This document discusses the three levels of prevention in community medicine: primary, secondary, and tertiary prevention. Primary prevention aims to prevent disease occurrence by promoting health and protecting against specific diseases through measures like immunization, fortification, and controlling risk factors. Secondary prevention focuses on early diagnosis and treatment to recover from disease and prevent complications through screening. Tertiary prevention addresses disability limitation and rehabilitation for individuals suffering from advanced disease to restore function and independence.

1. Concept of prevention
BPH, IOM (sagarhamal16@gmail.com)
Arjun hamal

2. Introduction
 Objective of community medicine is to preserve the health, promote the
health, prolonged the life and to minimize the suffering through
preventing the occurrence of disease by opposing its natural history of
disease causation at different levels.
 Approaches/ Levels of prevention
 Primary prevention
 Secondary prevention
 Tertiary prevention

3. Primary prevention
 This measures is taken at the period of pre-pathogenesis.
I.s. before developing the disease. Which removes the possibility of disease occurrence.
Specially those disease which is not curable or can't treatment such as cancer, HIV, hep-B,
dental carries etc
This method can be adopt by
1. Health promotion
2. Health protection

4. Health promotion : strengthen the individuals/host and prevents the occurrence of the disease by
interrupting the interaction among the three disease factors of the epidemiological triad. Eg health
education (oral hygiene, hygiene, nutrition edu.
Sex edu, adequate nutrition, yoga & meditation, family planning and spacing the birth, environmental
control measures etc
Health promotion : specific measures/ create barriers against the particular disease.
• Eg immunization against the specific disease,
• Salt fortification with iodine to prevent endemic goiter
• Deworming programs ( vit A and albendazole)
• Helmet against injuries
• Condom against HIV etc

5. Primordial prevention : its also primary level of prevention but this approach concern mainly non
communicable disease such cancers, heart disease, HTN, DM, obesity etc.
 This consist of elimination of the risk factors of the disease which causative agents are not known.
 Approach of this prevention are
1. Population strategy : directed whole population. Result is slow and takes several years to decade
. Eg Changing lifestyle education from childhood
2. High risk (individual) strategy : directed to those individuals who are at high risk of getting the
disease. High risk can be detected by screening.

6. Secondary prevention
 This method can be taken at the early stage of onset of disease or even much before the
development of permanent of pathology in the individual. This intervention is by “early diagnosis
and promote Rx”
 Eg : helps in recovery from the disease, reduce the duration of illness, minimizing suffering,
prevent from dev. complication, prevent from the spread of disease, postpones the disease,
screening and disease diagnose early.

7. Tertiary prevention
 This method taken when disease is sufficiently advanced. This can be adopted by two ways
1. Disability limitation : limiting the development of further disability in the individual by giving the intensive and
aggressive Rx. Sequence of event of disease are:
Disease impairment disability handicap
Eg accident loss of foot inability to walk loss of job
2. Rehabilitation : after suffering the advance disease stage and person experience the disadvantage in life such
as losing foot, due to losing foot losing the job, can not work even daily normal routine and become dependent.
Rehabilitation is the way of increasing capacity of disabled person. eg
Physical rehabilitation restoration of function by artificial foot or limbs
Vocational rehabilitation restoration of earning capacity
Social rehabilitation restoration of relationship in society
Psychological rehabilitation restoration personal dignity and confidence