Levels Of Prevention

LEVELS OF PREVENTION

There are four levels of prevention:

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

Primordial Level of Prevention:

• It is the prevention of the emergence or development of risk factors in countries or population groups in which they have not yet appeared.

Modes of Intervention:

1. Individual Education
2. Mass Education

• Primordial Level is Best level of prevention for Non-communicable diseases.

Examples

• Control of tobacco (discouragement from adopting a harmful lifestyle)

Primary Level of Prevention:

• It is the action taken prior to onset of disease, which removes the possibility that a disease will ever occur.
• Primary level of prevention is applied when ‘risk factors are present but disease has not yet taken place’. 
• It signifies ‘intervention in the Pre pathogenesis Phase of a disease/ health problem’
• Modes of Intervention:

Health Promotion:

• Is targeted at strengthening the host through a variety of approaches/ interventions,
•  e.g. Health Education, Environmental modifications, Nutritional interventions, Lifestyle & behavioural changes

Specific Protection:

•  Is targeting the prevention of disease through a specific intervention. 

Example

1. Immunization
2. Installation of sanitary latrines
3. Provision of safe water
4. Use of mosquito net
5. Health education (cancer education) and specific protection (radiation protection) are primary levels of prevention..
6. Wearing a seatbelt will not prevent the collision but may lessen its effects. Thus it is secondary level of prevention.

Secondary Level of Prevention:

• It halts the progress of disease at its’ incipient stage and prevents complications
• Modes of Intervention:

Early Diagnosis: 

• Detection of disturbances while biochemical, functional and morphological changes are still reversible or prior to occurrence of manifest signs & symptoms.

Treatment:

•  Shortens period of communicability, reduces mortality and prevents occurrence of further cases (secondary cases) or any long termdisability.
• Secondary level of prevention is applied when disease has possibly set in
• It attempts to arrest the disease process, seek unrecognized disease & treat it before irreversibility and reverse communicability of infectious diseases.
• National Health Programmes by Govt. of India mostly operate at Secondary level of prevention.
• Secondary prevention is an imperfect tool in control of transmission of disease: It is more expensive and less effective than primary prevention.
• It is an important level of prevention for diseases like Tuberculosis, Leprosy and STDs.

Examples

1. Breast self exam
2. Total mastectomy for breast cancer
3. Cervical pap smear checking

Tertiary Level of Prevention:

• Is applied when a disease has advanced beyond early stages.
• It aims to reduce or limit impairments & disabilities, minimize suffering caused by existing departures from good health.

Modes of Intervention:

Disability Limitation:

•  It ‘prevents the transition of disease from impairment to handicap‘.

Rehabilitation: 

• Training & retraining of an individual to the highest possible level of functional ability; It can be medical, vocational, social or psychological.
• Tertiary level of prevention signifies ‘intervention in late pathogenesis phase’.

Examples

1. Tendon transplant in leprosy
2. Physiotherapy in residual polio myelitisProvision of spectacles for refractive errors