UP NHM CHO cheat sheet

Incidence rate = (new cases in a period ÷ population at risk at start of period) × 1000; it measures risk of developing disease.

Prevalence = (all existing cases at a point ÷ total population) × 1000; prevalence ≈ incidence × mean duration of disease.

Crude death rate = (deaths in a year ÷ mid-year population) × 1000; use age-specific rates when comparing populations with different age structures.

Infant mortality rate = (deaths under 1 year ÷ live births in the same year) × 1000; neonatal deaths occur in the first 28 days, post-neonatal from day 29 to 11 months.

Maternal mortality ratio = (maternal deaths ÷ live births) × 100,000; a maternal death is a female death during pregnancy or within 42 days of termination, from pregnancy-related causes.

Attack rate = (new cases among exposed ÷ total exposed) × 100; food-borne outbreak investigation compares attack rates in those who ate versus did not eat a suspect item.

Sensitivity = TP ÷ (TP + FN); specificity = TN ÷ (TN + FP); a highly sensitive test is used for screening, a highly specific test for confirmation.

Herd immunity threshold = 1 − (1 ÷ R0); for measles R0 of 12–18 the threshold exceeds 90–95%, which is why measles outbreak control needs very high two-dose coverage.

Epidemic = cases above expected in a defined area/time; endemic = usual expected occurrence; pandemic = epidemic across countries; sporadic = isolated irregular cases.

Comprehensive Primary Health Care (as in the 2018 Astana Declaration) rests on first-contact access, continuity, comprehensiveness, coordination, and community participation; Ayushman Bharat has Health and Wellness Centres as its primary-care arm.

National Health Mission comprises the National Rural Health Mission (2005) and National Urban Health Mission (2013); it supports ASHAs, sub-centres, PHCs, and CHCs, with CHCs as first referral units.

Population norms: sub-centre for 5,000 (3,000 in hilly/tribal areas), PHC for 30,000 (20,000 hilly/tribal), CHC for 1,20,000 (80,000 hilly/tribal).

RMNCH+A covers Reproductive, Maternal, Newborn, Child and Adolescent health as a continuum of care across five life stages, with referral linkages between community and facility levels.

JSSK (Janani Shishu Suraksha Karyakram) entitles pregnant women and sick newborns to free delivery care, drugs, diagnostics, blood, diet, and free transport; RBSK screens children 0–18 years for 4 Ds: defects at birth, deficiencies, diseases, and developmental delay/disability.

National programmes to recall: NTEP (TB, daily fixed-dose combination, Ni-kshay portal), NVBDCP (malaria, dengue, kala-azar, filaria), NPCDCS (NCDs), NPPCD (hearing), NPCB (blindness), and PM-JAY for hospitalisation cover.

Mission Indradhanush and Intensified MI target unvaccinated and partially vaccinated children and pregnant women in low-coverage districts to raise full immunisation coverage.

Normal adult vitals: pulse 60–100/min, respiratory rate 12–20/min, blood pressure under 120/80 mmHg, oral temperature 36.5–37.5 °C, SpO2 95% or above at room air.

WHO danger signs in a child: unable to drink or breastfeed, persistent vomiting, convulsions, lethargy or unconsciousness, and chest indrawing or stridor in a calm child - classify as severe and refer urgently.

Order of abdominal examination: inspection, auscultation, percussion, palpation; auscultate bowel sounds before palpation because palpation alters their frequency.

Blood pressure cuff bladder should cover about 80% of arm circumference and 40% of arm width; a cuff that is too small falsely raises the reading.

Glasgow Coma Scale: eye 1–4, verbal 1–5, motor 1–6, total 3–15; score of 8 or less indicates need to protect the airway.

Pulse oximetry and respiratory rate are the earliest indicators in pneumonia and severe dehydration; capillary refill over 3 seconds and skin pinch over 2 seconds suggest dehydration.

