This document outlines 5 levels of prevention: primordial, primary, secondary, tertiary, and quaternary. Primary prevention occurs prior to disease onset and removes the possibility of disease through health promotion and protection measures. Secondary prevention detects disease early through screening and treats it before irreversible changes occur. Tertiary prevention focuses on reducing impairments and promoting adjustment for patients with advanced disease. Quaternary prevention aims to avoid over-medicalization and excessive health intervention.

2.  “Actions aimed at eradicating, eliminating, or
minimizing the impact of disease and disability.”
 The concept of prevention isbest defined in the
context of levels, traditionally called primary,
secondary,and tertiary prevention.

4. 1) Primordial prevention
2) Primary prevention
3) Secondary prevention
4) Tertiary prevention
5) Quaternary prevention

5.  Primordialprevention consistsof actions and
measures that inhibit the emergence of risk
factors in the form of environmental, economic,
social, and behavioural conditions and cultural
patterns of livinge
tc.
 It is the prevention of the emergence or
development of risk factors in countries or
population groups in which theyhave not yet
appeared.

6.  For example, many adult health problems (e.g.,
obesity, hypertension) have their earlyorigins in
childhood, because this is the time when lifestyles
are formed (for example, smoking, eating
patterns, physicalexercise).

7. • Primary preventioncanbe defined as the action taken
priorto the onset of disease, whichremoves the
possibilitythatthedisease will everoccur.
• It signifies intervention in the pre-pathogenesis phase
ofadisease or healthproblem.
• Primary preventionmay be accomplished by
measures of “Health promotion” and“specific
protection”

9.  The WHOhas recommended the following
approaches for the primary prevention of chronic
diseases wheretherisk factors are established:
a. Population (mass)strategy
b. High‐riskstrategy

10.  Population strategy is directed at the whole
population irrespective of individual risklevels.
 The population approach is directed towards
socio‐economic, behavioural and lifestyle
changes.

11.  The high‐risk strategy aims to bring preventive
careto individuals at specialrisk.
 This requires detectionof individuals athigh risk
by the optimum use of clinicalmethods.

12.  It is defined as “action which halts the progress
of a disease at its incipient stageand prevents
complications.”
 The specific interventions are:earlydiagnosis (e.g.
screening tests, and case finding programs) and
adequatetreatment.

13.  Secondary prevention attempts to arrest the
disease process, restore health by seeking out
unrecognized disease and treating itbefore
irreversible pathological changes take place,and
reverse communicability of infectiousdiseases.

14.  It thus protects others from in the community
from acquiring the infection and thus provide at
once secondary prevention for the infectedones
and primary prevention for their potential contacts.
 Theearlier the disease is diagnosed, and treated
the better it is for prognosis of the case and for
the prevention of the occurrence of other
secondary cases.

15.  It is used when thedisease process has
advanced beyond its earlystages.
 It is defined as “allthe measures availableto
reduce or limit impairments and disabilities, and
to promote the patients’adjustment to
irremediable conditions.”

16.  Intervention that should be accomplished in the
stage of tertiary prevention aredisability limitation,
andrehabilitation.
 Stages of tertiary prevention:
1) Disability limitation
2) Rehabilitation

17.  The quaternary prevention, concept coined
by the Belgian general practitioner Marc
Jamoulle.
 The actions taken to identify a patient at risk
of over-medicalisation, to protect them from
new medical invasion, and to suggest
interventions which are ethically acceptable.

18.  Quaternary prevention is the set of health
activities to mitigate or avoid the
consequences of unnecessary or excessive
intervention of the health system.