Modern aspercts of preventiv medicine
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The document discusses mortality trends, causes of death, and prevention of non-communicable diseases. It notes that diseases of the circulatory system and cancer are becoming the leading causes of death globally and in Russia. Prevention is highlighted as the most cost-effective approach, with measures to address diseases of the circulatory system and cancer able to increase life expectancy by 10 and 8 years respectively. The document outlines principles of health promotion, types of prevention including primary, secondary and tertiary, and Russia's federal program to promote healthy lifestyles and prevent non-communicable diseases from 2013-2017 with the goal of increasing life expectancy.
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Modern aspercts of preventiv medicine
- 1. DEPARTMENT FOR HEALTHCARE AND PUBLICDEPARTMENT FOR HEALTHCARE AND PUBLIC HEALTHHEALTH
- 2. Problems for discussion 1. Structure of mortality. The main causes of population deaths. 2. Methodology, model and principles of health promotion. 3. Types of prevention. Federal Program in Russia.
- 3. «Future belongs to preventive medicine» N. Pirogov
- 4. Expected changes in the mortality structure for 120 years Main cause of death 1900 2000 Prognosis for 2020 Trend infectious diseases 20% 1,7% 1% ↓ 20 times diseases of the circulatory system 15% 56% 60% ↑ 4 times cancer 5% 12% 25% ↑ 5 times 20 15 56 60 5 12 25 0% 50% 100% 1900 2000 2020 infectiousdiseases diseasesofthe circulatorysystem cancer others
- 5. The main causes of population death in the world 4% 16% 12% 21% 48% diseases of circulatory system neoplasms chronic pulmonary disease diabetes mellitus others
- 6. E urope 52 19 2,4 4 4 18,6 diseases of circulatory system neoplasms injury, poisoning… diseases of the digestive system pulmonary disease others Rus s ia 56,8 14,4 10,7 4,5 3,7 9,9 diseases of circulatory system neoplasms injury, poisoning… diseases of the digestive system pulmonary disease others The main causes of population death
- 7. The main causes of population death Rus s ia 56,8 14,4 10,7 4,5 3,7 9,9 diseases of circulatory system neoplasms injury, poisoning… diseases of the digestive system pulmonary disease others
- 8. Diseases of the circulatory system
- 9. Medical care Healthy lifestyle Diseases of the circulatory system
- 10. Measures for prevention of mortality due to diseases of circulatory system are able to increase the average life expectancy by 10 years!
- 11. Cancer 1. The 12th place in the structure of prevalence among adults; 2. Increasing trend in primary morbidity (+28,5% during 10 years). 3. More than 400 000 new cases each year, including 2500 children under 14. 4. The total prevalence 2029 cases per 100 000 people.
- 12. Leading localizations of cancer (both sexes) 12,6% 11,1% 10,7% 3,7% 6,5% 5,1% 50,3% s kin c anc er breas t c anc er lung c anc er s tomac h c anc er c olon c anc er pros tate c anc er others
- 13. Leading localizations of cancer (among men and women) men 18,9% 11,9% 11,5% 9,1% 48,6% lung c anc er pros tate c anc er s kin c anc er s tomac h c anc er others women 20,4% 14,7% 7,4% 7% 50,5% breas t c anc er s kin c anc er hys teroc arc inoma c olon c anc er others
- 14. 5. The 2d place (15,4 %) in the structure of deaths in Russia. 6. 300 000 deaths every year. 7. The 2nd place (22,9%) in the structure of causes of disability among adults. 8. Economic damage about 170 billion rubles. Cancer
- 15. Measures for prevention of mortality due to malignant tumors are able to increase the average life expectancy for 8 years!
