Surname Name ID Number Name of Centre DATE:1 SEPTEMBER Time: 09:00 12:00 Instructions All questions must be answered on this question paper

Transcription

1 Surname ame ID umber ame of Centre FIAL EXTERAL ITEGRATED SUMMATIVE ASSESSMET (EISA) PAPER 1 OCCUPATIOAL CERTIFICATE: HEALTH PROMOTIO OFFICER (COMMUITY HEALTH WORKER) SAQA ID: CREDITS: 163 LEARER DETAILS DATE:1 SEPTEMBER 2016 Duration 3 Hours Time: 09:00 12:00 Instructions All questions must be answered on this question paper This paper consists of IETEE (19) pages FIFTEE (15) pages in the question paper OE (1) page for Annexure A: Map TWO (2) pages for Annexure B: Household Registration form OE (1) page for Annexure C: Referral form 120 Marks (QUESTIO PAPER MUST BE USED AS YOUR ASWER SHEET) Question 1 (40 Marks) Question Question 2 (40 Marks) 3 (40 Marks) This is a closed book assessment. Read the instructions for each question before answering. Structure all written answers logically. Use the mark allocation for each written question to guide the length of your answer. For ALL multiple choice questions CIRCLE the answer from the choice provided. Circle only one answer per question Candidates are not allowed any form of assistance, and must adhere to the invigilator s instructions at all times. o cell phones are allowed. CHW in the question paper refers to Community Health Worker Question 1. Assessment of the social, physical and economic dynamics in communities 1.1. Complete the attached community map (Annexure A)

2 READ THE SCEARIO BELOW RELATED TO THE MAP (AEXURE A) Ward (A323) is located in Ostrich Street in Hillside. It is situated next to the busy Z1 highway close to the city. A high barrier wall was built with concrete to lower the noise from the road and to prevent people, especially children approaching the highway. This wall has been broken in a few places to make shortcuts for pedestrians to cross the road to the bus stop or catch a taxi. A narrow bridge has been built to provide safe crossing of the Z1 highway. Some of the shacks in this ward have recently been replaced by two-bedroom houses, each with electricity pre-paid meters with inside taps, a solar geyser, shower and an inside flush toilet. The ward is made up of a row of 10 houses. There is a concrete barrier wall that separates the community from the open space next to the Z1 highway. In each home there is at least one adult that is employed. There are no gardens in the yards. Children like to play soccer on the grass between the Z1 Highway and the concrete barrier wall where goats and cows also graze. The Hillside clinic, crèche and South African Police Service (SAPS) are also in Ostrich Street, near a shop. Several on-governmental Organisations (GOs), i.e. Rape Crisis, FAMSA, SATA share an office on the one side of the clinic. Across the road from the clinic there are several food sellers. The primary school is across the road from the SAPS office After reading the description of the ward, write the name of the community and the ward number on the appropriate space in the Map provided (Annexure A) (2) Use the information in the scenario and symbols on the map as a guide to your answers. Draw THREE (3) symbols for the following facilities: that are missing on this map in their correct position. Insert the following: (3) FAMSA SASSA GO Office Based on the scenario above, what contributes most to the health of those who live in this community? a) Having a clinic, SAPS, taxi and shops all in walking distance from the houses b) Having safe water, electricity, sanitation, solar geysers, clinic, GOs c) Having grazing for animals and place for children to play soccer d) Having a hospital, SATA, SAPS, Rape Crisis, safe drinking water (1) Which of the following public services contributes most to the health and well-being of the community described in the scenario? (1) a) SASSA, SAPS, SATA, vendors, road, animals and clinic b) Industry providing employment, SAPS, clinic and taxi and bus stop c) SAPS, clinic, crèche, employment, SATA, FAMSA d) Clinic, crèche, animals, SAPS, SATA, and taxi

