“Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability.”
The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention.
CONCEPT OF PREVENTION OF DISEASE
Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability.
The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention”
CONCEPT OF PREVENTION OF DISEASE
Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability.
The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention”
The concept of prevention is best defined in the context of levels, tradition...hosamELMANNA
Concept of control:
The term disease control describes ongoing operations aimed at reducing:
The incidence of disease
The duration of disease and consequently the risk of transmission
The effects of infection, including both the physical and psychosocial complications
The financial burden to the community.
Prevention and levels of prevention of Community Medicine lecture .This lecture also has concepts of disease,surveillance, monitoring and iceberg phenonomenon of disease.
DEFINITION
“Actions directed to preventing illness and promoting health to reduce the need for secondary or tertiary health care.
Mosby’s Medical dictionary, 8th edition, 2009
“The action of stopping something from happening or arising”.
Oxford English Dictionary. Lexico 2020
GOALS OF PREVENTION
To promote health
To preserve health
To restore health when it is impaired
To minimize suffering and distress
Successful prevention depends upon:
a knowledge of causation
dynamics of transmission
identification of risk factors and risk groups
availability of prophylactic or early detection and treatment measures,
LEVELS OF PREVENTION
1) Primordial Prevention
2) Primary Prevention
3) Secondary Prevention
4) Tertiary Prevention
PRIMORDIAL PREVENTION
It is the prevention of emergence or development of risk factors in countries or population groups in which they have not yet appeared.
Main intervention is through individual and mass education.
Eg: Efforts directed towards discouraging children from adopting harmful lifestyles.
PRIMARY PREVENTION
“Primary prevention can be defined as the action taken prior to the onset of disease, which removes the possibility that the disease will ever occur.”
Intervention is in the pre- pathogenesis phase of a disease or health problem.
The WHO has recommended the following approaches for the primary prevention of chronic diseases where the risk factors are established: –
A) Population (mass) strategy
B) High -risk strategy
SECONDARY PREVENTION
Definition
“ An Action which halts the progress of a disease at its incipient stage and prevents complications.”
Modes of intervention – Early Diagnosis and Specific treatment
The health programmes initiated by governments are usually at the level of secondary prevention.
Advantages:
Important in reducing the high mortality and morbidity of certain diseases like hypertension, cancer cervix and breast cancer.
Disadvantages:
More expensive and less effective than primary prevention.
Patient is already subjected to mental anguish, physical pain;
TERTIARY PREVENTION
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 the intervention in the late pathogenesis phase.
Treatment, even in late stages of disease, may prevent sequelae and limit disability.
Modes of Intervention - Disability limitation and Rehabilitation.
MODES OF INTERVENTION
“Intervention” can be defined as any attempt to intervene or interrupt the usual sequence in the development of disease in man.
5 modes of intervention
1. Health promotion
2. Specific protection
3. Early Diagnosis and treatment
4. Disability limitation
5.Rehabilitation
CONCLUSION
To initiate preventive measures it is not necessary to know everything about natural history of the disease.
Main objective of preventive medicine - to intercept or oppose the “cause” and thereby the disease process
Introduction to Public Health PracticePrevention Health Servic.docxvrickens
Introduction to Public Health Practice
Prevention Health Services
Program Name
Faculty Name :
Date:
Subject Code:
Module No. 4 – Public Health & Health Systems
School of Public Health
1
Objective
2
At the end of this module, the students should be able to
Describe the health system as a public health concern
Discuss Natural history of disease
Identify and describe the levels of prevention and modes of intervention
Learning Outcome
3
The students will acquire knowledge about the natural history of disease as well as the modes of intervention and will be able to apply this knowledge for the prevention of health problems in the community
Content
Public health system
Natural History of Disease
Levels of prevention
Modes of intervention
Health services pyramid
4
Public health system
Relationship between public health and other health activities has never been clear.
Different views prevail among health professionals
Public health is part of the health system or the health system is part of public health?
