Public health

What interviewers look for

• Outbreak thinking: you know case definitions and alert thresholds, and you can describe the first steps when cases rise: verify, report, respond, communicate.
• Programme basics across areas: immunisation and the cold chain, nutrition screening and CMAM, and how water, sanitation and hygiene link to disease.
• Comfort with data: you can calculate coverage, read a trend, spot a report that does not add up, and you know how facility data reaches DHIS2.
• Community sense: you work through CHWs, elders, religious leaders and women's groups, and your messages are simple enough for a mother to repeat.
• Coordination and reporting: you share information with the regional health office and partners on time, and you know which events must be reported the same day.

Questions they ask

1. 1“Suspected cholera cases are rising in a district. What do you do in the first 48 hours?”

   Why they ask: The panel checks that you follow a clear outbreak sequence and do not jump straight to one action. They listen for verification, reporting, case management, WASH and communication.

   How to answer

   • Verify first: check that the cases meet the case definition, and send samples for lab confirmation as your protocol says.
   • Report the alert the same day to the district or regional health office through the early warning system, and start a line list.
   • Support the response: ORS points and referral to a treatment centre, safe water and chlorination, and hygiene supplies agreed with WASH partners.
   • Start risk communication with elders, religious leaders and CHWs, and share a short daily update with partners.

   First I would verify the alert: check whether the cases meet the suspected cholera case definition and make sure samples reach the lab for confirmation. The same day I would report to the regional health office through the early warning system and start a line list with age, sex, village and date of onset. Mapping the villages often shows which water source is involved. With WASH partners we would chlorinate that source and set up ORS points, with referral to the treatment centre for severe cases. I would brief elders and CHWs on safe water and handwashing, and share a short daily update with partners.

2. 2“Immunisation coverage in one district is low. How would you find out why and improve it?”

   Why they ask: The panel wants to see that you look at data and causes before choosing a solution. Low coverage can come from distance, stock-outs, cold chain failures, missed follow-up or parents' doubts.

   How to answer

   • Start with the data: compare coverage by facility and by vaccine, and look at the drop-out between the first and third dose.
   • Find the real reasons by visiting: stock records, the fridge temperature log, and short talks with vaccinators and mothers.
   • Match the action to the cause: outreach sessions for distance, CHW defaulter tracing for missed doses, supply fixes for stock-outs.
   • Say how you would track progress every month and share it with facility staff.

   I would start with the facility reports and compare Penta1 and Penta3 for each facility. A high drop-out tells me children start but do not finish, so the problem is follow-up rather than access. I would visit the facilities with the weakest results, check the stock records and the fridge temperature log, and ask vaccinators and a few mothers what stops them coming back. If the cause is distance, we plan outreach sessions with the regional EPI team. If it is missed follow-up, CHWs trace defaulters from the register. I would review the figures every month with the facility staff.

3. 3“Explain how MUAC screening works and what happens after a child is screened.”

   Why they ask: Nutrition posts often test this with a tape in your hand. The panel checks that you know who is screened, what the colours mean, that oedema is always checked, and where each child is referred.

   How to answer

   • MUAC is measured on the left upper arm, halfway between shoulder and elbow, for children aged 6 to 59 months.
   • Know the colours: red is under 11.5 cm (severe), yellow is 11.5 to under 12.5 cm (moderate), green is 12.5 cm or more.
   • Always press both feet for pitting oedema: oedema in both feet means severe acute malnutrition, whatever the MUAC colour.
   • Refer by result: severe cases to OTP, or to a stabilisation centre if there are complications or no appetite; moderate cases to TSFP; then record and follow up.

4. 4“Which indicators would you track for a mother and child health programme, and where does the data come from?”

   Why they ask: The panel checks that you see an indicator as a number with a numerator and a denominator, not just a count of activities, and that you know the limits of the data.

