLD BANK, JICA, CARE, SCF, GTZ, DFID, Global Fund, IUHPE

15. HEALTH RELATED COUNCIL (2 Questions)

15.1. Nepal Medical Council, Nepal Nursing Council, Nepal Health Professional Council, Nepal Ayurveda Council, Nepal Health Research Council
15.2. Health Insurance Program In Nepal: Policy; Strategy; Communication Activities; Insurance Schemes.

Full marks = 100
Pass marks = 40
Time = 45 Minutes
No. of questions = 50

(A) Anatomy and physiology

 1. Names, types and functions of the different Organs of following system

 1.1 Skeletal System
1.2 Muscular System
1.3 Digestive System
1.4 Circulatory System
1.5 Urinary System
1.6 Nervous System
1.7 Respiratory System
1.8 Endocrine System
1.9 Sensory Organs

 2. Mechanism of the different system

 2.1 Mechanism of digestion of food
2.2 Mechanism of respiration
2.3 Mechanism of Menstrual cycle
2.4 Mechanism of urinary system

(B) Nursing Procedure and First Aid

 1. Nursing Procedure

1.1 Job description of Auxiliary Nurse Midwife (ANM) in Health Post, Community and district
1.2 Prevention and treatment of bed sore
1.3 Vital signs
1.4 Sterilization: – Importance, types and methods
1.5 Catheterization
1.6 Medicine (Essential drugs used in Health Post, Sub-Health Post and Hospital)

 2. First aid treatment of following condition
 2.1 Fracture
 2.2 Shock, Wound, Hemorrhages, Epistaxis, Scald and Burn
2.3 Unconscious, Fits
2.4 Dog bite, snake bite, Poisoning, foreign body in eye, ear and nose

(C) Family Planning, Maternal and Child Health (MCH) and Nutrition 
1. Methods of family planning
1.1 Temporary methods for male and female
1.2 Permanent methods for male and female
1.3 Family planning counseling
1.4 Various rates and ratio used in population education

 2. Maternal and Child Health (MCH)
 2.1 Immunization
2.2 Six killer diseases (Tuberculosis, Tetanus, Polio, Pertussis, Measles)
2.3 Milestone
2.4 Record Height, Weight and Mid Upper Arm Circumference (MUAC)
2.5 ARI (Acute Respiratory Tract Infection)
2.6 Malnutrition; Protein energy malnutrition (P.E.M.)
2.7 Control of Diarrheal Diseases (CDD)
2.8 Preparation of oral rehydration solution (ORS)
2.9 Advantages of breastfeeding
2.10 Vaccines
2.11 Maintenance vaccine potentiality

3. Nutrition
3.1 Importance of nutrition on the growth and development of the body
3.2 Nutritional requirement in normal children, adult, pregnancy and lactating mother
3.3 Disease due to vitamin deficiency and source of vitamin
3.3.1 Vitamin “A”
3.3.2 Vitamin “B”
3.3.3 Vitamin “C”
3.3.4 Vitamin “D”
3.4 Anaemia and its management
3.5 Goiter, cretinism, mental retardation and its prevention

(D) Diagnosis and treatment of simple disorders

1. Different types of microorganisms including spores and parasite
2. Common skin problems and its management
3. Nursing management of following conditions:
3.1 Diabetes
3.2 Peptic ulcer
3.3 Jaundice
3.4 Typhoid
3.5 Bronchial Asthma
3.6 Bronchitis
3.7 Hypertension
3.8 Congestive cardiac failure
3.9 Rheumatic fever
3.10 Sexually Transmitted Disease (STD)
3.11 Urinary Tract Infection
3.12 Meningitis, Encephalitis
3.13 Paralysis
3.14 Head injury
3.15 Infection of eye
3.16 Mental Health (Types and causes of mental problem)

(E) Health education and Communication
1. Principle and importance of health education 
2. Methods and media of health education
3. Elements, barriers and techniques of communication

(F) Midwifery 
1. Antenatal care (ANC)
1.1 Function of placenta
1.2 Physiological changes during pregnancy
1.3 Signs and symptoms of pregnancy.
1.4 Purpose of Antenatal care.
1.5 Calculation of Last Menstrual Period (LMP) and Expected Date of Delivery (EDD) and gestational week of pregnancy
1.6 Investigations during pregnancy
1.7 Health teaching during antenatal visit
1.8 Minor and Major disorders during pregnancy its management
1.9 High risk factors during pregnancy and their management

 2 Labour (Intranatal)
2.1 Signs & symptoms; and causes of onset of labour
2.2 Physiological changes during first, second and third stages of labour
2.3 Signs and symptoms and management of maternal and foetal distress
2.4 Indications and time of episiotomy
2.5 Method of scoring of the APGAR score
2.6 Immediate care of newborn baby
2.7 Examination of newborn baby
2.8 Complication of third stage and its management
2.9 Abnormal Labour
2.9.1 Occipito posterior position
2.9.2 Multiple pregnancy
2.9.3 Mal presentation
2.9.4 Prematurity
2.9.5 Post maturity
2.10 Management of prolonged labour
2.10.1 Cephalo pelvis disproportion (CPD)
2.10.2 Trial labour (Induction)

3 Postnatal care
3.1 Definition, Principles and purpose of postnatal care
3.2 Minor disorders during puerperium (After pain, retention of urine, constipation, Hemorrhoid, Crack nipple, Engorged breast, Subinvolution of the Uterus)
3.3 Major disorder during puerperium
3.3.1 Puerperal sepsis
3.3.2 Urinary Tract Infection (UTI)
3.3.3 Incontinence of urine and stool
3.3.4 Puerperal haemorrhage
3.3.5 Venus thrombosis
3.3.6 Pulmonary embolism
3.3.7 Postnatal psychosis and depression
3.3.8 Causes, signs and symptoms, complications and management of mother and baby
3.3.9 Major disorders of newborn

(G) Environmental Sanitation and Home visit
1. Community and home visit
2. Health problems and diseases due to poor environmental Sanitation
3. Water pollution
4. Excreta disposal and its importance
5. Types of latrines
6. Classification and management of solid waste disposal

(H) Epidemiology and communicable diseases
1. Definition and aims of epidemiology
2. Concept of diseases
3. Primary Health care (Definition, element, Basic Principles)
4. Immunity
5. Communicable diseases and its prevention, control and treatment including Acquired Immunodeficiency Syndrome (AIDS) and Sexual Transmitted Disease (STD)

(I) Community diagnosis
1. Importance and methods of community diagnosis