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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
25 July 2016
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

The working conditions of young doctors has recently come under the spotlight of the
medias attention following the death in a motor vehicle accident of a young intern who fell
asleep at the wheel of her car following an unbroken work shift of 36 hours. Letters to the
press have criticised the Health Department for failing to pay adequate attention to the
working conditions of its staff, to the detriment of both employee safety and the quality of
patient care. The National Department of Health convenes a Human Resources Taskteam to
address the problem and appoints you to serve as a Public Health Medicine specialist on the
team. Outline what you would propose as a comprehensive approach to the problem from a
Public Health Medicine perspective.
[33 ]

In 2012, the World Health Assembly endorsed an important new health goal: to reduce
avoidable mortality from non-communicable diseases (NCDs) by 25% by 2025 (the 25 by 25
goal). It remains a truth today that, despite global rhetoric and resolutions, NCDs remain the
least recognised group of conditions that threaten the future of human health and wellbeing.
Critically discuss the state of NCDs in SA, the challenge to economic development posed by
NCDs and the health sector response to NCDs, based on the 2020 targets set out by the
National Department of Health (NDOH). Outline how you would propose, as a Public Health
Medicine specialist, improving on the health sectors approach to NCDs in South Africa.
[33 ]

In his Budget Vote 2016, the Minister of Health announced important changes in the
prevention and control of HIV/AIDS in South Africa, one of which was the introduction of a
Universal Test and Treat policy. As Public Health Medicine Advisor in your Provincial Health
Department, prepare a briefing document in which you discuss the background and rationale
of this policy and outline an implementation plan for the Province.
[33 ]

Diarrhoea remains among the 10 leading causes of death in the world. As a Public Health
Medicine specialist in the Provincial Health Department, you are asked by the Chief Director
responsible for Communicable Disease Control to prepare a briefing paper on how best to
reduce the Burden of Disease in your province, which is to be submitted to the MEC for
Health. Provide a first draft of your briefing paper for the MEC.
[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
27 July 2016
Paper 3

Short Questions

(3 hours)

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 hand-held calculators is permitted.

All ten questions are to be answered. Each question counts 10 marks


1

a)

Compare traditional literature reviews and systematic reviews by completing the


table below.
(6)
Traditional literature review
Systematic review
Formulation of the question
Search strategy to identify studies
Quality assessment of identified studies
b)

A systematic review was conducted to assess the effects of pre-hospital


thrombolysis versus in-hospital thrombolysis for acute myocardial infarction. Read
the search strategy below and comment on what should be added to ensure
completeness.
(4)
[10]

PTO/ Page 2 Question 2

-22

From what you know of the effectiveness of Motivational Interviewing (MI) to effect
behaviour changes needed for health, how would you approach the introduction of an
intervention based on MI to prevent foetal alcohol syndrome in children born to mothers
who attend public sector health services? In your answer, briefly identify (a) whom you
would target and why?, (b) what the content of the MI intervention would focus upon?, (c)
what obstacles to behaviour changes you would expect and how you plan to deal with
these?; and (d) broadly how you would evaluate the intervention?
[10]

The Programme Manager for Child Health requests your assistance to address the problem
of helminthic infection in the district due to Ascriasis lumbricoides in children. Describe
briefly how you will advise the manager, taking note of the mode of transmission and
prevention and control measures.
[10]

"Terrorist incidents in the United States and elsewhere involving bacterial pathogens, nerve
gas, and a lethal plant toxin, have demonstrated that the United States is vulnerable to
biological and chemical threats..." What is biological and chemical terrorism? How can the
South African health sector best prepare against such terrorism?
[10]

Lead poisoning is a major potential environmental health challenge in South Africa


a)
Briefly outline the main sources and pathways of exposure to lead for communities
in South Africa.
(5)
b)
What surveillance mechanisms is in place to monitor lead poisoning in the
community and how effective is this mechanism?
(5)
[10]

Cabinet has recently approved the National Public Health Institute of South Africa (NAPHISA) Bill, 2015 (see
Government Gazette No 39392, Vol 605 of 11 November 2015) for public comments. Describe three of

the proposed functions of NAPHISA and explain how these will contribute to advancing
public health in South Africa.
[10]
7

Critically discuss the rationale for health-related food taxes.

[10]

How would you define Financial Management and what is the relevance of good financial
management to Public Health and Public policy?
[10]

The Sustainable Development Goals (SDGs) were ratified by the UN last year (2015)
a)
What are the major differences between the SDGs and the Millenium Development
Goals?
(6)
b)
South Africa was an important contributor to the development of the SDGs. Describe
the gap between our National Development Plan (NDP) and the SDGs and what
should be the appropriate measures to bridge this gap?
(4)
[10]

10

In a resource-constrained environment, there is a growing need for more health economic


analyses to be performed.
a)
List the different types of economic evaluation that can be conducted.
(5)
b)
Briefly outline elements of a critical appraisal checklist for an economic evaluation
study.
(5)
[10]