- 16. Keys of NCD prevention Most NCDs are preventable. Population based approach. Health promotion is the most cost-effective and sustainable way to improve public health
- 17. Methodology, model and principles of health promotion
- 18. Main factorsMain factors responsible forresponsible for healthhealth statusstatus 18% 20% 10% 52% lifestyle medical care environment heredity
- 19. Health promotion is the process of enabling people to increase control over and to improve their health WHO, 21 November 1986, The Ottawa Charter for Health Promotion
- 20. 8th Global WHO Conference on health promotion - “Health in all policies” From Ottawa to Helsinki (June 2013)
- 21. Model of health promotionModel of health promotion Reorienting the health services Building healthy public policy Strengthening community action Creating supportive environments Developing personal skills Ottawa Charter for Health Promotion WHO, 1986
- 22. 7 key principles of health promotion, WHO Holistic Inter-sectoral Participative Multi-strategy Sustainable Equitable Empowerment
- 23. COMBING PERSONAL AND PUBLIC RESPONSIBILITIES Personal Responsibility ”Nobody can take better care of your health than yourself” Public Responsibility ”Make the healthy choices the easy ones” (Ottawa charter)
- 24. 18
- 25. •POLICY INTERVENTIONS Vision for the future •The future is in our hands •From what to how •Political will and leadership •From predicting the future to making the future
- 26. Codes of health and longevity
- 27. PreventionPrevention refers to approaches and activities aimed at reducing the likelihood that a disease or disorder will affect an individual, interrupting or slowing the progress of the disorder or reducing disability.
- 28. Principles of prevention programs patient - oriented use of scientific progress multiple communication channels increasing range of preventive services creating a market for preventive and wellness services
- 29. Averaged data for the United States, Finland, Great Britain, Holland, New Zealand 55% 37% 8% prevention treatment others Contribution of curative and preventive measures in reductionContribution of curative and preventive measures in reduction of mortality from coronary heart diseaseof mortality from coronary heart disease
- 30. Socrates
- 31. Types of prevention. Federal Program in Russia.
- 32. Types of prevention Condition of an organism Healthy Disfunction Symptoms of pathology Organ failure Duration decades years months Donozological prevention Nozological prevention The purpose of intervention health promotion correction of disorders, strengthening adaptive capacity of the organism earlier detection of the disease, achieving long- term remission prevention of complications disability mortality primary secondary tertiary
- 33. Primary prevention Outcome Objective Activities Target audience Results Prolonged HALY To motivate for healthy lifestyle Social Healthy people ↑ number of healthy individuals ↑ index of health ↑ percentage of people who lead healthy lifestyle ↑ life expectancy Based on the formation of people's needs to keep healthy lifestyle Based on the formation of people's needs to keep healthy lifestyle
- 34. Secondary prevention Outcome Objective Activities Target audience Results Maintaining the health of people in high-risk group Early detection of disorders, strengthening adaptive capacity of organism Medico-social or socio- medical High-risk group • ↓Incidence Based on multi-level screening systemsBased on multi-level screening systems
- 35. Tertiary prevention Outcome Objective Activities Target audience Results Prolonged DALY Prevention of disease progression, relapses, decompensated disabilities, lethal outcomes Nosological Patients with chronic diseases •↓ frequency of relapses •↓ frequency of complications •↓temporary disability • ↓ disability rate • ↓ lethal outcomes Based on regular health check-upsBased on regular health check-ups
- 36. Coverage of population for different types of prevention
- 37. Federal Program: "Promotion of healthy lifestyles and prevention of noncommunicable diseases in the Russian Federation for 2013-2017 " Objective: To increase life expectancy by reducing the premature mortality from NCDs, primarily from cardio- vascular diseases
- 38. Ministry of Health Center for preventive medicine Population > 150 000 Population 50 000 -150 000. local hospital rooms of preventive medicine Out-patient clinics Health center departments of preventave medicine rooms of preventive medicine feldsher-midwife station rooms of preventive medicine Research institute of preventive medicine Federal Service for Consumer Rights Protection and Human Welfare Ministry of Education and Science of the Russian Federation Ministry foof Sport, Tourism and Youth Policy of the Russian Federation departments of preventive medicine rooms of preventive medicine City center for preventive medicine PopulationlevelIndividuallevelGrouplevel
- 39. Thank you for your attention!
