Levels of prevention in Community Health Nursing BSc V Sem

1. LEVELS OF
PREVENTION
Mr Devendra Singh
Faculty Of Nursing
UPUMS Saifai

3. Levels of Prevention
1) Primordial prevention
 Prevention of the emergence of risk
factors in population in which they
have not yet appeared
 It is primary prevention in purest sense
 Best level of prevention for Non-
Communicable diseases

4. Modes of intervention of Primary prevention:
Education
Examples:
i. Childhood obesity prevention through education
ii. Education on maintenance of normal body weight,
preservation of lifestyle, primitive nutritional habits
for prevention of myocardial infarction
iii. Education on benefits of salt restriction for
prevention of CAD

5. 2) Primary prevention
- Action taken prior to the onset of disease
- Intervention done in prepathogenesis phase of
disease
- Based on elimination of risk factors
- Removes the possibility that a disease will ever
occur

8. Modes of intervention
i. Health promotion
a) Health education:
 Through health care providers, community leaders,
decision makers
Example-Marriage counseling (Disease carriers),
Cancer education (Family history)
b) Environmental modification
Example- Provision of safe water (portable safe water
supply). Installation of sanitary latrines ,Insecticidal
spray & rodents' control & Improvement of housing

9. c) Nutritional Intervention
Food fortification, nutritional education, child feeding
program
Example-high fiber diet to prevent obesity, dietary salt
reduction, pasteurization of milk
d) Lifestyle and behavioual changes
Changing habits & behavior of the patients
Example-Control of tobacco, exercise promotion,
weight reduction

10. ii. Specific protection
Approaches
i. Mass startegy – for whole population
ii. High risk strategy – For individual at risk

12. Examples of specific protection :
1. Prospective screening (for people who can
spread disease )is a Primary level of prevention
e.g.-Screening of immigrants, HIV screening
among sex workers
2.Immunization/vaccines
3.Chemoprophylaxis/Vitamin A prophylaxis
4.contraceptives use of condoms
5.lodization of salt

13.  Defluorination of water
 Protection against occupational hazards &
accidents(helmets/seatbelts)
 Desks provided with table top to prevent neck
problem
 National Iron plus initiatives, mosquito bed nets
 Radiation protection
 Wearing of goggles by welders

14. 3. Secondary prevention
-Action taken to halt the progress of a disease at its
incipient stage & prevents complications
-Intervention done in Early pathogenesis phase
- More expensive(Disease already occurred so
diagnosis and treatment will incur expenses) & less
effective than primary prevention.
- Target group in secondary prevention is patients
- Early diagnosis & treatment is the best level of
prevention for breast cancer

15.  Modes of intervention:
i. Early diagnosis
 Screening test-
Prescriptive screening is a Secondary level of
prevention
- Pap smear self breast examination ,monitoring
of BP
 Diagnostic tests- sputum smear for AFB,
Peripheral smear for MP
ii. Treatment -DOTS, MDT

16.  Mass treatment
 Used when 1 clinical case of active disease can
give at least 5 latent cases in a community
 Used in control of-Yaws, Trachoma,filaria
 Variants- total mass treatment, juvenile mass
treatment, selective mass treatment
Examples of secondary prevention:
National health programs, contact tracing of STIs,
Case finding for malaria, Health screening for
diabetes

17. 4. Tertiary prevention
- Action taken to limit the impairment & disabilities
- Intervention done in Late pathogenesis phase of
disease
- Modes of Interventions
1.Disability limitation
2. Rehabilitation

18. 1.Disability limitation-
Prevents transition of disease from impairment to
handicap.
Example-
- Spectacles for refractory error ,
- Physiotherapy in poliomyelitis
-Resting limb in neutral position in polio (helps to prevent
overstretching of paralyzed muscles, thereby limits further
disability

19. Disease Impairement Disability Handicap

20. a. Disease-Any abnormal condition of an organism that
impairs function
b. Impairment- Any loss of anatomical structure or
physiological function
Example -loss of foot, defective vision
c. Disability- (Because of impairment) Any restriction or
inability to perform an activity in a range considered
normal for a human being
Example-Unable to walk
d. Handicap- A Disadvantages for a given individuals
resulting from an impairment or disability that
limits/prevents fulfillment of a role considered normal
for that individual

21.  Examples –
 Accident -----Disease
 Loss of foot -----Impairement
 Cannot walk ----Disability
 Unemployed ----Handicap

22. ii. Rehabilitation
 Combined & coordinated use of medical, social, educational &
vocational measure for training & retraining of individual to the
highest possible level of functional ability
 Types
a. Medical rehabilitation- Restoration of function
b. Vocational rehabilitation -Restoration of capacity to earn
livelihood
c. Social rehabilitation- Restoration of family & social relation
d. Psychological rehabilitation -Restoration of personal
dignity & confidence
Examples-Establishing schools for blind, Graded exercises in
polio, Reconstructive surgery in leprosy, Crutches in
poliomyelitis