   How to answer

   • Name a few real indicators: ANC first visits, deliveries by a skilled birth attendant, Penta3 and measles coverage, and the SAM cure rate.
   • Explain one fully: what is counted, out of whom, and where each part comes from.
   • Mention the sources: facility registers, monthly HMIS reports entered into DHIS2, programme databases, and household surveys.
   • Be honest about limits: population estimates are uncertain, so compare trends and facilities rather than trusting one percentage.

   For a mother and child programme I would track ANC first visits, deliveries with a skilled birth attendant, Penta3 and measles coverage, and the SAM cure rate. For Penta3 coverage, the numerator is children under one who received the third dose, taken from the immunisation register, and the denominator is the estimated number of under-ones in the catchment area. Facility reports go into DHIS2 every month. Because population estimates are often uncertain, I would watch the trend and compare facilities rather than rely on one percentage, and use survey results to check the picture.

5. 5“How do you check the quality of data coming from health facilities?”

   Why they ask: Programmes, the ministry and donors make decisions on these numbers. The panel checks that you know what data quality means and have a practical routine, not just “I check the data”.

   How to answer

   • Name the checks: completeness, timeliness, accuracy against the register, and consistency from month to month.
   • Describe a routine: review reports as they arrive, flag sudden jumps or drops, and call the facility to ask why.
   • On visits, recount one indicator from the register and compare it with the monthly report.
   • Fix the cause, not just the number: training, one agreed tally sheet, a missing register replaced.

   Each month I check completeness and timeliness first: which facilities reported, and which were late. Then I look for outliers, such as a facility reporting far more deliveries than usual, and I call the in-charge to ask why. On supervision visits I recount one indicator, for example ANC first visits, from the register and compare it with the monthly report. At one health centre the numbers did not match because two different tally sheets were in use. We agreed on one sheet, trained the staff, and the next reports matched the register.

6. 6“Design a short health message on handwashing for a community during a diarrhoea outbreak.”

   Why they ask: Health promotion panels want messages that are simple, correct and fit the audience and the channel. They also check that you would test the message and never blame the community.

   How to answer

   • Choose the audience first: mothers and caregivers, school children, or men at the mosque each need a different channel.
   • Give one clear action with the key moments: wash hands with soap after the toilet, before preparing food, before eating and before feeding a child.
   • Use trusted channels: CHWs, religious leaders, local radio, WhatsApp voice notes and school assemblies.
   • Pre-test with a few people, avoid fear and blame, and check later whether people remember and act on it.

7. 7“How would you support and supervise community health workers?”

   Why they ask: CHWs are the link between facilities and households. The panel checks that you understand supportive supervision, supplies, the data CHWs collect, and their safety and motivation.

   How to answer

   • Describe supportive supervision: join a home visit, give feedback in private, and solve problems together rather than only inspect.
   • Make sure they have supplies, such as MUAC tapes, ORS and registers, and a clear referral route to the nearest facility.
   • Check their reports, then share back what the data shows so they see why it matters.
   • Respect their time and limits: clear tasks, the support the programme agreed, and a way to raise problems or safety concerns.

Example answers are in English, the language most panels use. Say it in your own words.