Most components serve the same ends
The term health system refers to all aspects of the organization, financing and provision of programs and services for prevention and treatment of illness and injury.
The public health system is a component of this larger health system.
Public commonly perceives the health system to include only medical care and treatment aspects of the overall system.
However, public health activities are part of larger set of activities that focus on health, well-being, disease and illness.
Some questions to brainstorm
Does the countries have a rational strategy for investing its resources to maintain and improve people’s health?
Is the current strategy excessive in ways that inequitably limited access to and benefit from needed services?
Is the health system accountable to its end-users and ultimate payers for the quality and results of its services.
The issues of health,
Excess
access,
Accountability
and quality
Make the health system a public health concern
Prevention and Health service
Health and illness are dynamic state that are influenced by a wide variety of biological, environmental, behavioral, social and health services factors acting through an ecological model.
The complex interaction of these factors results in the occurrence or absence of disease or injury.
Which in turn contributes to the health status of individuals and populations.
Prevention and Health services
Before we go to prevention, its necessary to understand the Natural history of disease.
The nineteenth-century revolution in thinking brought about by Koch and Pasteur led to the recognition of distinct stages in the development of a disease.
If left untreated, a disease would evolve through a series of stages that characterize its natural history
But if an intervention is applied, the natural history is modified, producing a typical clinical course for the condit ...
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
“Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability.”
The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention.
CONCEPT OF PREVENTION OF DISEASE
Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability.
The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention”
CONCEPT OF PREVENTION OF DISEASE
Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability.
The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention”
The concept of prevention is best defined in the context of levels, tradition...hosamELMANNA
Concept of control:
The term disease control describes ongoing operations aimed at reducing:
The incidence of disease
The duration of disease and consequently the risk of transmission
The effects of infection, including both the physical and psychosocial complications
The financial burden to the community.
Prevention and levels of prevention of Community Medicine lecture .This lecture also has concepts of disease,surveillance, monitoring and iceberg phenonomenon of disease.
DEFINITION
“Actions directed to preventing illness and promoting health to reduce the need for secondary or tertiary health care.
Mosby’s Medical dictionary, 8th edition, 2009
“The action of stopping something from happening or arising”.
Oxford English Dictionary. Lexico 2020
GOALS OF PREVENTION
To promote health
To preserve health
To restore health when it is impaired
To minimize suffering and distress
Successful prevention depends upon:
a knowledge of causation
dynamics of transmission
identification of risk factors and risk groups
availability of prophylactic or early detection and treatment measures,
LEVELS OF PREVENTION
1) Primordial Prevention
2) Primary Prevention
3) Secondary Prevention
4) Tertiary Prevention
PRIMORDIAL PREVENTION
It is the prevention of emergence or development of risk factors in countries or population groups in which they have not yet appeared.
Main intervention is through individual and mass education.
Eg: Efforts directed towards discouraging children from adopting harmful lifestyles.
PRIMARY PREVENTION
“Primary prevention can be defined as the action taken prior to the onset of disease, which removes the possibility that the disease will ever occur.”
Intervention is in the pre- pathogenesis phase of a disease or health problem.
The WHO has recommended the following approaches for the primary prevention of chronic diseases where the risk factors are established: –
A) Population (mass) strategy
B) High -risk strategy
SECONDARY PREVENTION
Definition
“ An Action which halts the progress of a disease at its incipient stage and prevents complications.”
Modes of intervention – Early Diagnosis and Specific treatment
The health programmes initiated by governments are usually at the level of secondary prevention.
Advantages:
Important in reducing the high mortality and morbidity of certain diseases like hypertension, cancer cervix and breast cancer.
Disadvantages:
More expensive and less effective than primary prevention.
Patient is already subjected to mental anguish, physical pain;
TERTIARY PREVENTION
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 the intervention in the late pathogenesis phase.
Treatment, even in late stages of disease, may prevent sequelae and limit disability.
Modes of Intervention - Disability limitation and Rehabilitation.
