SECTION 2: SHORT ANSWER QUESTIONS 41. Explain three (3)principles of Primary health care in community strategy concept. (6 marks) 42. Explain three (3)social services available for management of various persons with special needs in the community. 43. State the five (5) stages in the process of bacilli of 'calmette Guerin (BCG)reaction following administration. (6 marks) (5 marks) (6 marks) 46. Explain three (3)reasons for carrying out programmed annual staff appraisal (6 marks) 47. State four (4)general principles in management of sexually transmitted infection(marks) 48. Draw a diagram to show the transmissior cycle of Schistosoma Hacmatobium. (5 marks) SECTION 3: LONG ANSWER QUESTION (20 MARKS) 49. You are deployed as a community health nurse in charge of a Sub County where health seeking behavior of majority of lifecycle cohorts in the community is very low and communicable diseases prevalence is on the increase. a) State four (4)factors that influence health seeking behavior of the community (4 marks) b) State four (4)principles of prevention and control of communicable diseases. c) Describe specific services to be rendered to each of the six lifecycle cohorts in this community according to Kenya essential package of Health (KEPH) to improve their health status. (12 marks) (4 marks) (40 MARKS) 44. Explain the components in the epidemiological triad KMTCQP-8FPS 45. State four (4) Health sector flagship projects for attainment of visian 2030 (4 marks)

41. Three principles of Primary health care in community strategy concept are:<br /> - Accessibility: Ensuring that health services are accessible to all individuals in the community, regardless of their socioeconomic status.<br /> - Community participation: Involving community members in the planning, implementation, and evaluation of health programs to ensure that they are culturally appropriate and meet the specific needs of the community.<br /> - Intersectoral collaboration: Collaborating with other sectors such as education, agriculture, and social services to address the broader determinants of health and improve overall well-being.<br /><br />42. Three social services available for management of various persons with special needs in the community are:<br /> - Special education services: Providing tailored educational programs and support for individuals with disabilities or special needs.<br /> - Rehabilitation services: Offering therapies and interventions to help individuals regain or improve their physical, cognitive, or emotional functioning.<br /> - Social support services: Providing assistance and resources to individuals and their families, such as counseling, financial aid, and advocacy.<br /><br />43. The five stages in the process of bacilli of calmette Guerin (BCG) reaction following administration are:<br /> - Incubation period: The time between the administration of the vaccine and the appearance of the reaction.<br /> - Redness and swelling: The appearance of localized redness and swelling at the injection site.<br /> - Formation of papule: The development of a small raised bump or nodule at the injection site.<br /> - Ulceration: The rupture of the papule, resulting in an open sore or ulcer.<br /> - Healing: The resolution of the ulcer and the return of the skin to its normal appearance.<br /><br />44. The three components in the epidemiological triad are:<br /> - Agent: The microorganism or pathogen that causes the disease.<br /> - Host: The individual or organism that harbors the disease.<br /> - Environment: The external factors that influence the transmission and severity of the disease.<br /><br />45. Four Health sector flagship projects for attainment of vision 2030 are:<br /> - National Hospital Insurance Fund (NHIF): Providing affordable access to healthcare services for all citizens.<br /> - National Hospital Construction Program (NHCP): Building new hospitals and upgrading existing ones to improve healthcare infrastructure.<br /> - National Health Management Information System (NHMIS): Collecting and analyzing health data to inform policy and program planning.<br /> - National Health Research Institute (NHRI): Conducting research to generate evidence for improving health outcomes and informing policy decisions.<br /><br />46. Three reasons for carrying out programmed annual staff appraisal are:<br /> - Performance evaluation: Assessing the performance of staff members and identifying areas for improvement.<br /> - Professional development: Providing opportunities for staff to receive feedback, set goals, and engage in professional development activities.<br /> - Organizational development: Identifying areas for improvement in organizational processes and systems to enhance overall effectiveness.<br /><br />47. Four general principles in management of sexually transmitted infection are:<br /> - Early detection and diagnosis: Prompt identification of infections to initiate appropriate treatment and prevent further transmission.<br /> - Partner notification and treatment: Informing and treating sexual partners to prevent reinfection and further spread of the infection.<br /> - Patient education and counseling: Providing individuals with information and support to make informed decisions about their health.<br /> - Confidentiality and privacy: Ensuring that patient information is kept confidential and that privacy is respected in all aspects of care.<br /><br />48. Diagram showing the transmission cycle of Schistosoma Haematobium:<br /> - The diagram would depict the life cycle of the Schistosoma Haematobium parasite, including the free-swimming larva (miracidium), the snail host, the cercariae (infective stage), and the adult worms in the human host.<br /><br />49. a) Four factors that influence health seeking behavior of the community are:<br /> - Socioeconomic status: Access to resources and financial means to seek healthcare services.<br /> - Cultural beliefs and practices: Influence of traditional beliefs and practices on health-seeking behaviors.<br /> - Accessibility of healthcare services: Availability and accessibility of healthcare facilities and providers.<br /> - Health literacy: Knowledge and understanding of health issues and the importance of seeking medical care.<br /><br />b) Four principles of prevention and control of communicable diseases are:<br /> - Early detection and diagnosis: Identifying cases promptly to initiate appropriate treatment and prevent further transmission.<br /> - Isolation and quarantine: Separating infected individuals from healthy individuals to prevent the spread of disease.<br /> - Immunization: Providing vaccines to protect individuals from specific communicable diseases.<br /> - Vector control: Implementing measures to control or eliminate disease-carrying organisms, such as mosquitoes or ticks.<br /><br />c) Specific services to be rendered to each of the six lifecycle cohorts in this community according to Kenya essential package of Health (KLPH) to improve their health status:<br /> - Newborns: Providing essential newborn care, including breastfeeding support, cord care, and immunizations.<br /> - Children: Offering immunizations, growth monitoring, and treatment of common childhood illnesses.<br /> - Adolescents: Providing reproductive health services, including contraception and sexually transmitted infection prevention.<br /> - Adults: Offering preventive screenings, management of chronic conditions, and treatment of acute illnesses.<br /> - Elderly: Providing geriatric care, chronic disease management, and support for functional limitations