Editor's Notes
- Good morning, dear ladies and gentlemen! First of all, let me thank you all for being here today. Those, of you, who have been at my first lecture a month ago, know me well, for the rest - my names is V. Reshetnikov. I am the head of department, where you are staying now. You know, this is my second lecture, I don`t worry, because you listened with interest to my talk. Do you remember what I said in my previous lecture on “ Introduction on Public Health and Health Systems?”. I`ll remind the main issues: 1. PH – studies the impact of social, environmental, economic and other factors on population with a view to development a complex medical and preventive measures. 2. PH is a strategic asset to the Nations development. 3. The health sector is the key social sector for development of society. 4. Good health affects life expectancy and personal well-being. 5. A healthy population will have high work product`ivity and health care costs less for both individual and public sector. Nevertheless, now we have a global problem in PH in the world. It is NCDs. NCDs kill more than 36 mln people every year. Nearly 80% of NCDs deaths ( 29 mln) occur in low and middle income countries. More than 9 million of all deaths attributed to NCD occur before the age of 60. CVD, cancer, respiratory diseases and diabetes account for around 80% of all NCD deaths. This brings the issue of prevention to the top of PH agenda. Today`s topic is …MODERN ASPECTS OF PREVENTIVE MEDICINE. ….
- It is very important to all of you, because today || prevention of diseases is the basis for social and Healthcare policy in most countries in the world. Today I`d like to tell you about our new plans of Prevention and control of NCDs. I`ve divided my presentation in to three parts. First of all I`ll show you the structure of mortality from 1990 to 2030. In the first part of my presentation I`ll focus at the main causes of population deaths: diseases of CV system and neoplasms. After that, I`ll go on to Method`ology, model and principles of health promotion. I`ll end with Types of prevention ( primary prevention, secondary and tertiary prevention, the WHO program and Russian Federal Program of preventive medicine in 2013-2017. My presentation will take about 80 min. There will be time for questions after my presentation. I remind:» Don`t worry about taking notes. I`ll be handing out copies of the slides at the end of our talk.» Do you know that only 30% of visits to doctors in outpatent clinics have been made for preventive purpose in our country? At the same time total morb`idity rate has increased by 15% in the Russian Federation in the last decade . Imagine that you have been appointed to the position of the Minister of Health. What do you suggest to do in this situation? I`d like to come back to this question later.
- My next slide shows that the great Russian surgeon N. Pirogov one said that Future belonged to preventive medicine. This idea was shared by other famous doctors Y. Mudrov, N. Semashko S. Botkin. In those early years they understood that it is easier to prevent a disease than to treat a patient.
- Now let`s compare changes in the structure of mortality for 120 years. This slide illustrates that CVD and Cancer will be a big problem by 2020 . The bar chart across the bottom shows the proportion of deaths among Infectious diseases, CVD, Cancer and others diseases. We can see that in 1900 almost 20% of deaths were attributed to infections ( lilac color), followed by CVD ( 15% ,red color) and others diseases consisted about 60%. (grey color). However, in 2020 CVDs will increase up to 60% and Cancer - just over 20%. Forecast for Others diseases is near 14% and infectious diseases a little less than 1%.
- Let`s go back to what I said at the beginning of my presentation. You can see this pie chart shows the main causes of death in the world and how they are divided among the main NCDs. Let`s begin with the biggest area, which is shown in red. We can see that almost 50% of all deaths are att`ributed to CVDs. The second biggest area with a total of 21 % is neoplasms, that’s the yellow s`egment here. Respiratory diseases have almost the same share as all the other causes of deaths. That is 12% and 16% respectively. Let`s look at the smallest segment in green. That is diabetes. Thus, CVDs and neoplasms steadily outweight the others causes of population death.