3 The most important benefit of community mapping is: (1) a) To assist with making introductions in the community b) To list health problems of communities c) To generate a list of resources that should be available to the community d) To develop a suitable health plan for the particular community What should the CHW do with the community map they developed: (1) a) Discuss the information with some community members b) Share the information with the team leader c) Make sure every community member has a copy of it d) Show the municipality where the houses are 1.2. Governance and Society List FOUR (4) important community resources you as a CHW can use to refer to household members to depending on their need, based on the scenario: (4) What type of services would you expect from SASSA? (1) a) Social grants b) Home-based care c) Support groups d) Food parcels What type of services would you expect from FAMSA? (1) a) Support for families with problems b) Support for people with mental illness c) Support for teenagers with drug problems d) Support for caregivers of older persons What type of services would you expect from SATA? (1) a) Counselling for alcohol abuse b) Supporting stop smoking programme c) Promoting research on TB d) Establishing exercise programmes

4 What type of services would you expect from HOSPICE (HPCA)? (1) a) Support patients who need palliative care b) Support for people who fall c) Support older persons who live on their own d) Support those without medical aid What type of service would you expect from SAPS? (1) a) Provide identity documents b) Support women who have been raped c) Provide social grants application d) Support people who have disabilities What is the role of the local municipality (1) a) Supply free electricity to all in the community b) Allocate plots of land to newcomers in the community c) Provide adequate water, sanitation and refuse collection services d) To provide housing 1.3. Social Determinants What is the most important effect of not littering in the community of Hillside? (1) a) Healthy community b) Less disease c) Healthy environment d) Less pollution Choose the most important effect that social determinants of health have: (1) a) Wellness b) Jobs c) Income d) Transport Choose the most appropriate statement describing how mental health affects ability to participate in health promotion activities (1) a) Depression limits people from participating in health promotion activities b) Depression will be eased if people participate in health promotion activities c) Depression encourages people to participate in health promotion activities d) Depression has not effect on participation in health promotion activities What is the most important effect of not littering in the community? (1) a) Healthy community b) Less disease c) Healthy environment d) Less pollution

5 What do stray animals roaming in the community OT lead to? (1) a) More children becoming sick b) Improved health and wellness of the community c) Fewer clinic visits d) Better control of grass on the pavements Stagnant water in the community can lead to: (1) a) Less water supply needed b) Increased recreational activities c) Higher risk for drowning d) More food gardens What is the most important reason for food vendors to have access to clean water? (1) a) To prevent dehydration b) To wash the food they sell c) To ensure food hygiene d) To keep their stall clean List FOUR (4) of the key social determinants of health based in the scenario of the map at the beginning of question 1 (4) 1.4. Household Registration Complete the attached partially completed forms referred to in Annexure B and Annexure C by using the information in the scenario below: Annexure B: Household Registration forms (5) Annexure C: CHW Referral forms (5) Insert your details on Annexure B and C where the forms require CHW information In an informal dwelling at the back of no. C449 Ostrich Street, there is a child-headed household (surname Gazi) where both parents died last year. A neighbour helps to look after the three children (2 boys aged 15 and 13 and a girl aged 12). The children know very little about their family s health history. The eldest boy wants to be circumcised at the hospital whilst the girl does not understand the changes that are happening in her body and the 13-year-old seems depressed. The dates of birth of these three children are: Sipho was born on 06 April 2000, Vilapi was born 03 February 2002, and Mary was born on 06 January (Subtotal 40)

6 Question 2. Assessing and identifying those at risk of health related issues 2.1. Screening The table below lists health problem/s in the left side and the screening process on the right side. Match the health problem/s with the correct screening processes by writing in the column titled Answer in the middle: e.g. 6F (5) HEALTH PROBLEM ASWER SCREEIG Respiratory problems in A. adults Check growth curve in the road to health card Observe behaviour of child for irritability and excessive crying Observe skin health and hair for dryness Observe for skin elasticity and muscle mass Measure height Arthritis B. Any feelings of tiredness Frequency in passing urine Sensitive breast or nipples Malnutrition C. Through questioning determine if the following symptoms are experienced by the patient: Burning urine, Lower abdominal pains, Sores on the genitals Painful genitals Pregnancy D. Measure temperature Pulse and breathing rate Observe colour of sputum Ask if patient is feeling pain in the chest Sexually Transmitted E. Infections (STIs) Ask patient to extend flex and rotate limbs and Observe movement Observe swelling and snapping of joints Ask patient if pain moves from joint to joint 2.2. Key steps to using various screening processes Feeling a pounding in the chest or in your neck or ringing in the ears is a warning sign of: (1) a) Diabetes mellitus b) Stroke c) Asthma d) Hypertension

