Levels of prevention
Levels of prevention
Definitions
"Activities designed to protect patients and other members of the public from actual or potential health threats and their harmful consequences."
[According to Mosby's Medical Dictionary 8th edition 2009]
"Prevention is the action aimed at eradicating, eliminating or minimizing the impact of disease and disability (According to A Dictionary of Epidemiology)
Goals-
- Promotion of health
- Prevention of illness
- Preserve health
- Restoration of health
Levels of Prevention -
- Primordial Prevention
- Primary Prevention
- Secondary Prevention
- Tertiary Prevention
1. Primordial Prevention
Definition-
"It is the prevention of development of risk factors in population groups in which they have not yet appeared."
- Special Attention is Given in preventing Chronic Disease.
Intervention-
Individual and mass education.
Examples-
- Adult health problem eg.- Obesity, hypertension
- Lifestyle changes eg. - Smoking, Physical exercise
- Food and nutrition
2. Primary Prevention -
Definition-
Primary Prevention can be defined as "action taken prior to the onset of disease, which removes the possibility that the disease will ever occur."
- In this Action are taken before the onset of Disease.
- It signifies intervention in the pre- pathogenesis phase of a disease or health problem.
Approaches of Primary Prevention -
The WHO has recommended the following approaches for primary prevention-
- Population (Mass) Strategy
- High risk strategy
1. Population (Mass) strategy- It is directed at the whole population irrespective of individual risk levels.
- The population approach is directed towards socio-economic, behavioral and lifestyle changes.
2. High Risk Strategy - It is aim to bring preventive care to individuals at special risk. Examples-Immunization and taking regular exercise.
Intervention-
- Health promotion
- Specific protection
A. Health promotion
Definition-"A process of enabling people to increase control the determinants of health and thereby improve their health”.
- “ Health Promotion is directed towards Strengthening the Host.”
- Process of enabling people to increase control over and to improve health
Intervention-There aim can be achieved by following intervention-
- Environmental modification
- Health Education
- Life style change
- Behavioral changes
- Nutritional intervention
B. Specific Protection
Definition-Efforts directed toward protection against specific diseases."
- “ The provision of Conditions for normal Mental & Physical Functioning of the Human beings & in Group.it includes the Promotion of Health , Prevention of Sickness , & Care of Individuals .”
Intervention-
- Immunization (BCG, DPT, MMR Vaccines) and seroprophylaxis
- Chemoprophylaxis(tetracycline for Cholera, dapsone for Leprosy, Chloroquine for malaria,etc.,)
- Protection against accidents
- Use of specific nutrients or supplementations (vitamin A for Children, iron folic acid tablets for Pregnant mothers)
- Safety of drugs and foods
- Protection against occupational hazards e.g. - Use of helmet, Seat belt etc.
- Control of environmental hazards e.g. - Air pollution
- Avoidance of allergens.
3. Secondary Prevention-
Definition- "The action which halts the progress of a disease at its incipient stage and prevents complications."
Intervention-
- Early diagnosis(e.g. screening tests, breast self examination, pap smear test, radiographic examinations etc.)
- Adequate treatment
Objectives-
- To prevent the spreads of disease.
- To prevent the complications.
- Complete cure of disease.
- To shorten the period of disability.
Examples- Include screening for high blood pressure and breast self examination.
4. Tertiary Prevention-
Definition-
"It is defined as "all the measures available to reduce or limit impairments and disabilities, and to promote the patients adjustment to irremediable conditions"
- It is used when the disease process has advanced beyond its early stages.
Modes of Intervention-
- Disability limitation
- Rehabilitation
a. Disability limitation-
- To prevent or halt the transition of disease process from Impairment & Handicap.
- Impairment- any loss or abnormality of psychological, physiological or anatomic structure or function.
- Disability- any restriction or lack of ability to perform an activity in the manner considered normal for a human being.
- Handicap- disadvantage for a given individual, resulting from impairment or disability, that limits or prevents the fulfillment of a role that is normal for that individual.
b. Rehabilitation-
- Rehabilitation is “ the combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability.”
- Requires cooperation from different sections of society.
- Rehabilitation Medical rehabilitation Vocational rehabilitation Social rehabilitation Psychological rehabilitation
Types of Rehabilitation
- Medical Rehabilitation - Restoration of body function.
- Vocational Rehabilitation - Restoration of the capacity to earn a livelihood.
- Social Rehabilitation - Restoration of family and social relationship.
- Psychological Rehabilitation - Restoration of personal dignity and confidence.