ASSIGNMENT

DRIVE

FALL 2015
MBA/ MBAFLEX/ MBAHCSN3 (Sem3)
MBADS (Sem3 / Sem5)
PGDHSMN (Sem1)

PROGRAM
SUBJECT CODE &
NAME
BOOK ID
CREDIT & MARKS

Question No. 1)
A)
ANSWER: -

MH0051 Health Administration

B1212
4 Credits, 60 marks

Explain the types of epidemiological studies and list the uses of

epidemiology.
Explanation of types of epidemiological studies
Uses of epidemiology

Epidemiological Studies:-

The epidemiological approach permits investigation of

the characteristics of the total target population for health services, users and nonusers.
The method yields patterns of physician, pharmacist, and traditional service use;
quantification of the size of various user and nonuser groups, and differential
morbidity rates.
Epidemiological studies can be divided into two basic types depending
on (a) whether the events have already happened (retrospective) or (b) whether the
events may happen in the future (prospective). The most common studies are the
retrospective studies which are also called case- control studies. The first step in an
epidemiological study is to strictly define exactly what requirements must be met in order
to classify someone as a "case." This seems relatively easy, and often is in instances where
the outcome is either there or not there (a person is dead or alive).The strength of an
epidemiological study depends on the number of cases and controls included in the
study.

1.

Observational studies:- In observational studies, the epidemiologist does not assign a

treatment but rather observes.
a) Case control studies: - The "why me?" study investigates the prior exposure of individuals
with a particular health condition and those without it to infer why certain subjects, the
"cases," become ill and others, the "controls," do not. The main advantage of the casecontrol study is that it enables us to study rare health outcomes without having to follow
thousands of people.
Page 1 of 9

b) Cohort studies:- The "What will happen to me?" study follows a group of healthy people
with different levels of exposure and assesses what happens to their health over time. It
is a desirable design because exposure precedes the health outcome a condition
necessary for causation and is less subject to bias because exposure is evaluated
before the health status is known.
2. Experimental studies:In experimental studies, the epidemiologist assigns subjects treatments. This is in
contrast to the observational study, where the researcher observes subjects and, in a
sense, 'waits' for the 'treatment' or results to happen. The hallmark of the experimental
study is that the allocation or assignment of individuals is under control of investigator
and thus can be randomized. The key is that the investigator controls the assignment of
the exposure or of the treatment but otherwise symmetry of potential unknown
confounders is maintained through randomization. Properly executed experimental
studies provide the strongest empirical evidence.

Pictorial Representation of the Different Types of

Epidemiological Studies

Uses of Epidemiology
There are seven identified uses of epidemiology.
1. Studying the history of the health of the population: For example, the types of
problems that affect society and humanity have changed over periods of time. If
you look at data for the 1900s, you would see that there were certain infectious
diseases that predominated at that time. If you compare those with the patterns
that we have at present, you would see that many of the infectious diseases have
been replaced by chronic diseases of long duration, of long standing.
2. Diagnosis of the health of the community: In this type of epidemiology, we
try to make a picture of the characteristics of the community with respect to its
demographic makeup, in terms of particular health problems that exist in the
community. From that information we can propose specific plans and programs to
intervene in order to optimize the health of the community.
3. Operations Research: Another use is known as studying the working of health services.
For example, we want to find out if there are areas of the community or our city or
county, our state or whatever geographic subdivision we're looking at, that are
Page 2 of 9

lacking in health services or whether there are some that are overlapping. That is
also known as Operations Research.
4. Study of individual risks: Another use of epidemiology is called the study of individual
risks. For example, one may have observed the prognosis of cancer patients who are
diagnosed with a specific form of cancer, or cancer patients who undergo a certain
type of treatment. What is their prognosis over time? How long are they likely to live?
5. Identifying syndromes: The use of epidemiology known as identifying syndromes has to
do with identifying characteristic patterns of symptoms and other dimensions that are
associated with a specific disease. As an example, the common cold has certain
symptoms associated with it or the flu - runny nose, headaches, muscle aches, fever
and so forth. This is another use of epidemiology.
Question No. 2)
A)

Describe the demographic profile of India.

Mentioning the components of demography
Explanation of components of demography

ANSWER: -

Demographic Profile:India is presently following the demographic transition

pattern of all developing countries from initial levels of high birth rate high death
rate to the current intermediate transition stage of high birth rate low death rate
which leads to high rates of population growth, before graduating to levels of low birth
rate low death rate.