7 Sudden confusion, trouble speaking, loss of balance, sudden numbness or weakness of the face, arm or leg, are danger signs of: (1) a) Heart attack b) Stroke c) Tuberculosis d) Mental illness Coughing, tiredness, muscle aches, diarrhoea and nausea are the signs and symptoms of: (1) a) Tuberculosis b) STI c) Malaria d) Common cold Extremely watery diarrhoea, vomiting, confusion and cramps in the lower limbs are symptoms of: (1) a) Typhoid b) Malaria c) Cholera d) Shigella infection Craving, impaired control and physical dependence are symptoms of which health related condition? (1) a. Binge drinking b. Alcohol dependence c. Casual drinker d. Substance abuse Subtotal (5) 2.3. Communicable and on-communicable health conditions For multiple choice questions, choose the most correct statement and mark it by putting an encircling on the letter a, b, c, or d. Mark only one letter for each question Sexually active individuals can be referred to the clinic to test for: (1) a) Pap Smear b) Urinary tract infection c) Herpes zoster d) Human immune virus

8 A person can prevent herself/himself and others from becoming infected with HIV by (1) a. Using condoms only with his wife b. Having multiple sexual partners c. Having a warm bath after sex d. Knowing his/her status and partner/s status, and modification of behaviours An example of diseases spread through contact with bodily fluids is: (1) a. Hepatitis A b. Gastro-enteritis c. Ebola d. Conjunctivitis Examples of diseases spread by skin or mucous membrane contact are: (1) a. Pubic lice b. Hepatitis B c. Impetigo d. Shigella An example of food or waterborne disease is: (1) a. Thrush b. Salmonella infection c. Worms d. Campylobacter infection Answer the following by indicating TRUE OR FALSE (4) All female adolescents who are sexually active should have a pap smear once a year. Early identification of STIs is important to minimise its spread Chlamydia is the most common sexually transmitted condition Pap smear is related to Human Papilloma Virus List TWO (2) primary goals of anti-retroviral treatment (ART); (2)

9 Mention SEVE (7) ways on how you as a CHW advise and support a member of the household to control his/her blood pressure. (7) Mention SIX (6) key health education messages for people with TB (6) Describe TWO (2) important ways of preventing malaria (2) List FOUR (4) symptoms of tuberculosis (TB) (4) Sub -Total 40 Marks

10 Question 3 Identifying and managing minor health problems 3.1. Minor ailments Which of the following is not true about prevention of diarrhoea? (1) a. Access to safe drinking water b. Use of improved sanitation c. Hand washing without soap d. Exclusive breast feeding for the 6 months of life The most common symptom of scabies is the following EXCEPT (1) a. Severe itchiness b. Bleeding c. Rash d. Swollen Treatment for worm infection should be given once a year when the prevalence (presence) of soil transmitted worm infections in a community is over (1) a. 10% b. 20% c. 40% d. 50% How long will it take for treatment for lice to work? (1) a. 4-8 hours b hours c hours d hours The following describes symptoms of asthma: (1) a. Having problems breathing, chest pain b. Chills, wheezing c. Shallow breathing, cough producing phlegm d. Coughing at night, feeling short of breath Sexually transmitted infections are prevented by: (1) a. Making sure that condoms are used correctly and consistently b. Discussing need for treatment of STIs with sexual partners c. Household member knowing if he/she has an STI d. Household member informing sexual partners that they have an STI Which of the following is a sign of dehydration? (1) a. Darker urine than usual b. Temperature of below 37.5 degrees c. Dry mouth or crying with lots of tears d. Baby who refuses to drink