- On the next slide let`s compare the situation with main causes of population death in Russia vs Europe. .This slide shows that CVDs are estimated to account for more than 55% of total deaths in Russia… and…around 52% in Europe ( red area)…The second biggest area in both pie charts is neoplasms (yellow segment). It is 19% and 14% for Europe and Russia respectively. An interesting fact that the third biggest segment for Russia (Injury and p`oisoning) is the smallest segment for Europe, almost 11% and a bit over 2% respectively. There is an interesting trend in Russia|| life expectancy under 60 goes down|| and the number of people aged 60 and over|| goes up. Thus, aging population increases the prevalence of CVDs in total morbidity in Russia. This brings preventive medicine|| on healthcare ag`enda. USs and Europe saw a significant decrease in CVD mortality| mainly due to the low rate of new CVD cases detected|| and elimination of Risk Factors|| such as hypertension and smoking.
- On this slide let`s compare the situation with main causes of population death in Russia vs South-East Asia Region... This slide shows that CVDs are estimated to account for more than 55% of total deaths in Russia… and…around 26% in South-East Asia ( red area)…The second biggest area in the pie charts of Russia is neoplasms (yellow segment) and in South-East Asia – neoplasms take only fifth place (yellow segment). It is 14% and 9% for Russia and Asia respectively. The third segment for Russia is Injury and poisoning (the purple segment) and in Asia injury and poisoning take fourth place, almost 11% and 11% respectively. An interesting fact that the fourth biggest segment (light blue segment) in Russia are diseases of the digestive system, and the diseases of the digestive system take only six place in Asia, but the percentage is about the same. It is 4,5% against 4,7% for Russia and Asia respectively.
- Let me just show you|| some interesting details. State Health policy in Russia is targeted at a patient and treatment of a disease. According to WHO health policy should be « health – centered «. That means the doctors should try their best to save and prot`ect good health of an indivi`dual. And that is exactly what our famous doctors told us about: ||that Future belonged to preventive medicine.
- To find the right way to fight CVDs we need to understand : How we can improve Healthcare and Public Health. The morbidity rate is growing in working population in Russia. Social security system spends almost 100 billion Rubles for sick-leave compensations every year. Economic losses are about 30 billion Rubles. The role of lifestyle and living conditions (smoking, stresses, sedentary lifestyle) is very important. The development and implement`ation of integrated prevention programs can significantly reduce the pr`evalence of CVDs.
- As you can see in this slide - Measures for prevention of mortality due to CVDs are able to increase the average life expectancy || by 10 years! So, you can see, that « Almost all is in our hands». Healthy diet, regular physical training, healthy lifestyle are essential for the prevention of CVDs. Please raise your hands those who keep these rules. …1 2 3 4 5 Wow!….Well. I am glad for you.
- Look at the figures on the next slide. Mal`ignant diseases are on the 12th place in the structure of prevalence among adults; The number of people suffering from cancer has grown by almost 30% in the last decade. More than 400 thousand people develop cancer each year, including 2500 children under 14. The total prevalence of malignant diseases in Russia amounted to 2029 cases per 100 000 people. Only 10% to 20% of patients with cancers detected || have early stage of disease. Meanwhile|| many hospitals have improved their diagnostic capacities.
- As you can see|| this pie chart shows the leading localization of cancer. There are top 6 localizations, with a total of almost 50%. They are skin, breast, lungs, stomach, colon and prostate. We can see that almost 50% of all localization are attributed to different cancers. The leading position || belongs to skin cancer with a total of 12 %, || that’s the brown s`egment here. I think you`ll be surprised to see that breast cancer (red segment ) and lung cancer (green segment) have almost the same shares. That is 11% and 10% respectively. I`d now like to draw your attention to the smallest segment in orange. That is stomach cancer.
- On the next slide let`s compare the situation with leading localizations of cancer (among men and women). This slide shows that breast cancer in women (red segment ) and lung cancer in men (blue segment) are estimated to account for 20% and almost 18% of total localizations of cancer respectively. The second biggest area is skin cancer in women near 15% and prostate cancer in men over 10 % . What do you think about the reasons for the differences in cancer structure for men and women? Mind about risk factors and modern standard for beauty. Today|| sun tan is very popular with women|| while many studies have proved UVA|UVB ( ultraviolet )|| to be a risk factor for breast and skin cancers.
