Health Problems in India by Preeti ThakurSMVDCoN ,J&K
India has huge burden of Health problems .In India health problems are discussed under six major headings as commonly seen in the country.
1.Communicable Disease Problem
2. Non-Communicable disease problem
3.Nutritional problem
4.Environmental sanitation problem
5.Medical care problem
6.Population problem
Health Problems in India by Preeti ThakurSMVDCoN ,J&K
India has huge burden of Health problems .In India health problems are discussed under six major headings as commonly seen in the country.
1.Communicable Disease Problem
2. Non-Communicable disease problem
3.Nutritional problem
4.Environmental sanitation problem
5.Medical care problem
6.Population problem
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Globalization, Global Health and Public Health.
Changing Concepts of Public Health.
Causes, Aspects and Types of Globalization.
Social Changes due to Globalization.
How Globalization affects Public Health.
Globalization of Public Health.
Threats to Global Health.
Published in The Lancet in November 2018, GBD 2017 provides for the first time an independent estimation of population, for each of 195 countries and territories and the globe, using a standardized, replicable approach, as well as a comprehensive update on fertility. GBD 2017 incorporates major data additions and improvements, using a total of 68,781 data sources in the estimation process.
The global burden of disease refers to the cumulative impact of illnesses, injuries, and risk factors on the health and well-being of populations worldwide. This comprehensive measure takes into account both fatal and non-fatal health outcomes and provides a holistic view of the challenges affecting communities.
Assessed through metrics such as Disability-Adjusted Life Years (DALYs), the global burden of disease considers the years of healthy life lost due to premature death and the years lived with disability. This approach enables policymakers and public health professionals to prioritize interventions and allocate resources effectively.
Understanding the global burden of disease is crucial for shaping health policies, designing preventive strategies, and addressing the most pressing health issues. It serves as a valuable tool for promoting health equity, guiding healthcare investments, and fostering collaboration on a global scale to alleviate the impact of diseases and improve overall well-being
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Globalization, Global Health and Public Health.
Changing Concepts of Public Health.
Causes, Aspects and Types of Globalization.
Social Changes due to Globalization.
How Globalization affects Public Health.
Globalization of Public Health.
Threats to Global Health.
Published in The Lancet in November 2018, GBD 2017 provides for the first time an independent estimation of population, for each of 195 countries and territories and the globe, using a standardized, replicable approach, as well as a comprehensive update on fertility. GBD 2017 incorporates major data additions and improvements, using a total of 68,781 data sources in the estimation process.
The global burden of disease refers to the cumulative impact of illnesses, injuries, and risk factors on the health and well-being of populations worldwide. This comprehensive measure takes into account both fatal and non-fatal health outcomes and provides a holistic view of the challenges affecting communities.
Assessed through metrics such as Disability-Adjusted Life Years (DALYs), the global burden of disease considers the years of healthy life lost due to premature death and the years lived with disability. This approach enables policymakers and public health professionals to prioritize interventions and allocate resources effectively.
Understanding the global burden of disease is crucial for shaping health policies, designing preventive strategies, and addressing the most pressing health issues. It serves as a valuable tool for promoting health equity, guiding healthcare investments, and fostering collaboration on a global scale to alleviate the impact of diseases and improve overall well-being
National Program for Prevention and Control of Cancer, Diabetes, CVD and Stro...Vivek Varat
Government of India initiated a National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) during 2010-11 after integrating the National Cancer Control Programme (NCCP) with (NPDCS).
Coronary heart disease (CHD) is a disease in
which a waxy substance called plaque (plak) builds up inside the coronary
arteries. These arteries supply oxygen-rich blood to your heart muscle.