MODES OF INTERVENTION
“Intervention” can be defined as any attempt to intervene or interrupt the usual sequence in the development of disease in man.
5 modes of intervention
1. Health promotion
2. Specific protection
3. Early Diagnosis and treatment
4. Disability limitation
5.Rehabilitation
CONCLUSION
To initiate preventive measures it is not necessary to know everything about natural history of the disease.
Main objective of preventive medicine - to intercept or oppose the “cause” and thereby the disease process
Introduction to Public Health PracticePrevention Health Servic.docxvrickens
Introduction to Public Health Practice
Prevention Health Services
Program Name
Faculty Name :
Date:
Subject Code:
Module No. 4 – Public Health & Health Systems
School of Public Health
1
Objective
2
At the end of this module, the students should be able to
Describe the health system as a public health concern
Discuss Natural history of disease
Identify and describe the levels of prevention and modes of intervention
Learning Outcome
3
The students will acquire knowledge about the natural history of disease as well as the modes of intervention and will be able to apply this knowledge for the prevention of health problems in the community
Content
Public health system
Natural History of Disease
Levels of prevention
Modes of intervention
Health services pyramid
4
Public health system
Relationship between public health and other health activities has never been clear.
Different views prevail among health professionals
Public health is part of the health system or the health system is part of public health?
Most components serve the same ends
The term health system refers to all aspects of the organization, financing and provision of programs and services for prevention and treatment of illness and injury.
The public health system is a component of this larger health system.
Public commonly perceives the health system to include only medical care and treatment aspects of the overall system.
However, public health activities are part of larger set of activities that focus on health, well-being, disease and illness.
Some questions to brainstorm
Does the countries have a rational strategy for investing its resources to maintain and improve people’s health?
Is the current strategy excessive in ways that inequitably limited access to and benefit from needed services?
Is the health system accountable to its end-users and ultimate payers for the quality and results of its services.
The issues of health,
Excess
access,
Accountability
and quality
Make the health system a public health concern
Prevention and Health service
Health and illness are dynamic state that are influenced by a wide variety of biological, environmental, behavioral, social and health services factors acting through an ecological model.
The complex interaction of these factors results in the occurrence or absence of disease or injury.
Which in turn contributes to the health status of individuals and populations.
Prevention and Health services
Before we go to prevention, its necessary to understand the Natural history of disease.
The nineteenth-century revolution in thinking brought about by Koch and Pasteur led to the recognition of distinct stages in the development of a disease.
If left untreated, a disease would evolve through a series of stages that characterize its natural history
But if an intervention is applied, the natural history is modified, producing a typical clinical course for the condit ...
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
3. The goals of medicine are to promote health, to
preserve health, to restore health when it is impaired,
and to minimize suffering and distress.
These goals are embodied in the word "prevention"
4. Prevention; Definition and
Concept
Actions aimed at eradicating,
eliminating or minimizing the impact
of disease and disability, or if none of
these are feasible, retarding the
progress of the disease and disability.
The concept of prevention is best
defined in the context of levels,
traditionally called primary, secondary
and tertiary prevention. A fourth level,
called primordial prevention, was later
added.
5. Determinants of Prevention
Successful prevention depends upon:
a knowledge of causation,
dynamics of transmission,
identification of risk factors and risk groups,
availability of prophylactic or early detection
and treatment measures,
an organization for applying these measures to
appropriate persons or groups, and
continuous evaluation of and development of
procedures applied
6. Preventable Causes of Disease
BEINGS
Biological factors and Behavioral Factors
Environmental factors
Immunologic factors
Nutritional factors
Genetic factors
Services, Social factors, and Spiritual
factors
[JF Jekel, Epidemiology, Biostatistics, and Preventive Medicine, 1996]
7. Leavell’s Levels of Prevention
Stage of disease Level of prevention Type of response
Pre-disease Primary Prevention Health promotion and
Specific protection
Latent Disease Secondary prevention Pre-symptomatic
Diagnosis and
treatment
Symptomatic Disease Tertiary prevention •Disability limitation for
early symptomatic disease
•Rehabilitation for late
Symptomatic disease
9. Primordial prevention
Primordial prevention consists of actions and measures
that inhibit the emergence of risk factors in the form of
environmental, economic, social, and behavioral
conditions and cultural patterns of living etc.