- As you can see here … mali`gnant diseases occup`y the 2d place in the structure of deaths of Russia’s population. 300 000 die every year. Men die more often|| than women. There is a trend of growing death rate due to mal`ignacies. 4. Mal`ignant diseases are on the 2nd place in the structure of causes of disability among a`dults. 5. Economic d`amage is about 170 billion rubles a year due to premature death, disability and expensive and prolo`nged treatment. As a result Russians die from tumors 15 years earlier than Europeans and Americans.
- I have a slide which shows that….по слайду… We have seen that structure of cancers is different for men and women. So don`t forget about gender// when developing programs for prevention.
- Summary. I`d like to run through my main points again. …. From medical point of view most NCDs are preventable|| till late stages of life. It is possible to treat NCDs. But in terms of prevention the population based approach is the most promising one. Population based prevention is the most cost-effective and sustainable way to improve public health through i`nfluencing NCDs related lifestyles|| including health promotion and policies. Conclusion. Consequently, an important way to reduce NCDs is to focus on lessening the risk factors associated with these diseases. Low- cost solutions exist to reduse the common modifiable risk factors ( mainly tobacco use, unhealthy diet, and physical inactivity and the harmful use of alcohol). Other ways to reduse NCDs are high impact essential NCD interventions that can be delivered through a primary health-care approach to strengthen early detection and timely treatment. Evidence shows that such interventions are excellent economic investments because, if applied to patients early, can reduce the need for more expensive treatment. These measures can be implemented in various resource levels. The greatest impact can be achieved by creating healthy Public policies that promote NCDs prevention, control and reorienting health systems to address the needs of people with such diseases. To conclude, I want to say : « If you want to be healthy, you need to care about your health.
- In the second part of our presentation we will look at the role of education and information in prevention. The participation of a patient in the treatment process - is the basis for successful control of the disease. The purpose of the individual consulting is to give the patient the necessary knowledge, to educate him and motivate him for a healthy lifestyle. A physician should include the simple but important things in the personal consulting of a patient : active forms of training, motivation for behavior change. The process of changing behavior is difficult, because, you will change the lifestyle.
- What do you think about Main factors responsible for health status? In this slide you can see these factors. Lifestyle is responsible for Just over 50% of health status. Almost 20 % is environment, the third is heredity under 20%, the medical care have appr`oximately 10%. What do you do in this situation as a Minister of Health? This leads us directly to my next slide.
- This slide defines health promotion in terms of the O`ttawa Charter for Health Promotion by WHO adopted in Novermber 1986. «Health promotion is the process of enabling people to increase contr`ol over and to improve their health». Do you agree with this definition?. It is connected with the idea|| that a patient education program|| is aimed at motivating him/her to follow doctor`s recommendations .
- I`ll show you the slide, which demonstrates the evolution of the idea for the last 30 years: From theory to practice and From a community – based program to national action plans and policies. Some results of this progress were announced at...the 8th Global WHO Conference on health promotion in Helsinki in June 2013. The slogan of this Conference was: - “Health in all policies”.
- Let`s now look at the next slide which demonstrates the Model of health promotion. This model was also adopted in 1986 in Canada. It consists of the following levels: Building healthy public policy, reorienting the health services, creating supportive environments, strengthening community action, developing personal skills. This model illustrates the idea of health promotion, as a top – down hierarchy , from public policy to an individual. These ideas are relevant today. Activities in the field of the state policy, community action, reorganization of the healthcare system, creating a culture of healthy lifestyle will help to maintain and improve the health of the population. Now Health promotion is a priority for the Healthcare in Russian Federation. The Russian Federation supported a WHO project on strengthening health systems for the prevention and contr`ol of NCDs. It included preparing str`ategies and policies, strengthening integrated sur`veillance systems, promotion of healthy lifestyles and training decision-makers in countries of eastern Europe and Central Asia. Russia provided fin`ancial, technical and methodological support through experts and leading instistutions, including our University.