When plaque builds up in the arteries, the
condition is called atherosclerosis
(ATH-er-o-skler-O-sis). The buildup of plaque occurs over many years. Over time, plaque can harden or rupture
(break open). Hardened plaque narrows the coronary arteries and reduces the
flow of oxygen-rich blood to the heart. If
the plaque ruptures, a blood clot can form on its surface. A large blood clot
can mostly or completely block blood flow through a coronary artery. Over time,
ruptured plaque also hardens and narrows the coronary arteries. If the flow of oxygen-rich blood to your
heart muscle is reduced or blocked, angina
(an-JI-nuh or AN-juh-nuh) or a heart attack
can occur.
Angina is chest pain or discomfort. It may
feel like pressure or squeezing in your chest. The pain also can occur in your
shoulders, arms, neck, jaw, or back. Angina pain may even feel like
indigestion.
A heart attack occurs if the flow of
oxygen-rich blood to a section of heart muscle is cut off. If blood flow isn’t
restored quickly, the section of heart muscle begins to die. Without quick
treatment, a heart attack can lead to serious health problems or death.
Prof. DR. Dr. Rochmad Romdoni, SpJP(K), FINASIM, FIHA, FAsCC. 3rd Pekanbaru Cardiology Update, August 24th 2013. Pangeran Hotel Pekanbaru. Learn more at PerkiPekanbaru.com
A detailed view of National Control Programme for Diabetes, 1987 and the changes in the programme.. for nursing students.
From Community health nursing..
National programme for prevention and control of cancer, diabetes, CVDs and s...Dr Lipilekha Patnaik
NCDs are surpassing the burden of communicable diseases in India, need for National Programme on Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke was envisaged.
A non-communicable disease (NCD) is a medical condition or disease that is not caused by infectious agents (non-infectious or non-transmissible). NCDs can refer to chronic diseases which last for long periods of time and progress slowly. Sometimes, NCDs result in rapid deaths such as seen in certain diseases such as autoimmune diseases, heart diseases, stroke, cancers, diabetes, chronic kidney disease, osteoporosis, Alzheimer's disease, cataracts, and others. While sometimes referred to as synonymous with "chronic diseases", NCDs are distinguished only by their non-infectious cause, not necessarily by their duration, though some chronic diseases of long duration may be caused by infections. Chronic diseases require chronic care management, as do all diseases that are slow to develop and of long duration.
NCDs are the leading cause of death globally. In 2012, they caused 68% of all deaths (38 million) up from 60% in 2000. About half were under age 70 and half were women.Risk factors such as a person's background, lifestyle and environment increase the likelihood of certain NCDs. Every year, at least 5 million people die because of tobacco use and about 2.8 million die from being overweight. High cholesterol accounts for roughly 2.6 million deaths and 7.5 million die because of high blood pressure.
Health problems in India, Community health nursingAKHILAPK2
Health problems in India
Problems related to communicable diseases
Problems related to Non-communicable diseases
Problems related to Improper nutrition
Problems due to environmental pollution
Problems related to population
Problems due to improper medical care
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Burden of nc ds, policies and programme for
1. Burden of NCDs in India
Policies and Programme for Prevention and Control
Guided by-
Dr Y. D. Badgaiyan
Prof. & Head
Deptt. of Community Medicine,
CIMS, Bilaspur (C.G.)
2. Introduction
• Chronic non-communicable diseases (NCDs)
are most common causes of morbidity and
premature mortality worldwide.
• And its has been replaced communicable
diseases.
3. • About 80% of the burden occurs in low and
middle-income countries and
• 25% of NCDs occur, in individuals younger
than 60 years.
4. • The global economic impact of NCDs is
enormous.
• By 2015, just two diseases (cardiovascular
diseases and diabetes) are expected to reduce
global GDP by 5%.
5. • Approximately half of the total economic
burden is reported to account for by CVD
including stroke, ischemic heart disease and
peripheral vascular disease.
• Which together cause more deaths than
HIV/AIDs, malaria and tuberculosis combined.
6. • In recognition of the increasing burden
and importance of chronic diseases, in
2005, the World Health Organization
(WHO) released a plan for NCD
prevention and control.