10. Primordial prevention (cont.)
It is the prevention of the emergence or
development of risk factors in countries or
population groups in which they have not
yet appeared
For example, many adult health problems
(e.g., obesity, hypertension) have their
early origins in childhood, because this is
the time when lifestyles are formed (for
example, smoking, eating patterns,
physical exercise).
11. Primordial prevention (cont.)
In primordial prevention, efforts are directed towards
discouraging children from adopting harmful lifestyles
The main intervention in primordial prevention is
through individual and mass education
12. Primary prevention
Primary prevention can be defined as
the action taken prior to the onset of
disease, which removes the possibility
that the disease will ever occur.
It signifies intervention in the pre-
pathogenesis phase of a disease or
health problem.
Primary prevention may be
accomplished by measures of “Health
promotion” and “specific protection”
13. Primary prevention (cont.)
It includes the concept of "positive
health", a concept that encourages
achievement and maintenance of "an
acceptable level of health that will
enable every individual to lead a socially
and economically productive life".
Primary prevention may be accomplished
by measures designed to promote general
health and well-being, and quality of life
of people or by specific protective
measures.
14. Primary prevention
Specific protection
Health promotion
Achieved by
Health education
Environmental modifications
Nutritional interventions
Life style and behavioral changes
Immunization and seroprophylaxis
chemoprophylaxis
Use of specific nutrients or supplementations
Protection against occupational hazards
Safety of drugs and foods
Control of environmental hazards,
e.g. air pollution
15. Health promotion
Health promotion is “ the process of enabling people to
increase control over the determinants of health and
thereby improve their health”.
16. Approaches for Primary
Prevention
The WHO has recommended the following approaches
for the primary prevention of chronic diseases where
the risk factors are established:
a. Population (mass) strategy
b. High -risk strategy
17. Population (mass) strategy
“Population strategy" is directed at the whole
population irrespective of individual risk
levels.
For example, studies have shown that even a
small reduction in the average blood pressure
or serum cholesterol of a population would
produce a large reduction in the incidence of
cardiovascular disease
The population approach is directed towards
socio-economic, behavioral and lifestyle
changes
18. High -risk strategy
The high -risk strategy aims to bring preventive care to
individuals at special risk.
This requires detection of individuals at high risk by the
optimum use of clinical methods.
19. Secondary prevention
It is defined as “ action which halts the progress of a
disease at its incipient stage and prevents complications.”
The specific interventions are: early diagnosis (e.g.
screening tests, and case finding programs….) and
adequate treatment.
Secondary prevention attempts to arrest the disease
process, restore health by seeking out unrecognized disease
and treating it before irreversible pathological changes
take place, and reverse communicability of infectious
diseases.
It thus protects others from in the community from
acquiring the infection and thus provide at once secondary
prevention for the infected ones and primary prevention
for their potential contacts.
20. Secondary prevention (cont.)
Secondary prevention attempts to
arrest the disease process, restore
health by seeking out unrecognized
disease and treating it before
irreversible pathological changes take
place, and reverse communicability of
infectious diseases.
It thus protects others from in the
community from acquiring the
infection and thus provide at once
secondary prevention for the infected
ones and primary prevention for their
potential contacts.
21. Early diagnosis and treatment
WHO Expert Committee in 1973 defined
early detection of health disorders as “
the detection of disturbances of
homoeostatic and compensatory
mechanism while biochemical,
morphological and functional changes are
still reversible.”
The earlier the disease is diagnosed, and
treated the better it is for prognosis of
the case and in the prevention of the
occurrence of other secondary cases.
22. Tertiary prevention
It is used when the disease process has
advanced beyond its early stages.