11 People who are at greater risk for pneumonia are whose who: (1) a. Are between 60 and 70 years of age b. Spend a lot of time working outside c. Have had a recent bacterial infection d. Have difficulty coughing 3.2. Treatment actions to deal with minor ailments A CHW visits a household where there is a child under five years old. As part of screening, the CHW conducts a MUAC and find that the child is in the yellow zone. What advice should the CHW give the mother? (5) Read the scenario and answer the related questions A household member tells the CHW that her husband has been coughing and has a fever. He has started to vomit and in feeling very weak. He doesn t want to take time off work to go to the clinic What condition could the husband have? (1) What can he do at home to treat it? (4) While conducting a household visit, the grandmother tells you that two of her grandchildren have runny noses. She asks you what she can do to help her grandchildren. (5)

12 3.3. Wellness, Health and Mental Health Explain what is meant with the term health. (2) Explain what is meant with the term wellness. (2) Explain what is meant with the term mental health. (4) 3.4. Impact of lifestyle choices The table lists lifestyle choices on the left side and the impact of lifestyle choice on the right side. Match the lifestyle choice with the impact that it has, by writing the answer in the column titled ASWER, e.g. 10J. (9) Lifestyle Choice Impact Answer Column 1. Eating smaller meals more often A. Increased risk of asthma 2. Smoking B. Increased risk for HIV 3. Exercising C. Early diagnosis 4. Alcohol D. Prevention of diabetes 5. Adherence to treatment E. Prevention of stroke 6. Condom use F. Prevention of cholera 7. Many sexual partners G. Premature babies 8. Regular check-ups H. Prevention of cervical cancer 9. Use of safe water I. Prevention of complications Sub-Total 40 Marks Grand Total: 120

13

14 Community Health Worker Household Registration Form Clinic name: (DHIS name) Hillside Clinic ame of household Mr. Sipho Gazi head/ contact: Household street address/ descriptive location House umber C449 Ostrich Street Hillside Household head phone number: Household member details War d no. A32 3 Date of Birth (dd/mm/yy) Official Household identifier number: HS-A323 CHW Household identifier A323-HS-OS number: Date of visit: Insert the date of examination (dd/mm/yyy) CHW Student name name: Household respondent A= available /A= not available R= refused Were all household members captured in this visit? age in years gender male female A X /A R Y X 3. Information about the house Does the house have electricity? 1 15 Is there piped water in the house or in the yard? Y X Is there a working fridge in the house? Y X 4 5 Is there a toilet in the house? Y X 6 7 Total number of rooms in the house? How many grants does the household receive in total? How many people in the house are currently working? ame of school(s) for learners Add up the ticks above for the totals for household (fill this section in later after the interview) Hillside Primary School Hillside Secondary School 4. General household screening questions for all households (If yes to any of following questions, refer for further care) a. Does anyone in the household have any of the following: (circle all that apply) (refer for sputum test for TB) Cough that won t go away? ight sweats Weight loss Fever Loss of appetite? Y X b. It is very important to know your HIV status. Would anyone in the household like to have an HIV test? (refer for HCT) Y X c. Is there anyone who does not use a family planning method but wants to? (refer for family planning services) Y X d. Is there anyone in the household who cannot get out of bed or needs help with daily living activities? (refer for home based care) Y X e. Are any household members who need help applying for social grants? (refer for social services) Y X f. Is this a child (<18 years) headed household? (refer for social services) Y 5.Household screening questions for CHW follow up. Y X Write the number(s) of the household member(s) below a. Is anyone in the household currently pregnant or has not had a menstrual period in the last 6 weeks and may be pregnant? Y X b. Has there been a delivery (baby) in the last 6 weeks? Y X c. Are there any children under the age of 5 in the household? Y X d. Is anyone in the household taking daily medication (like TB /ARV/diabetes medication/ high BP medication)? Y X OTES: ***DOES THIS HOUSEHOLD EED FOLLOW UP?*** YES Complete page 2 of this form O Write date for next HH reassessment visit

