Prevention Strategies: Levels of Prevention

Prevention includes the actions required to eradicate, eliminate or minimizing the impact of diseases. The various countries are using this strategy to control the prevalence of many major diseases throughout.There are different levels of prevention. 

Levels of Prevention

Primordial Prevention

A level of prevention that is applied before the emergence of risk factors. It is achieved by providing health education. For Instance- 

• Do not start smoking.
• Prevention of childhood obesity by teaching children good eating habits.
• Making bikeways to avoid road traffic accidents.

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Primary Prevention

At this level of prevention, the risk factor is already present in the society but the disease has not started. Health promotion is an important term which comes under primary prevention. This strategy is followed by many countries and it enables people to lead a healthy lifestyle. Health education is very important for implementation of this strategy.

• Ottawa Chapter ( November 1986)
• Concept of Health Promotion was adopted in a conference held in Ottawa in Canada in November , 1986.
• Jakarta Declaration
• It happened in July, 1997 and conveyed the concept of health promotion.

Health promotion includes:

• Health education
• Environmental modification
• Nutritional intervention
• Lifestyle and behavioural changes

Examples of Primary Prevention are:

• Providing safe water
• Providing sanitary latrines
• Controlling Insects and Rodents
• Promoting Breastfeeding
• Promoting small family norms
• Improvement in overall socioeconomic status of population.
• Use of helmets and seat belts to protect against head injuries.
• Chemoprophylaxis
• Vitamin A prophylaxis

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Secondary Prevention:

It is the mode of intervention in which the strategy is to diagnosing the disease early and starting the treatment. Here the disease has started but there are no complications. The examples of Secondary Treatment are:

• Active search for Malaria cases.
• School health examination and Health camps
• PAP smear
• MDT for leprosy
• DOTS for Tuberculosis
• Self breast examination
• In industries, The Post placement examination is done on yearly basis to see whether the workers has developed the disease or not.

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Tertiary Prevention

• The disease has progressed to a stage of irreversibility, complications are present. Now the strategy is to limit further damage and this is achieved by disability limitations and Rehabilitation. The concept of Disability includes:
  • Disease- A person that suffers from an accident and lose his leg.
  • Impairment- Loss or abnormality of physiological or psychological structure
  • Disability - It is the restriction or inability to perform an activity. 
  • Handicapped- It is the person that cannot fulfill his roles and responsibilities.

Rehabilitations

It is the combined and coordinated use of medical , social , educational and vocational measures for training and retaining the individuals to the highest possible level of functionality. For example- Crutches for Polio and Blind schools.

Types of Rehabilitation

• Restoration of function
• Restoration of capacity to earn a livelihood
• Restoration of family and social relationship
• Restoration of personal dignity and confidence.

Social Integration

It is the tertiary level of prevention and is a form of rehabilitation. It includes :

• Reconstructive surgery
• School for blind
• Crutches for polio patient
• Providing hearing aids.

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Quaternary prevention

It is the set of health activities to mitigate or avoid the consequences of unnecessary or excessive intervention of the health system. It identifies the patients at risk of overmedication.

High Yield Points

• Best level of prevention for NCD : PRIMORDIAL
• Most NHP: SECONDARY 
• Prevention of occurrence of risk factors: Primordial 
• Prevention of occurrence of disease: Primary 
• Prevention of occurrence of complications from disease: Secondary
• Prevention of occurrence of disability or fatality due to a complication from disease: Tertiary
• Establish and maintain conditions that minimize hazards to health: Primordial
• Reduce incidence of disease: Primary
• Reduce prevalence of disease by shortening its duration: Secondary
• Reduce number and/or impact of complications: Tertiary

 Summary

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FAQs

Q. Discouraging children from adopting harmful lifestyles?

1. Primordial
2. Primary
3. Secondary  
4. Tertiary

Ans. 1

Q. Actions taken prior to onset of disease which removes the possibility that a disease will ever occur :

1. Primordial prevention 
2. Primary prevention
3. Secondary prevention  
4. Tertiary prevention

Ans. 2

Q. A person going for self health check up to a hospital as his father died last week due to   ischemia. Which level of prevention is this? 

1. Primordial
2. Primary
3. Secondary  
4. Tertiary

Ans. 3

Q. The prevention of emergence or development of risk factors in countries or population groups in which they have not yet appeared is called ?

1. Primordial prevention 
2. Primary prevention
3. Secondary  prevention
4. Tertiary prevention

Ans. 1

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Q. An example of primary prevention is  ?

1. Measles vaccination 
2. Smoking cessation after a heart attack 
3. Self breast examination for lumps 
4. Cervical cytology screening 

Ans. 1

Q. Use of seat belt while driving car is an example of :

1. Health promotion
2. Specific protection
3. Early diagnosis and treatment
4. Disability limitation

Ans. 2

Q. Desks provided with table top to prevent neck problems is an example of :

1. Primordial prevention 
2. Primary prevention
3. Secondary  prevention
4. Disability limitation

Ans. 2

Q. School health checkups under which level of prevention:

1. Primordial prevention 
2. Primary prevention
3. Secondary  prevention
4. Tertiary prevention

Ans. 3

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Q. Fetal cardiac monitoring comes under which level of prevention?

1. Primary prevention
2. Secondary prevention
3. Tertiary prevention 
4. Primordial prevention

Ans. 2

Q. After excision of breast for Ca breast, a surgical reconstruction of breast tissue was done. This reflects:

1.  Primary prevention
2. Secondary prevention
3. Tertiary prevention 
4. Medical treatment 
5. Surgical treatment 

Ans. 3

Q. The chest xray ,sputum analysis and DOTS therapy for TB detection constitutes:

1. Medical treatment
2. Primordial prevention
3. Primary prevention
4. Secondary prevention
5. Tertiary prevention

Ans. 4

Q. Use of condoms for protection against sexually transmitted diseases qualifies as :

1. Primordial prevention
2. Health promotion
3. Specific protection 
4. Secondary prevention

Ans. 3

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Q. Vitamin A prophylaxis to a child is:

1. Health promotion
2. Specific protection
3. Primordial prevention
4. Secondary prevention

Ans. 2

Q. Secondary level of prevention includes all of the following except:

1. Health screening for diabetes mellitus 
2. Case finding for falciparum malaria 
3. Contact tracing for STI’S
4. Reconstructive surgery in leprosy 

Ans. 4

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Q. Which of the following is an example of Disability limitation in poliomyelitis?

1. Reducing occurrence of polio by immunization 
2. Arranging for schooling of children suffering from PRPP 
3. Resting affected limbs In neutral position 
4. Providing calipers for walking 

Ans. 3

Q. Early ambulation after a major operation is an example of :

1. Health promotion 
2. Specific protection 
3. Disability limitation 
4. Rehabilitation 

Ans. 3

Q. National iron plus initiative is an example of :

1. Primordial prevention 
2. Primary prevention 
3. Secondary  prevention
4. Tertiary prevention

Ans. 2

Q. Example of disability limitation:

1. DOTS 
2. Quit smoking 
3. BCG vaccine 
4. Spectacles for refractory errors 

Ans. 4

Q. Installation and usage of sanitary lantrines by the general public constitutes which level of prevention ?

1. Health promotion 
2. Specific protection 
3. Early diagnosis and treatment
4. Disability limitation and Rehabilitation 

Ans. 2

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