Topics to revise

• Case definitionA standard description of who counts as a case, often split into suspected, probable and confirmed. Everyone uses the same definition, so numbers from different facilities can be compared. Panels may ask you to explain why a clinician's diagnosis alone is not enough for surveillance.
• Alert and epidemic thresholdsAn alert threshold is the point where a rise in cases must be reported and investigated. For some diseases, such as suspected measles, cholera or acute flaccid paralysis (polio), even one case is reported immediately. An epidemic threshold triggers a full response. Know which diseases are reported at once in your system.
• Line list and epidemic curveA line list is a table with one row per case: ID, age, sex, location, date of onset, symptoms and outcome. From it you draw an epidemic curve, a bar chart of cases by date of onset, whose shape shows whether the outbreak is growing, has peaked or comes from one source. A written test may ask you to build both.
• EPI and the cold chainEPI is the routine immunisation programme. Most vaccines are kept between +2 and +8 °C from the national store to the vaccination session, with a temperature log checked twice a day. Know what the vaccine vial monitor (VVM) shows, and that some vaccines are damaged by freezing as well as by heat.
• Drop-out rate and zero-dose childrenDrop-out rate: (Penta1 minus Penta3) divided by Penta1, times 100. A high drop-out points to a follow-up problem; low Penta1 points to an access problem. Zero-dose children have received no routine vaccine, usually measured as missing Penta1, and are often in mobile, displaced or hard-to-reach communities.
• MUAC and bilateral pitting oedemaMUAC (mid-upper arm circumference) screens children aged 6 to 59 months: red under 11.5 cm, yellow 11.5 to under 12.5 cm, green 12.5 cm or more. Bilateral pitting oedema, a dent that stays after pressing both feet, means severe acute malnutrition whatever the MUAC. Expect to measure a volunteer or a doll at a skills station.
• CMAM (OTP, SC, TSFP)Community management of acute malnutrition. OTP treats severe cases without complications at home with ready-to-use therapeutic food and regular clinic visits; a stabilisation centre (SC) admits severe cases with complications or no appetite; TSFP treats moderate cases with supplementary food. Know the key results: cured, died, defaulted, not recovered.
• WASH and healthWater, sanitation and hygiene. Unsafe water, open defecation and no handwashing spread diarrhoea, cholera and worms, and repeated diarrhoea makes malnutrition worse. Expect a question on how a WASH activity, such as chlorination, latrines or hygiene promotion, connects to a health result you can measure.
• Coverage: numerator and denominatorCoverage is the people reached (numerator) divided by the people who should be reached (denominator), times 100. The denominator usually comes from population estimates, which can be wrong, so a coverage above 100% normally means the estimate is off, not that the programme did extra well.
• HMIS and DHIS2HMIS is the routine health information system: registers and tally sheets at facilities, a monthly summary report, and data entry at district or regional level. DHIS2 is open-source software that many health ministries use for this. Say honestly what you have done in it: entered data, built a report, or only viewed dashboards.
• Data quality (completeness, timeliness, accuracy)Completeness: did every facility report, with every field filled? Timeliness: did reports arrive by the deadline? Accuracy: does the report match the register? Consistency: do the numbers make sense over time? Panels often ask how you would find and fix a facility whose numbers look wrong.
• Risk communication (RCCE)Risk communication and community engagement: giving people clear, true and timely information in an outbreak, listening to rumours and concerns, and working with trusted local voices. Good messages give one action, use plain Somali, and are tested before wide use. Panels may ask how you would answer a rumour about a vaccine.

Practical tasks you may get

1. 1Data exercise in Excel or on paper: a table of monthly facility reports. You calculate coverage and drop-out, spot missing or odd numbers, and make a simple chart. Practise percentages, a basic formula and a bar chart in Excel before the day.
2. 2Written outbreak case study, 45 to 60 minutes: a district reports a rise in cases. Structure your answer as verify, report, investigate (line list, map), respond (case management, WASH, vaccination if relevant), communicate and monitor.
3. 3Health promotion task: write a short radio message, poster text or talk plan for mothers on one topic. Keep one action per message in plain Somali, and add one line on how you would pre-test it.
4. 4Situation report: turn a page of data into a half-page sitrep for the regional health office: what happened, the numbers, actions taken, gaps and next steps. Practise writing one in 20 minutes.

Mistakes to avoid

• Jumping to one action, such as a campaign, without verifying the alert and looking at the data first.
• Quoting indicators without knowing the numerator and denominator, or presenting a coverage above 100% as a success.
• Saying you are an expert in DHIS2 when you have only viewed dashboards; panels ask what exactly you did in it.
• Writing messages full of technical words, or messages that blame the community, which people ignore or resent.
• Forgetting coordination: acting alone without informing the regional health office, the cluster or partners.
• Inventing figures from past projects; if you do not remember the exact number, describe the result in words.

Quick check

5 questions. Answer each one to see the explanation.