It is defined as “all the measures
available to reduce or limit
impairments and disabilities, and to
promote the patients’ adjustment to
irremediable conditions.”
Intervention that should be
accomplished in the stage of tertiary
prevention are disability limitation,
and rehabilitation.
24. Impairment
Impairment is “any loss or abnormality of psychological,
physiological or anatomical structure or function.”
25. Disability
Disability is “any restriction or lack of ability to perform
an activity in the manner or within the range considered
normal for the human being.”
26. Handicap
Handicap is termed as “a disadvantage for a given
individual, resulting from an impairment or disability,
that limits or prevents the fulfillment of a role in the
community that is normal (depending on age, sex, and
social and cultural factors) for that individual.”
27. 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.”
29. Strategy for Prevention
Assess
Exposure
Identify
Populations
at High
Disease Risk
(based on demography /
family history,
host factors..)
Conduct
Research on
Mechanisms
(including the study of
genetic susceptibility)
Apply
Population-Based
Intervention
Programs
Evaluate
Intervention
Programs
Modify Existing
Intervention
Programs
Epidemiology Division
31. Control
Concept of control:
The term disease control describes
ongoing operations aimed at reducing:
The incidence of disease
The duration of disease and consequently
the risk of transmission
The effects of infection, including both
the physical and psychosocial
complications
The financial burden to the community.
32. Control activities focus on primary prevention or
secondary prevention, but most programs combine
both.
control
elimination
eradication
33. Disease Elimination
Between control and eradication, an
intermediate goal has been described,
called "regional elimination"
The term "elimination" is used to
describe interruption of transmission
of disease, as for example, elimination
of measles, polio and diphtheria from
large geographic regions or areas
Regional elimination is now seen as an
important precursor of eradication
34. Disease Eradication
Eradication literally means to "tear out by roots".
It is the process of “Termination of all
transmission of infection by extermination of the
infectious agent through surveillance and
containment”.
Eradication is an absolute process, an "all or
none" phenomenon, restricted to termination of
an infection from the whole world. It implies that
disease will no longer occur in a population.
To-date, only one disease has been eradicated,
that is smallpox.
35. Monitoring
Monitoring is "the performance and
analysis of routine measurements
aimed at detecting changes in the
environment or health status of
population" (Thus we have monitoring
of air pollution, water quality, growth
and nutritional status, etc).
It also refers to on -going
measurement of performance of a
health service or a health professional,
or of the extent to which patients
comply with or adhere to advice from
health professionals.
36. Surveillance
surveillance means to watch over with
great attention, authority and often
with suspicion
According to another, surveillance is
defined as "the continuous scrutiny
(inspection) of the factors that
determine the occurrence and
distribution of disease and other
conditions of ill-health"
37. Objectives of Surveillance
The main objectives of surveillance are:
(a) to provide information about new and changing
trends in the health status of a population, e.g.,
morbidity, mortality, nutritional status or other
indicators and environmental hazards, health practices
and other factors that may affect health
(b) to provide feed-back which may be expected to
modify the policy and the system itself and lead to
redefinition of objectives, and
(c) provide timely warning of public health disasters so
that interventions can be mobilized.
38. Control of infectious diseases
(the 4 “C”s
Control
Cases Contacts Carriers Community
Diagnosis
notification
isolation
disinfection
treatment
follow up
release
observation detection Epidemiological
Investigation &
containment
standard
strict
protective
39. Evaluation of control
Evaluation is the process by which results are compared
with the intended objectives, or more simply the
assessment of how well a program is performing.
Evaluation should always be considered during the planning
and implementation stages of a program or activity.
Evaluation may be crucial in identifying the health benefits
derived (impact on morbidity, mortality, sequelae, patient
satisfaction).
Evaluation can be useful inidentifying performance
difficulties.
Evaluation studies may also be carried out to generate
information for other purposes, e.g., to attract attention to
a problem, extension of control activities, training and
patient management, etc.