1. Age composition: The age distribution of the population of India is projected to change by
2016, and these changes should determine allocation of resources in policy
intervention. The population below 15 years of age (currently 35 percent) is projected
to decline to 28% by 2016. The population in the age group 15-59 years (currently 58
percent) is projected to increase to nearly 64% by 2016. The age group of 60 plus years is
projected to increase from the current levels of 7% to nearly 9% by 2016.
2. Inter-state differences: India is a country of striking demographic diversity.
Substantial differences are visible between states in the achievement of basic demographic
indices. This has led to significant disparity in current population size and the potential to
influence population increases during
1996-2016. There are wide inter-state, male-female and rural-urban disparities in outcomes
and impacts. These differences stem largely from poverty, illiteracy, and inadequate access
to health and family welfare services, which coexist and reinforce each other. In many parts,
the widespread health infrastructure is not responsive.
3. Maternal mortality: With 16% of the world's population, India accounts for over 20% of the
world's maternal deaths. The maternal mortality ratio, defined as the number of maternal
deaths per 100,000 live births, is incredibly high at 408 per 100,000 live births for the
country (1997), which is unacceptable when compared to current indices elsewhere in Asia.
4. Infant mortality: It is estimated that about 7% of new-born infants perish within a
year. Poor maternal health results in low birth weight and premature babies. Infant and
Page 3 of 9

childhood diarrhea diseases, acute respiratory infections and malnutrition contribute to

high infant mortality rates. Additionally, in India, across the board (rural or urban
areas), there are more female deaths in the age group of 0-14 than elsewhere. Although
the Infant Mortality Rate (IMR) has decreased from 146 per1000 births in 1951 to
72 per 1000 births (1997), and the sex differentials are narrowing, again there are
wide inter-state differences recorded in 1998.
5. Sex ratio: India shares a distinctive feature of South Asian and Chinese populations as
regards the sex ratio, with a century's old deficit of females. The (female to male) sex
ratio has been steadily declining. From 1901 to 1991, the sex ratio has declined from
972 to 927. This is largely attributed to the son preference, discrimination against the girl
child leading to lower female literacy, female feticides, higher fertility and higher
mortality levels for females, in all age groups up to 45.
Question No. 3)
A)

Define disaster management. Explain the steps in disaster management.

Definition
Explanation of steps in disaster management

ANSWER: -

Disaster management:-

It can be defined as the organization and

management of resources and responsibilities for dealing with all humanitarian aspects of
emergencies, in particular preparedness, response and recovery in order to lessen the
impact of disaster.
It is the discipline of dealing with and avoiding risks. It is a discipline
that involves preparing for disaster before it occurs, disaster response (e.g., emergency
evacuation, quarantine, mass decontamination, etc.), and supporting, and rebuilding
society after natural or human-made disasters have occurred.
Mainly there are four steps in disaster management: mitigation,
preparedness, response and recovery. Every disaster is different and response is decided
by the events at hand. Disasters might be natural or unnatural in origin. The type of
emergency determines the response. Some disasters might require evacuation or
relocation. Others might demand quarantine or decontamination. The meanings of the
terms used in the disaster management are as follows:
1.

Mitigation: The mitigation phase of disaster management focuses on long-term

preparation or avoidance of disaster completely. The accurate identification of risks is
very significant at this point. Risks are ranked through catastrophic modeling, which uses
mathematical formulas and computer calculations to weigh risk. Mitigation also comprises
preventive actions categorized as either structural solutions, such as shoring up levees,
to prevent flooding, or nonstructural solutions such as connecting with local and
government agencies to work out the flow of emergency process.

2.

Preparedness: Preparedness
comprises
collecting
supplies in anticipation
of disaster scenarios as well as training of emergency and non-emergency staff. Disaster
Page 4 of 9

management focuses on ensuring the availability of shelter for displaced citizens as well
as maintenance and storage of equipment, training of staff and volunteers, and preparing
for resource mobilization. Large-scale disaster training exercises are often conducted to
test preparedness and look for weaknesses in disaster response. Corporations might also
have emergency response teams consisting the volunteers that undergo drills meant for
disaster preparedness.
3. Response: First responders to a disaster are generally law enforcement, firefighters and
emergency medical technicians. After that, if a disaster warrants a large-scale response,
the chain of command and resource utilization moves to the county, then to the state
and, finally, to the local level. Volunteer organizations such as the Red Cross are often
pivotal to the response effort as well. Response timing is very important as most disaster
victims die within the first two days of a catastrophic event.
4. Recovery: Once the initial crisis has passed, it is time to rebuild and restore what was
lost. This is known as the recovery phase of disaster management. The central
government coordinates and provides the majority of post-disaster assistance as
determined by the National Response Plan, which is managed by the Department
responsible for the management and rescue of the disaster victims. As the recovery phase
comes to a close, a thorough assessment of what failed or succeeded should be taken and
used to improve all phases of disaster management.
Question No. 4)
A)

What is ergonomics? Discuss the occupational related legislations in India.