Informed consent requires capacity, adequate information (diagnosis, options, risks, benefits), and voluntariness; document the discussion and use a guardian for minors.

WHO recommends at least 8 antenatal contacts; in India, Pradhan Mantri Surakshit Matritva Abhiyan provides a free comprehensive antenatal check on the 9th of each month, and PMSMA plus Kalazar/anaemia screening are linked.

Essential newborn care: immediate drying, delayed cord clamping (1–3 minutes), skin-to-skin contact, early breastfeeding within one hour, and exclusive breastfeeding for 6 months.

Kangaroo Mother Care: continuous skin-to-skin contact, exclusive breastfeeding, and early discharge with follow-up - for low-birth-weight and preterm stable newborns.

Danger signs in pregnancy: bleeding, severe headache with blurred vision, fits, high fever, reduced fetal movements, and draining of fluid - refer immediately.

Immunisation schedule (India): BCG, OPV-0, and hepatitis B birth dose at birth; 6, 10, and 14 weeks for pentavalent, OPV, rotavirus, fIPV, and PCV; measles-rubella at 9–12 months and 16–24 months; DPT and OPV boosters at 16–24 months; Td at 10 and 16 years.

Vitamin A: 9 doses of 1 lakh IU (6 months to 5 years) - first dose at 9 months with measles-rubella, then every 6 months; iron-folic acid supplementation and deworming (albendazole) are part of child health.

Adolescent health: Rashtriya Kishor Swasthya Karyakram covers nutrition, sexual and reproductive health, mental health, substance misuse, injuries, and NCDs; anaemia and menstrual hygiene are priority issues.

Tuberculosis: diagnosis by sputum microscopy, CBNAAT/NAAT as the initial test per NTEP, and drug-susceptibility testing; treatment is daily fixed-dose combination, with 6 months for drug-sensitive TB and longer regimens for drug-resistant TB.

Malaria: Plasmodium falciparum causes severe disease; diagnosis by rapid diagnostic test or microscopy; artemisinin-based combination therapy plus primaquine for falciparum, and chloroquine plus primaquine for vivax.

Dengue: Aedes aegypti, daytime biting, breeds in clean stagnant water; warning signs are abdominal pain, persistent vomiting, mucosal bleeding, and fluid accumulation - refer for hospital care.

Kala-azar (visceral leishmaniasis): sandfly vector, fever with splenomegaly and weight loss; diagnosis by rK39 rapid test; elimination target is under 1 case per 10,000 population at block level.

Leprosy: caused by Mycobacterium leprae, diagnosed clinically by loss of sensation in hypopigmented patches; multi-drug therapy is given for 6 months (paucibacillary) or 12 months (multibacillary).

NCDs: four main groups are cardiovascular disease, cancer, diabetes, and chronic respiratory disease; shared risk factors are tobacco, unhealthy diet, physical inactivity, and harmful alcohol use.

Hypertension is diagnosed at 140/90 mmHg or above on repeated measurements; diabetes at fasting plasma glucose of 126 mg/dL or above, or HbA1c of 6.5% or above.

Levels of prevention: primordial (risk factor prevention in populations), primary (pre-disease, e.g. immunisation), secondary (early detection and treatment), tertiary (limitation of disability and rehabilitation).

Health Belief Model constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action, and self-efficacy.

Stages of Change (transtheoretical) model: precontemplation, contemplation, preparation, action, maintenance, and relapse - interventions must match the stage.

Communication channels: interpersonal channels are better for complex behaviour change and trust; mass media raises awareness; a mix of both is usually most effective.

For a message to be understood, use plain local language, short sentences, pictures, and teach-back to confirm comprehension; address the specific barrier, not the general topic.

IEC (information, education, communication) is one-way; BCC is participatory and dialogue-based, uses audience segmentation, and is evaluated through behaviour change, not just message recall.

Flip charts, flash cards, role-play, and demonstration are common community education methods; group teaching should be interactive, with 6–10 participants and a session of about 30–45 minutes.