- We have a slide, which names seven key principles of health promotion. Let`s start with the yellow element. It`s Empowerment. Empowerment means|| that - Health promotion initiatives should enable individuals and communities to assume more power over the personal, socio-economic and environmental factors that aff`ect their health. The next principle is Holi`stic , which is colored in green. According to this principle Health promotion initiatives should foster physical, mental, social and spiritual health as a whole. Now I`d like you to take a look at the red area. We have Inter-sectoral principle here. Now please, who can describe key ideas of inter-sectoral approach? …… Inter-sectoral means|| that Health promotion initiatives should involve the collaboration of all relevant sectors. Вставить предложение!! Now we have two more areas left, blue and grey , which are Multi-strategy and Sustainable principles respectively. Multi-strategy principle claims - Health promotion initiatives should use a vari`ety of approaches in combination with one another, including policy development, organizational change, community development, legislation, ad`vocacy, education and communication. -Sustainable means Health promotion initiatives should bring about changes that individuals and communities can maintain once initial funding has ended. If you look at the orange element you can see the E`quitable principle here. That means - Health promotion initiatives should be guided by a concern for e`quity and social justice. The next area is Participative. It is marked in violet. Participative means// that Health promotion ini`tiatives should involve those concerned in all stages of planning, implement`ation and evaluation. The last in the list but not the least is the E`quitable principle (orange) . That means - Health promotion initiatives should be guided by a concern for e`quity and social justice.
- Let`s now look at the next slide. We have two phrases here. One is PR, the other one is PR. Let`s compare these phrases . What do you think about it? Who wants to discuss this question?..... - I think, that you will agree that without personal participation there would be no public health. Government can do nothing with this problem alone. At the same time, people can`t adopt healthy lifestyle with no facilities for it. So, success is possible only in shared responsibility.
- In the next slide you can see a picture of a man, walking up the stairs of life…. Prolonged healthy life is one of the main objectives of the European health policy . WHO and the World Bank carried out a study on the global burden of disease. The aim of this project was to id`entify the loss of health among the population in various countries and recomme`nd pri`orities in the development of health programs in these countries. The main task was to calculate health adjusted life years (HALY), that is life years lived without significant limitations due to health problems. A WHO study showed that healthy life expectancy in Russia was ranked 107 from 191 countries in 2010. ( Новая цифра). It was found that a 20-years-old male in Russia was going to live a healthy life by 5.2 years shorter than his peers in Eastern Europe, 13.7 years less than in Western Europe, and 13.9 years less than in Northern Europe. Thus, the longer people suffer from diseases , the more money society spend for treatment.
- As you can see here society must move to active actions, shaping the future. Policy interventions require the political will, a strategic plan and specific activities. It is necessary to prevent premature mortality, significantly reduce the burden of morbidity associated with NCDs, improve quality of life and ensure a more e`quitable distribution of healthcare. Therefore complex measures are necessary in all sectors targeted at risk factors. Health systems should improve prevention of NCDs .
- Let`s now look at this slide. Many important priorities have been identified in our country and other countries. During the last few years a great number of st`rategies and plans for e`vidence-based, effective prevention and health promotion have been produced. «Code of health and lon`gevity was developed in our country. This is informational and educational project targeted at each resident of Russia. This project is an important step in health promotion in our country. Its purpose was to increase knowledge of citizens with respect to their own health and health of family and friends. The authors of the project were leading experts in public health. 5 separate »Codes of health and lon`gevity» were developed: for pregnant women and young mothers; for parents with children under 14 ; for teenagers aged 12-18 ; for young and middle-aged people; for elderly people.
- Before we move to principles of prevention let`s take a closer look at the definition of prevention. I suggest to use a def. of WHO. Because it is universal for many countries. The key ideas of this definition are … см Слайд!