Meaning of ergonomics
Discussing occupational related legislations in India

ANSWER: -

Ergonomics: -

The applied science of equipment design, as for the workplace,

intended to maximize productivity by reducing operator fatigue and discomfort is called
ergonomics. The primary aim of ergonomics according to Grand jean is to optimize the
functioning of a system by adapting it to human capacities and needs. Ergonomics is a
multidisciplinary task the occupational health station should have good contacts with
the management and safety personnel of the company. Participation of the workers in
the design and implementation of the ergonomic changes will convey the users' point
of view into the process and make certain its success.
Occupation-related Legislation
Occupational Health & Safety are broadly divided into three Statutes:

Statutes for safety at workplaces

Statutes for safety of substances
Statutes for safety of activities
At present, safety and health statutes for regulating Occupational Health & Safety of
persons at work exist only in four sectors:
Mining
Page 5 of 9

 Factories
Ports
Construction
The major legislations are:
Factories Act, 1948
It regulates health, safety, welfare and other working conditions of workers in factories.
It is enforced by the State Governments through their factory inspectorates.
The Directorate General Factory Advice Service & Labour Institutes (DGFASLI) co-ordinates
matters concerning safety, health and welfare of workers in the factories with the State
Governments.
DGFASLI conducts training, studies and surveys on various aspects relating to safety
and health of workers through the Central Labour Institute in Mumbai and three other
Regional Labour Institutes located at Kolkata, Chennai and Kanpur.
Mines Act, 1952
It contains provisions for measures relating to the health, safety and welfare of
workers in the coal, metalliferous and oil mines.
The Mines Act, 1952, prescribed duties of the owner (defined as the proprietor,
lessee or an agent) to manage mines and mining operation and the health and safety in
mines. It also prescribes the number of working hours in mines, the minimum wage rates,
and other related matters.
Directorate General of Mines Safety conducts inspections and inquiries, issues
competency tests for the purpose of appointment to various posts in the mines, and
organizes seminars/conferences on various aspects of safety of workers.
Courts of Inquiry are set up by the Central Government to investigate into the
accidents, which result in the death of 10 or above miners. Both penal and pecuniary
punishments are prescribed for contravention of obligation and duties under the Act.
Dock Workers (Safety, Health & Welfare) Act, 1986
It contains provisions for the health, safety and welfare of workers working in
ports/docks.
It is administered by Director General Factory Advice Service and Labour Institutes,
Directorate General FASLI as the Chief Inspector there are inspectorates of dock safety
at 10 major ports in India viz. Kolkata,
Mumbai, Chennai, Visakhapatnam, Paradip,
Kandla, Mormugao, Tuticorin, Cochin and New Mangalore
Overall emphasis in the activities of the inspectorates is to contain the accident rates
and the number of accidents at the ports.
Other legislations and the rules framed there under:
Plantation Labour Act, 1951
Explosives Act, 1884
Page 6 of 9

Petroleum Act, 1934

Insecticide Act, 1968
Indian Electricity Act, 1910
Indian Boilers Act, 1923
Indian Atomic Energy Act, 1962
Building and Other Construction Workers (Regulation of Employment and Conditions
of Service) Act, 1996
Beedi and Cigar Workers' (Conditions of Employment) Act, 1966

Question No. 5)
A)

Explain the different types of health insurance policies in India.