HMIS indicators are calculated as numerator ÷ denominator × 100 or × 1000; always state the multiplier and the time period.

Common HMIS indicators: ANC registration in the first trimester, 4 or more ANC visits, institutional delivery, early initiation of breastfeeding, full immunisation, and outpatient per 1,000 population.

Data quality dimensions: completeness, timeliness, accuracy, consistency, validity, and integrity; validate by cross-checking registers against reports.

Weekly reporting: IDSP (Integrated Disease Surveillance Programme) reports weekly; outbreak thresholds should trigger immediate reporting.

RCH portal records maternal and child health data; the Ni-kshay portal records TB patients; these are used for tracking and not only for summary reporting.

Data flow: sub-centre and ASHA registers to PHC to block to district to state to national level; feedback should flow back down to the reporting level.

Confidentiality: patient identifiers must not be shared on public or unofficial channels; aggregate data are shared, and individual data only for care or authorised purposes.

Core principles: autonomy, beneficence, non-maleficence, and justice; confidentiality and truth-telling are derived duties.

Valid consent needs capacity, disclosure, comprehension, and voluntariness; for a minor under 18, a parent or guardian consents, and assent is sought from the child.

Medical termination of pregnancy: under the amended MTP Act, a woman's own request is sufficient up to 20 weeks; 20–24 weeks requires two registered medical practitioners' opinion.

PCPNDT Act prohibits prenatal sex determination and advertising of such services; the reason for any antenatal diagnostic test must be recorded.

Notifiable diseases and medico-legal cases (poisoning, assault, burns, road traffic injury, suspected sexual assault) must be reported to police and recorded in the register.

Medical negligence requires duty of care, breach of that duty, causation, and damage; documentation and adherence to standard protocols are the best defence.

Maintain confidentiality except where disclosure is required by law, court order, or to prevent serious harm; never discuss a patient's identity in public or on social media.

Percentage change = (new value − old value) ÷ old value × 100; percentage increase and decrease are not symmetric (a 20% rise needs a 16.7% fall to return to the original).

Simple interest = P × R × T ÷ 100; compound amount = P × (1 + R ÷ 100)^T; for 2 years the difference between CI and SI is P × (R ÷ 100)^2.

Ratio and proportion: if a : b = c : d then ad = bc; divide a quantity in ratio a : b by giving parts a ÷ (a + b) and b ÷ (a + b) of the total.

Average = sum ÷ count; combined average of two groups = (n1 × mean1 + n2 × mean2) ÷ (n1 + n2).

Speed = distance ÷ time; to convert km/h to m/s multiply by 5/18, and m/s to km/h multiply by 18/5.

Work: if A finishes in x days and B in y days, together they finish in xy ÷ (x + y) days.

Number series and coding-decoding questions: identify the constant difference, ratio, or alternating pattern first; for letter codes, map each letter to its position number (A=1 … Z=26).

Blood relations and direction sense: draw a diagram; for direction, a left turn after facing north means facing west.

Profit or loss percentage is always calculated on cost price: profit% = (SP − CP) ÷ CP × 100.

Discount is calculated on marked price: SP = MP × (1 − discount% ÷ 100).

Mixture problems: use alligation - ratio of quantities = (mean price − cheaper price) : (dearer price − mean price).

Probability = favourable outcomes ÷ total outcomes; for independent events multiply probabilities; for mutually exclusive events add them.

Permutation of n distinct items taken all at a time = n!; combination of r from n = n! ÷ (r! × (n − r)!).

Calendar and clock: a clock's hands coincide 11 times in 12 hours; the angle between the hands = |30H − 5.5M| degrees.

Syllogism: draw Venn diagrams for the premises; a conclusion is valid only if it holds in every possible diagram.

Data interpretation: read the units and the base year before calculating; percentage of total = part ÷ total × 100.