• It offers the health community a new
global goal to reduce death rates from all
chronic diseases by 2% every year,
• over and above the existing trends during
the next 10 years.
7. Burden of non-communicable diseases in India
• As of 2004, NCDs contributed half of the total
mortality and were the major causes of death.
• Among the NCDs, cardiovascular diseases are
number one cause of mortality (52%).
8. • NCDs account for more than two-fifth (43%)
of the DALYs, and
• among this group, cardiovascular diseases,
diabetes, cancers together account for 40% of
the NCD-related DALYs in India.
9. • Regional studies have reported that even
in rural India the leading cause of death
(32%) is NCDs followed by injuries and
external cause of deaths (12%).
10. • Projection estimates from the WHO have
shown that by the year 2030, CVDs will
emerge as the main cause of death (36%) in
India.
• Since the majority of deaths are
premature, there is a substantial loss of lives
during the productive years as compared to
other countries.
11. The salient features of the Causes of Death in India.
(Survey (2001-03) conducted by the Registrar General of India)
• The overall non-communicable diseases are
the leading causes of death in the country.
• They constitute 42% of all deaths.
12. • Urban areas have a lower number of deaths from
communicable, maternal, peri-natal and nutritional
conditions.
• But a higher proportion from non-communicable
diseases (56%).
13. Overall, leading causes of deaths in India
1. cardiovascular disease (19%), followed by
2. respiratory diseases ( 9%),
3. diarrheal diseases (8%),
4. perinatal conditions (6.3%),
5. respiratory infections such as acute pneumonia
(6.2%), tuberculosis (6%),
6. malignant and other neoplasms (5.7%),
7. senility (5.1%),
8. unintentional injuries: other (4.9%), and
9. symptoms, signs and ill-defined conditions (4.8%)
15. Table 1: Estimated burden and trends of Non-communicable diseases in India
16. National response to NCDs
• Government of India had supported the
States in prevention and control of NCDs
through several vertical programs.
• National Health Programs for Cancer and
Blindness were started as early as 1975
and 1976, respectively, followed by
program on Mental Health in 1982.
17. • However, during the 11th Plan, there was considerable
upsurge to prevention and control NCDs.
• New programs were started on a low scale in limited
number of districts.
• Convergence with public sector health system was a
feature of these programs.
18. • Some of the programs were within the framework of
National Rural Health Mission.
• New programs are focused on
CVDs, diabetes, stroke, tobacco
control, deafness, trauma, burns, fluorosis and
geriatric problems.
19. Future plan to prevent and control NCDs
• There is adequate evidence that NCDs are major
contributors to high morbidity and mortality in the
country.
• Risk factors including tobacco and alcohol use, lack
of physical activity, unhealthy diet, obesity, stress
and environmental factors.
20. • The modifiable risk factors can be
controlled to reduce incidence of NCDs
and better outcomes for those having
NCDs.
21. • Most of the NCDs like
cancer, diabetes, cardiovascular diseases
(CVD), mental disorders and problems relating
to aging are not only chronic in nature,
• but also may have long pre-disease period
where effective lifestyle changes can turn
around health status of individuals.
22. • Costs borne by the affected individuals and
families may be catastrophic as treatment is long
term and expensive.
• The economic, physical and social implications of
NCDs are significant, justifying investment both
for prevention and management of NCDs and
well-established risk factors.
23. • There is urgent need for a comprehensive
scheme that should focus on health
promotion and prevention of NCDs and
• their risk factors and comprehensive
management of NCDs at various levels
across the country.
25. • Considering the fact that NCDs are surpassing the
burden of communicable diseases in India and
existing health system is mainly focused on
communicable diseases,
• need for National Programme for control of
Diabetes, CVD and Stroke was envisaged.
26. • Later on this programme was integrated with
National Cancer Control Programme and
• National Programme for Prevention and
Control of Cancer, Diabetes, CVDs and Stroke
was came in to existence.