Mentioning health insurance policies in India
Explanation of important health insurance policies in India

ANSWER:

Health Insurance Policies

The New India Assurance and Mediclaim 2007: The National
Insurance, New India Assurance, United India and Oriental Insurance, which were
earlier subsidiaries of the General Insurance Company (GIC), have become autonomous
and their mediclaim policies are more or less the same with slight variations.
Though the premium of mediclaim policy has almost doubled in the last five years; the
middle class is forced to opt for this policy due to various reasons
The decline in medical cover by employers, increase in income and the growing number
of diseases. Also the treatment costs have increased manifold.
Group Mediclaim New India: The employer can also take group mediclaim scheme to
provide medical cover to the employees. He added that under the group policy, the
company would give a discount of 2.5 to 30 per cent in premium depending upon the
number of policyholders.
Bhavishya Arogya: Bhavishya Arogya is essentially to take care of medical expenses needs
of persons in their old age.
Coverage
The policy provides for expenses in respect of hospitalization and domiciliary
hospitalization during the period commencing from the Policy Retirement Age selected
till survival. This is selected by the insured for the purpose of commencement of
benefits in the policy.
The pre-retirement period incepts from the date of acceptance of the proposal
and ends with the policy retirement age during which the insured pays premium
either in installments or as single premium.
Amount: The sum insured ranges from Rs. 50,000 onwards and the premium depends on
the sum insured and the policy retirement age selected and mode of payment
(single/installment).

Page 7 of 9

Mediclaim insurance
Age: Between 5-80 years. Children between 3 months and 5 years can be covered
provided one or both parents are also covered.
Coverage: Insures against any hospitalization expenses that may arise in future. The
scheme reimburses hospitalization expenses for illness, diseases or injury sustained,
excludes any disease existing before taking the policy.
Cost: Sum insured can be anywhere between Rs. 15,000 Rs. 500,000. Rate of premium
ranges between Rs. 175 per year to Rs. 2,500 per year depending on the age and capital
sum insured.
Amount: Compensation up to the extent of sum insured.
LICs Ashadeep
Provides insurance against four major critical ailments cancer (malignant), paralytic
stroke resulting in permanent disability, renal failure of both kidneys and coronary artery
diseases where by-pass surgery has been done.
Age: Between 18-65 years. Maximum age at entry is 50 years.
Cost: Premium ranging from Rs. 70.95 to 99 Rs. Per Rs. of the sum assured depending
on the age of the claimant and the policy term (15, 20 or
25 years).
Amount: Insurance can be taken for a sum ranging from Rs. 50,000 to Rs.
300,000. Immediate payment of 50 per cent of sum assured and payment of an amount
equal to 10 per cent of the sum assured every year from the establishment of affliction to
the date of maturity or death, whichever is earlier?
Health Insurance in Private Health Sector
The year 1999 set the beginning of a new era for health insurance in the Indian context.
With the passing of the Insurance Regulatory Development Authority Bill (IRDA) the
insurance sector was opened to private and foreign participation, thereby giving way for
the entry of private health insurance companies. The Bill also eased the establishment
of an authority to protect the interests of the insurance holders by regulating, promoting
and ensuring orderly growth of the insurance industry. The bill allows foreign promoters to
hold paid up capital of up to 26 percent in an Indian company and necessitates them to
have a capital of Rs 100 crore along with a business plan to start its operations. Presently,
a few companies such as Bajaj Alliance, ICICI, Royal Sundaram, and Cholamandalam among
others are offering health insurance schemes.

Page 8 of 9

Question No. 6)
A)

Discuss the impact of lifestyle diseases on healthcare industry and

economy.
What are lifestyle diseases
Mentioning few examples for lifestyle diseases Explanation of impact of
lifestyle diseases on healthcare industry and economy

ANSWER: - Life style disease:- Life style disease or disease of longevity or disease of
civilization- it refers to the disease that appear in young age populations due to living in
the western way or more industalized area ,so the diseases like cancer, dubieties,
obesity etc. appear in greater rate and their increased incidence is not related to age ,so
the terms cannot accurate be used interchangeably for all disease.
Impact of lifestyle diseases on healthcare industry and economy
Lifestyle diseases like diabetes, hypertension and other circulatory diseases are on the
rise as a result of the adoption of modern diets high in saturated fats, oils and
processed sugar. A lot of people are suffering from such diseases which reduce
their work efficiency. Healthcare industry has to apportion a large amount of funds for
these types of diseases, and need to employ doctors and medical practitioners for
curing them despite curing other widely spread diseases. Whereas it has an adverse
effect of the economy as well because the disease incidence is occurring in younger
population strata, which restricts the ability of the stricken individual to contribute
to the economic well being of his family. Community support structures rarely fully
compensate for the loss of an economically active family member. These losses can
and often do result in the impoverishment of families, restricting the ability to
support children's education, and ultimately resulting in a cycle of poverty that is
difficult to break. In a larger sense, earlier disease onset impedes the ability of a
developing country to exploit the energies and talents of a segment of the population
that normally is the most dynamic contributor to economic growth.

Page 9 of 9