Concept of Prevention

Health Hygiene & Sanitation

Lesson 09 : Concept Of Control And Prevention Of Diseases

Concept of Prevention

The goal of medicine is
  • To promote health
  • To preserve health
  • To restore health when impaired
  • To minimize sufferings and distress

All these together are called prevention. Successful prevention depends upon

  • 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
  • Continuous evaluation and development of procedures applied.

It is not necessary to know everything about the disease instead removal or elimination of an essential cause may be sufficient to prevent a disease. Major objective of preventive medicine is to intercept the cause and disease process.

Levels of prevention

The prevention can be defined in terms of four levels

  1. Primordial prevention
  2. Primary prevention
  3. Secondary prevention
  4. Tertiary prevention
  1. Primordial Prevention: A new concept gaining importance I prevention of chronic diseases. This involves prevention of the emergence or development of risk factors in countries or population groups where they have not yet appeared. For e.g. Childhood onset diseases of adults, particularly life style disorders. Prevention involves discouraging children to develop harmful habits and encouraging to sound eating habits, ensilaging in exercise etc through personal education or mass media.

  2. Primary Prevention: This can be defined as action taken prior to the onset of disease, which removes the possibility that disease can occur. Primary prevention is accomplished by

    1. Measures designed to promote general health and well being-quality of life of people

    2. Specific protective measures

    Primary prevention includes the concept of positive health, a concept that encourages achievement and maintenance of acceptable level of health that will enable every individual to lead a socially and economically productive life. It is concerned to an individual’s attitude towards life and health and the efforts towards positive health and responsible measures for self, family and community.

    The concept of primary prevention includes elimination or modification of risk factors of chronic diseases like CHD, diabetes etc.

    WHO recommended approaches for chronic diseases includes-population strategy and high risk strategy.

    Population or mass strategy: Directed towards the entire population without accounting for individual risk levels. It is directed towards socio-economic behavioural and life style changes among the population.

    High risk strategy: Aims to bring preventive care to individuals at special risk. It involves detection of individuals at high risk by the optimum use of clinical methods.

    Primary prevention is a desirable goal. Mere raise in the standard of living can help in reducing number of communicable diseases. Improving water supply and sanitation go a long way in preventing not only water borne diseases but also common infections.

    To get maximum benefit for the population all three approaches-primordial, population and high risk strategy have to be implemented together as they complement each other.

    Hence, primary prevention is a holistic approach, that promotes health, protects against disease agents and environmental hazards.

  3. Secondary Prevention:
  4. Secondary prevention can be defined as “action which halts the progress of disease and prevents complications”. It includes early diagnosis and adequate treatment. Secondary prevention attempts

    1. To arrest the disease process
    2. Restore health by seeking out unrecognized disease and treating it before irreversible changes are evident.
    3. Reverse communicability of infectious diseases

    Secondary prevention might protect others in the community from acquiring the infections. Hence it offers secondary prevention for those infected and primary prevention for potential contact.
    Secondary prevention is the domain of clinical medicine. Most of the government health programmes are at the secondary prevention level.


    1. The patient has already been subjected to mental anguish, physical pain and
    2. The community has already lost productivity

    Secondary prevention is an imperfect tool in the control of disease transmission. It is more expensive and less effective than primary prevention.

  5. Tertiary Prevention:
  6. Even when the disease process has progressed, it is possible to prevent called tertiary prevention. It can be defined as ‘all measures available to reduce or limit impairments and disabilities and minimize suffering caused by existing departures from good health and to promote the patients adjustments to irremediable conditions.

    Even if the treatment is provided late after the natural history of the disease, it is still possible to prevent the after effects and disability. When defect or disability are more or less stabilized, rehabilitation can play a preventable role. Rehabilitation includes

    1. Psychological
    2. Vocational
    3. Medical components based on team work

    Tertiary prevention extends the concept of prevention into fields of rehabilitation.

Last modified: Monday, 23 April 2012, 9:31 AM