15 PAPER 1 HEALTH PROMOTIO OFFICER (CHW) EISA 6. Further assessment and screening questions for all households to be followed by CHW For each question: Write the number of the household member (or members) from the list of household member names and details on page 1. For any other problems you have identified, write this in the last box in detail and indicate HH member number. For questions 2-7: check RTHC If a referral is needed, write the total number of clients referred to the clinic for each line. If the client was referred elsewhere- indicate the reason, the place of referral and number of referral forms issued in box 9 1. If someone in the house is pregnant, what is the estimated EDD (dd/mm/yy) delivery date (EDD)? Check the AC card if available or ask mother when her LMP was and use pregnancy wheel to estimate. (Write unknown if delivery date is not known) HH member number(s) ** umber of referral forms issued 2. If there was a birth in the last 6 weeks, what was the date? Check the RTHC or ask mother for the date of births. (dd/mm/yy) a. Was the baby s birth weight under 2500 grams? Refer to clinic for monitoring. Schedule further home visits 3. Are there any children under 5 in the house whose immunizations are not up to date? Refer for catch up EPI at clinic 4. Are there any children under 5 who have not had a dose of vitamin A in the last 6 months? Refer for vitamin A supplement at clinic 5. Are there any children who have not been weighed according to the growthmonitoring schedule or who show signs of malnutrition/ growth faltering? Refer for growth monitoring. Complete a nutritional assessment and schedule follow up visits if needed. 6. Are there any children with suspected illness or does mother/ caregiver have concerns about any child s current or recent health status? Assess and refer to clinic if needed. Schedule follow up visits. 7. Are there any HIV exposed children in the household 6 weeks or older who have not had a PCR test? Check the RTHC. Refer to clinic for PCR test. Schedule follow up visit. Y Y Y Y Y Y X X X X X X 8. Is anyone taking medication for (tick all that apply) T AR Hypertensio V n Diabetes Other (specify) If treatment defaulter, refer to clinic for further care. Schedule follow up visit for treatment adherence support Y X 9. Any other problems identified (state). CHW Signature Verified by Team Leader on (date) **OTE: It is expected that an individual health record is complete for every client that is being followed in the household. 15 P a g e

16 PHC Outreach Team Community Health Worker Referral Form PAPER 1 HEALTH PROMOTIO OFFICER (CHW) EISA A person has been referred to your service by a member of the PHC Outreach Team working in your ward. Community Healthcare Workers are mandated by the ational Department of Health to identify community members in need of primary health and social services. Thank you for seeing this client, we look forward to working together for improved health and welfare for all South Africans. Client referred to: Date of referral: (facility name) ame of CHW referring client: Contact number for CHW: PHC Outreach Team Leader name: PHC Outreach Team Leader contact number: Outreach Team Client details: Ward number Client Address: C449 Ostrich Street Client name and surname: Sipho Gazi Vilapi Gazi Mary Gazi Client contact telephone number: DOB: dd/mm/yyyy) 06/04/ /02/ /01/2003 Gender: Mx2 Fx1 Referred to Clinic(Tick all that apply) MCH Under 5 Treatment related problems Other AC Post-natal care Pregnancy test Family Planning Emergency contraception Cervical cancer screen PCR test for infants ewborn care Low birth weight Immunisation Vitamin A Persistent diarrhea Pneumonia utritional/ Growth problems TB symptoms STI testing Mental health Treatment adherence Chronic health problem HCT CD4 test OIs 16 P a g e

17 PAPER 1 HEALTH PROMOTIO OFFICER (CHW) EISA Referred to Social Services (Tick all that apply) Referred for Home based care Food support Other (specify in box below) Protection services Mental health Support groups Housing (Please write condition that needs home care. Use box below for more space if needed) Vital documents Provide a brief explanation for the referral: (include place client is being referred if not above and reason for referral) Thank you for seeing this client. Please complete Back-Referral Form on the other side of this paper so we can ensure follow up care. Please contact the PHC Outreach Team Leader noted on this form if you have any further questions regarding this referral. Signed: