Koshi Province Lok Sewa Aayog Health Assistant Exam Question Paper: A Complete Breakdown
The Provincial Public Service Commission, Koshi Province, Biratnagar, conducted the open competitive written examination for the post of Health Assistant (Assistant Level 5) under the Local Government Service, Technical Category, Local Health Service, Health Inspection Group. The exam was held on 2082/12/28 (approximately April 11, 2026).
Here is a complete breakdown of the question paper, which is divided into three sections totaling 100 marks. The exam duration was 2 hours 30 minutes.
Exam Overview
| Detail | Information |
|---|---|
| Position | Health Assistant |
| Level | Assistant Level 5 |
| Subject | Service-Related Job Knowledge |
| Total Marks | 100 |
| Time | 2 hours 30 minutes |
| Date | 2082/12/28 |
| Exam Type | Written (Open Competitive) |
General Instructions:
- All questions are compulsory.
- Answers must be written in separate answer sheets according to the section.
- Mobile phones and other electronic devices are prohibited.
Section A: Public Health & Program Management (40 Marks)
This section focuses on Nepal’s health programs, health systems, and community-level interventions.
1. Integrated Vector Management (5 marks)
How does Nepal implement integrated vector management to control vector-borne diseases like malaria and dengue?
Focus: Key strategies – larval source management, insecticide-treated nets, indoor residual spraying, community awareness, and surveillance.
2. District Health Office Structure & Functions (5 marks)
List the organizational structure of the District Health Office and briefly describe its function in the federal context.
Focus: Post-federal restructuring roles of DHO, coordination with local levels, and technical support.
3. Microplanning in Healthcare Delivery (5 marks)
What is microplanning? Describe its importance in delivering healthcare services in the community.
Focus: Bottom-up planning, resource allocation, reaching marginalized populations, and immunization campaigns.
4. Circulatory System (5 marks)
Which organ in the circulatory system pumps blood throughout the body? Write in brief.
Focus: The heart – structure, chambers, and basic pumping mechanism.
5. Malaria in Nepal (1+2+2+5 = 10 marks)
Describe the cause, clinical features, management, and control measures of malaria in Nepal.
Focus: Plasmodium parasite, fever/chills, ACT treatment, and Nepal’s malaria elimination strategy.
6. Health Insurance Program in Nepal (4+6 = 10 marks)
Define health insurance with the provisions of the health insurance program in Nepal. Write about the implementation challenges of the National Health Insurance program.
Focus: Premium-based coverage, family package, challenges – low enrollment, claim delays, awareness gaps, and provider payment issues.
Section B: Clinical & Medical Management (40 Marks)
This section tests clinical knowledge relevant to the Health Assistant role at the health post level.
7. Pelvic Inflammatory Disease (PID) (5 marks)
What is PID? Describe signs, symptoms, and management at the health post level.
Focus: Infection of female reproductive organs, lower abdominal pain, abnormal discharge, and antibiotic treatment/referral.
8. Dental Caries (5 marks)
Describe the treatment and prevention of dental caries.
Focus: Fillings, fluoride use, oral hygiene, dietary advice, and pit and fissure sealants.
9. Haematuria (5 marks)
What is haematuria? Describe the causes and management at the health post level.
Focus: Blood in urine – causes (UTI, stones, trauma, infection), dipstick test, and referral pathway.
10. Importance of History & Examination (5 marks)
Why is a combination of history taking, physical examination, and systemic examination essential for accurate diagnosis?
Focus: Differential diagnosis, identifying red flags, and avoiding misdiagnosis.
11. Acute Otitis Media & Tonsillitis (5+5 = 10 marks)
Explain in detail the management of acute otitis media. Describe the management and complications of tonsillitis.
Focus: AOM – antibiotics, pain relief, follow-up. Tonsillitis – supportive care, abscess formation, airway obstruction.
12. Public Health Service Act, 2075 (6+4 = 10 marks)
Describe the importance and use of the Public Health Service Act, 2075 for the national health system. List the challenges of its implementation.
Focus: Regulation of health services, quality assurance, challenges – enforcement, resource gaps, and coordination.
Section C: Provincial Governance & Legal Provisions (20 Marks)
This section tests knowledge of provincial laws, financial procedures, and constitutional provisions relevant to local government service.
13. Account Responsible Officer (5 marks)
Who is referred to as the Account Responsible Officer? Clarify based on the definitions under the Provincial Financial Procedure and Fiscal Responsibility Act, 2078 (Koshi).
Focus: Designated officer responsible for budget management, expenditure authorization, and financial accountability.
14. Employee Awards under Provincial Good Governance Rules (5 marks)
On what basis can an employee be recommended for an award under the Provincial Good Governance (Management and Operation) Regulations, 2077 (Koshi)?
Focus: Criteria – outstanding performance, integrity, innovation, and long-term service excellence.
15. Disqualifications for Local Government Service (5 marks)
What provisions exist regarding disqualification (ineligibility) for a Nepali citizen to be a candidate for a position in the Local Government Service?
Focus: Conviction of criminal offense, dismissal from government service, bankruptcy, or being of unsound mind.
16. Citizenship Provisions in the Constitution of Nepal (5 marks)
Introduce citizenship and write about the types of citizenship provisions in the Constitution of Nepal.
*Focus: Citizenship by descent, birth, naturalization, and honorary citizenship as per Articles 11-14 of the Constitution.*
Key Takeaways for Aspirants
This question paper reveals the expected competencies for a Health Assistant in Koshi Province:
| Domain | Weight | Key Topics |
|---|---|---|
| Public Health Programs | 40% | Vector control, microplanning, health insurance, malaria |
| Clinical Management | 40% | PID, dental caries, haematuria, otitis media, tonsillitis |
| Provincial Governance | 20% | Financial procedures, employee awards, disqualifications, citizenship |
Practical Advice for Candidates:
- Focus on Nepal-specific protocols – NMIS (Nepal Malaria Indicator Survey), NHIS guidelines.
- Understand the federal context – roles of local, provincial, and federal health structures.
- Memorize key legal provisions – Act names and section numbers are important.
- Practice clinical case scenarios – especially for conditions commonly seen at health posts.
The Koshi Province Health Assistant examination tests a balanced mix of public health knowledge, clinical skills, and legal awareness. For aspirants, mastering Nepal’s national health programs, common disease management protocols, and provincial governance acts is essential.
If you are preparing for this exam, use this breakdown as a study guide. Focus on high-yield areas like malaria control, health insurance challenges, and clinical management of PID and otitis media.
Good luck to all future Health Assistants serving the communities of Koshi Province.
This blog post is based on the official question paper published by the Provincial Public Service Commission, Koshi Province. Please refer to the original notice for any updates or official corrections.
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