27. • During 11th Five Year Plan 100 districts in 25
states have been covered under the NPCDCS.
• The programme focused on health promotion,
capacity building and early diagnosis and
management of the diseases with integration
with the primary health care system.
28. Objectives of NPCDCS
1. Prevention and control of common NCDs through
behavior and life style changes.
2. Provide early diagnosis and management of
common NCDs.
3. Build capacity at various levels of health care for
prevention, control and treatment of NCDs.
4. Train human resources for in Primary Health Care to
cope with burden of NCDs.
5. Establish and develop capacity for palliative and
rehabilitative care.
29. ACTIVITIES AT VARIOUS LEVELS
PHC and Sub-Center Level
• Health promotion by life style change through health
education like banner, poster, personal communication and
camps.
• Opportunistic screening of population above 30 years by BP
and Blood Glucose measurements.
• Referral services for the suspected cases of CVD and Cancer.
30. • At CHC Level
• NCDs clinic at CHC shall do the diagnosis by
required investigation, management and stabilization
of common CVDs.
• One of the nurse appointed under programme shall
undertake home visit for bedridden cases, supervise
the work of health workers and monthly clinic for
NCDs random at villages.
31. • At District Hospital
• NCDs clinic at district hospital screen persons above the
age 30 years for DM, CVDs and HTN.
• Detailed investigation of high risk persons.
• Regular management and annual assessment for person
suffering from the Cancer, DM, HTN and CVDs.
32. Urban Health Check-up scheme
( for diabetes and high blood pressure)
• To screen urban slum population for DM and HTN.
• To create database for prevalence of diabetes and HTN in
urban slum.
• To sensitize urban slum population about healthy life-style.
The blood sugar and BP will be checked for all > 30 years and
all pregnant women.
33. Cancer component under NPCDCS
• With objective of early diagnosis and treatment the national
cancer control programme was launched in 1975-76.
• During 2010, the programme was integrated with NPCDCS.
• Objectives of the programme are -
1. Primary prevention of cancer by health education.
2. Secondary prevention by early diagnosis and treatment.
3. Tertiary prevention by stregthening of existing institutions of
comprehensive therapy including palliative care.
34. Policies and approach
• There have been some legal measures taken by
Government of India aiming at non-
communicable diseases e.g.
the Tobacco Control Act 2003
• which aimed at prohibition on advertisement
and regulation on production, supplies and
distribution of tobacco products.
35. • However, implementation of these acts is a
challenge.
• It is expected that revision in National Health Policy
is due and should duly emphasize policies and
strategies to prevent and control NCDs including
population-based interventions that require multi-
sectoral approach.
36. Key Strategies:
1. Health promotion for healthy lifestyles that
preclude NCDs and their risk factors.
2. Specific prevention strategies which reduce
exposure to risk factors.
3. Early diagnosis through periodic/opportunistic
screening of population and better diagnostic
facilities.
37. 4. Infrastructure development and facilities required for
management of NCDs.
5. Establish emergency medical services with rapid
referral systems to reduce disability and mortality due
to NCDs.
38. 6. Treatment and care of persons with NCDs including
rehabilitation and palliative care.
7. Health legislation and population-based interventions
through multi-sectoral approach for prevention of
NCDs.
8. Building evidence for action through
surveillance, monitoring and research.
40. Conclusion
• There is evidence to show that NCDs are
leading causes of death, disability and
morbidity and
• their burden is likely to increase if urgent
interventions are not initiated on a mass scale
throughout the country.
41. • Currently implemented programs that address
NCDs have not been able to reduce their
burden due to limited scale of implementation.
• An integrated and comprehensive approach is
suggested.
42. • Emphasis should be given on health
promotion, population-based
interventions, prevention of exposure to risk
factors, specific measures at individual and family
level, early diagnosis through screening and better
diagnostic facilities, improved capacity for
management and universal access to health services.