FCPHM(SA)

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Examination for the Fellowship of the

College of Public Health Medicine of South Africa
17 March 2014
Paper 1

Long Questions

(3 hours)

Each question to be answered in a separate book (or books if more than one is required for the one answer). Candidates
must answer three of the following four questions.
All the questions carry equal marks. The use of personal hand-held calculators is permitted.

THREE OF THE FOUR QUESTIONS MUST BE ANSWERED

1

2014 has seen the release of the UN Secretary-Generals progress report on Non
Communicable Diseases (NCDs). This report was mandated by the 2011 UN Political
Declaration on NCDs, and marks the first step in the preparatory process for the 2014 UN
Review and Assessment on NCDs. The reports recommendations for accelerating
progress on NCDs cover four main areas: (a) Governance; (b) NCD prevention (c) Health
system strengthening (d) Measuring results. Discuss the challenges for implementing these
recommendations in a South African Health District.
[33 ]

According to the National Health Insurance (NHI) Policy paper (August 2011): The NHI will
contribute to an integrated and enhanced National Health Information System. You have
been appointed to the National Task team and are required to conceptualise and develop
the implementation framework for this integrated system. Discuss your approach- indicating
the various components of this system and the planned roll out. (Details on the software
and hardware are not required).
[33 ]

A new secondary hospital has been built which provides medical, surgical and obstetrics
and gynaecology basic speciality services. You are asked to develop a needlestick injury
policy for this hospital. How would you go about developing the policy? What would be the
key elements of such a policy? How would you implement it? How would you monitor
and evaluate implementation?
[33 ]

Targets, or performance indicators, have been proposed as an effective means for improving
health care services. What are the advantages and drawbacks of employing targets, or
performance indicators, to improve the performance of those delivering health care services?
Use examples from the South African context to illustrate your answer.
[33 ]

FCPHM(SA)

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Examination for the Fellowship of the

College of Public Health Medicine of South Africa
19 March 2014
Paper 3

Short questions

(3 hours)

All questions are to be answered. Each question to be answered in a separate book (or books if more than one is
required for the one answer). The use of personal handheld calculators is permitted.

Global warming is becoming an increasingly important public health issue

a)
What do we mean by the term global warming?
(3)
b)
Briefly discuss the cause of global warming and the potential resultant health
effects.
(7)
[10]

What are the challenges of conducting surveillance for tuberculosis in young children
(< than five years of age)?
[10]

Both the World Health Organisation and the United Nations declaration on Universal Health
Coverage note the importance of locating universal health coverage in the context of action
on social determinants of health
a)
Do you think the concepts of universal health coverage and social determinants of
health are interchangeable in terms of population health. Briefly motivate your
answer.
(5)
b)
How does one ensure that social determinants of health remain central to the
concerns of those pursuing universal health coverage in their national setting?
(5)
[10]

According to the National Health Act (Act 61 of 2003) the national department, every
provincial department and every municipality must establish such health services as are
required in terms of the Act
a)
What services are listed in the act as being municipal health services?
(3)
b)
What are the implications of provincialisation of municipal health services?
(7)
[10]

You have been tasked with developing an educational pamphlet for school health nurses on
Shistosomiasis. What information should the pamphlet contain?
[10]

The District Management team would like to review the quality of medical records for patients
with hypertension at primary health care facilities. Outline how you would employ a rapid
epidemiological technique that will allow them to establish a benchmark for the district.
[10]
PTO/Page 2 Question 7

-27

In South Africa, new HIV infections are most common amongst the 15 to 24 year age group.
A national survey shows while knowledge of HIV prevention and transmission is high, there
have been little change in sexual behaviour, particularly among the youth.
a)
List and briefly describe at least four risky sexual behaviours that are commonly
describes among South African youth aged 15 to 24 years.
(2)
b)
Using an appropriate framework, outline the determinants of the risky sexual
behaviour you listed above as well the mechanisms through which these
determinants lead to the specific risky sexual behaviour.
(8)
[10]

In planning for the delivery of health care services, mental health is often neglected. Briefly
outline why this might be the case, and how you would build into the planning processes
mechanisms to ensure that the Burden of Disease from mental health is properly reflected
in resources allocated to deal with patients with mental health problems.
[10]

You are the principal investigator of a cluster randomised controlled trial evaluating the
effectiveness of peer counselling for smoking cessation in pregnant women. You plan to
randomise 20 community health centres to either receive the intervention or the standard of
care. Outline the issues you will need to consider to ensure the integrity of the intervention
and the robustness of the outcomes.
[10]

10

According to the World Health Organisations global status on non-communicable diseases

(NCDs) in 2010, cardiovascular diseases (CVDs) accounted for the majority of NCD deaths
globally. In South Africa, CVD is amongst the biggest contributors to the cause of death in
adults. Outline and motivate an approach for reducing the modifiable risk factors associated
with CVDs in South Africa.
[10]