- This slide illustrates the basic Principles of prevention programs. They are: далее по слайду… Therefore, people should be offered to strengthen their health, interact effectively with health services and participate actively in treatment and diagnostic process.
- Summary / Look at this pie chart. This is the last slide in the second part of my presentation. You can see the contribution of treatment and prevention to reduction of mortality from CVDs. Let`s begin with the biggest area, which is shown in green. We can see that prevention reduces mortality from coronary heart disease by more than 50%. The second biggest area with a less than 40% is the treatment, that’s the red segment here. Thus, prevention can double survival of patients with CVDs at all stages of life and is an effective investment in the health of population. Conclusion/So, that’s all I have to say in the second part of our talk.
- Finally I would like to quote the great philosopher Socrate who said that"Health is not everything, but without it , everything is nothing.
- There are signs of progress in the development of effective interventions, programs and policies for the prevention and control of NCDs in the past decade. In the third part we will look at the levels of prevention, the main areas of prevention activities and federal program for prevention of NCDs in Russian Federation.
- Now, look at this slide. …When developing a prevention program one should consider 3 main issues: a target health problem, a target population, and cost effectiveness of the program. WHO identifies 3 types of prevention: Primary, Secondary and Tertiary. Primary prevention focuses on elimination of Risk factors. Secondary prevention is targeted at early detection and treatment of population at Risk. Tertiary prevention is aimed at reducing diseases complications and progression. We can see that the effect of primary prevention lasts for decades, secondary prevention is effective for years and tertiary – for months. So, primary prevention results in health promotion and improvement, tertiary prevention prevent disability and mortality.
- Now take a closer look at each type of prevention. PP motiv`ates people for healthy lifestyle. Its main idea is to provide prolonged Health Adjusted Life Years, that is to make healthy people live long and healthy life without disability. I would like to draw your attention to target audience for primary prevention. It is Healthy people. The results of PP are an increase in the number of healthy individuals, life expectancy, index of health and percentage of people who adopt healthy lifestyle.
- Let me just show you some interesting details about Secondary prevention. The objective of Secondary prevention is mainta`ining the health of population at risk. In this case we should solve the following problems: early detection of disorders and strengthening adaptive capacity of organism. The result of SP is a decrease in the incindence of NCDs.
- I`d now like to draw your attention to the next slide. This slide describes Tertiary prevention. The main idea of TP is to provide Prolonged Disability Adjusted Life Years, that is to make sick people live longer. TP is focused on Patients with chronic diseases. The main results of TP are declines in….. cсм снизу вверх!!!
- Take a look at this bar chart. It illustrates the coverage of population for different types of prevention. You can see that the highest coverage ( 100%) is provided by the PP, which uses the population strategy. Secondary Prevention covers only 1/3 of the target audience, and Tertiary Pr. – a quarter of target audience.
- Russian Minister of Health has developed a Federal Program: on promotion of healthy lifestyles and prevention of noncommunicable diseases in the Russian Federation starting from 2013 for the next 5 years. The Objective of this program is to increase life expectancy by reducing the premature mortality from NCDs, primarily from cardio-vascular diseases.
- The following flow chart presents the model for implementation of the Federal program. You can see three main levels in it, basing in the coverage (population, group, individual), and institutions responsible at each level. At the top of the flow chart Ministry of health in close collaboration with other sectors and National Research Institute for preventive medicine develops federal programs for prevention and provides monitoring and control of its implementation. At the second/group level regional sites for prevention amend the program according to the current environment and with regard to the size of municipal union translate the program either to out-patient clinics and health centers or to local hospitals. Actually these institution are the place where individuals meet prevention.
- Thus, to conclude let`s run through the key ideas of my presentation. First: Now you know that poor health status costs much not only to healthcare but also to other sectors. Second: Most diseases are preventable. Third: Strategies for prevention should focus on elimination of Risk Factors and be sponsored by different sectors. And the last but not the least: Cross-sectoral collaboration is essential for successful implementation of preventive programs.