Order 995769: Capstone project on physical health, levels of prevention and sampling in research
tutorthammy
Module6Levelsofprevention.pptSchool of Public Health
Epidemiology
Module 6 Levels of prevention
School of Public Health
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Objectives
At the end of this sub-module, each student should be able to:
- Describe the Concept of prevention
- Describe the levels of prevention
- Give examples of each level of prevention
Concept of Health& Prevention
- State of complete physical, mental and social wellbeing and not merely an absence of diseases or infirmity.
- Goal to promote health, to preserve health, to restore health when impaired, and to minimize suffering and distress
- These goals are embodied in the world “prevention”
Prevention
- It requires Knowledge of causation
- Dynamics of transmission
- Identification of risk factors & risk groups
- Availability of prophylactic or early detection a& treatment measures
Prevention
- Prevention- derived from Latin
- “Prae Venire”= to come Before
- Preventive actions can be taken at any stage of spectrum of Health
- Mostly on “Healthy People”
- Goal –to achieve health for all- to lead a productive and socially useful life
- But it can be applied to unhealthy or sick –to restore their health at the earliest and prevent deaths/disability
Scope of prevention
- Reduction in death rates
- Reduction in deaths from infectious diseases
- General improvements in standard of living, nutrition, and sanitation
- Major causes of diseases are preventable
Levels of Prevention
| Phase of Disease | Target | |
| Primordial | Underlying conditions-causation | Total/selected population |
| Primary | Specific causal factors | Total/selected population/Healthy |
| Secondary | Early stage of disease | patients |
| Tertiary | Late stage (treatment, Rehabilitation) | patients |
Levels of Prevention
- Primordial healthy people
- Primary
- Secondary
- Tertiary sick people
Primordial Prevention
- To prevent emergence of unhealthy life styles in population (Social, economic, cultural patterns of living)
- To prevent the emergence of risk factors in the community
- Risk prevention strategies right from the childhood to develop healthy lifestyle
- Examples -lifestyle modification –smoking cessation, obesity reduction
- Physical exercise
- Air Pollution control by legislation
- Individual and mass education
Primary Prevention
- Action taken to prevent development of a disease in a person who is well and does not have the disease in question
- To limit the incidence of disease by controlling causes and risk factors
- S.Cholesterol and risk of CHD
- Population & High risk strategy
Strategies :
- Health promotion-healthy practices
- Adequate nutrition
- Safe water and sanitation
- Periodic health checkups
- Specific prevention/protection against disease/trauma/accidents
Specific protection
- Immunization
- Mega doses of Vit A , IFA tablets
- Salt iodization
- Chemoprophylaxis
- Environmental protection
- Contraception
- Condom use
- Accidents prevention-safety belts & Helmets
Approaches-Population based
- Intention to cover whole population
- High impact on reduction of incidence of disease
- Do not require any screening to identify high risk group
High risk Approach
- Identify high risk group
- Identify specific factors/characteristics that put them in high risk group
- Try to modify these risk factors
- Preventive – Screening for early case detection-interventions
- Examples: Smokers, Commercial sex workers, STD clinic attendees
- Family H/o DM, HT,CHD
Population Vs. High risk strategy
Advantages
- Radical
- Large potential for whole population
- Behaviorally appropriate
Advantages
- Appropriate to individuals
- Subject motivation
- Physician motivation
- Favorable benefit- to -risk ratio
Population vs. High risk strategy
Disadvantages
- Small benefit to individuals
- Poor motivation of subject & Physician
- Benefit –to- risk ratio may be low
Disadvantages
- Difficulties in identifying high risk individuals
- Temporary & Limited effect
- Behaviorally in appropriate
Secondary Prevention
- To cure patients & reduce more serious consequences
- To reduce prevalence of disease in the community
- Early detection at early stage & prompt Treatment (EDPT)
- Ex. Sputum examination-DOTS,
- BS for Malaria, Leprosy, Blindness, Cancer prevention (Both primary and secondary )
Early detection
- Screening programme – for diseases-
- Natural history easily identified and treated so that progression to more serious stage can be stopped
- preclinical stage and Effective methods of intervention
- Vision-refractory errors, cataract
- Ca Cx,
- Blood pressure measurement
- Mass treatment –trachoma, malaria, yaws, pinta, etc.
Tertiary Prevention(disability limitation and rehabilitation)
- To reduce the progress & development of complications of established disease
- To reduce impairment and disability
- To provide rehabilitative measures
- To prolong life & to prevent deaths
- Examples: Poliomylitis,strokes,injuries,blindness
Concept of disability
- Disease- impairment-disability-handicap
- Impairment- any loss or abnormality of psychological, physiological or anatomical structure or function
- Disability- any restriction or lack of ability to perform an activity in a manner or within the range considered normal for a human being.
- Handicap- as a result of disability, the person experiences certain disadvantages in life and is not able to discharge the obligations required of him and play the role expected from him in society.
- Example-
- Accident- disease/disorder
- Loss of foot- impairment
- Cannot walk- disability
- Unemployed- handicap
Rehabilitation
- The combined and coordinated use of medical, social, educational, vocational measures for training, and retraining the individual to the highest possible level of functional ability
- Examples - paraplegics, amputees, blinds, deaf and deaf & dumb,
- Mentally retarded
- Leprosy cases
Rehabilitation
- Medical- restoration of function
- Vocational-restoration of the capacity to earn a livelihood
- Social- restoration of family and social relationships
- Psychological-restoration of personal dignity and confidence
