health.ppt Concept of health and prevention of disease

health.ppt Concept of health and prevention of disease

1. Concepts of Health and
Disease and Prevention

3. Understanding the concept of prevention and control of diseases
Understanding the concept of prevention and control of diseases is crucial for
maintaining public health.
Here are five major points in this regard:
1.Primary Prevention:
Primary prevention focuses on preventing the occurrence of diseases before they
start.
This often involves health promotion, education, and lifestyle interventions.
Immunizations, health education campaigns, and policies aimed at reducing risk
factors (such as tobacco use, poor nutrition, and lack of physical activity) fall under
primary prevention strategies.

4. Understanding the concept of prevention and control of diseases
2. Early Detection and Screening:
Early detection is a key component of disease prevention.
Screening programs and regular health check-ups can identify diseases in their
early stages, when interventions are more likely to be effective.
Early detection allows for prompt treatment and management, preventing the
progression of the disease and reducing its impact.

5. Understanding the concept of prevention and control of diseases
3. Vaccination and Immunization Programs:
Vaccination is a powerful tool for preventing infectious diseases.
Immunization programs aim to build immunity in populations, reducing the spread of
infectious agents and protecting individuals from serious illnesses.
Vaccination not only benefits individuals but also contributes to community immunity,
indirectly protecting those who cannot be vaccinated.

6. Understanding the concept of prevention and control of diseases
4. Health Promotion and Education:
Public awareness and education play a crucial role in preventing and controlling
diseases.
Promoting healthy behaviors, disseminating information about risk factors, and
encouraging lifestyle changes contribute to disease prevention.
Health education empowers individuals to make informed choices about their well-
being.

7. Understanding the concept of prevention and control of diseases
5. Disease Surveillance and Control Measures:
Surveillance systems monitor the occurrence and spread of diseases in populations.
Early detection of outbreaks allows for timely implementation of control measures.
This may include quarantine, isolation, contact tracing, and other public health
interventions to limit the spread of infectious diseases.
Effective prevention and control of diseases require a multidimensional approach
that incorporates public health policies, healthcare infrastructure, community
engagement, and individual responsibility.
By addressing risk factors, promoting healthy behaviors, and implementing timely
interventions, public health efforts can significantly reduce the burden of diseases
on individuals and communities.

8. DISEASE CAUSATIVE FACTORS
1.Socioeconomic Disparities:
1.Lower socioeconomic status often correlates with higher incidences of
certain diseases.
2.Limited access to education, healthcare, and nutritious food can contribute
to health disparities. Social determinants such as income, employment, and
education play a crucial role in shaping health outcomes.

9. FIVE MAJOR DISEASE CAUSATIVE FACTORS
2. Environmental Factors:
1.Social and economic conditions can expose certain populations to
environmental hazards that impact health. For example, communities with
poor infrastructure may be more susceptible to pollution, leading to
respiratory diseases.
2.Access to clean water, sanitation, and safe living environments are crucial
social factors influencing health.

10. FIVE MAJOR DISEASE CAUSATIVE FACTORS
3. Healthcare Access and Equity:
1.Disparities in healthcare access can result in unequal distribution of
resources and services, affecting the prevention, diagnosis, and treatment of
diseases.
2.Limited access to healthcare facilities, lack of health insurance, and cultural
barriers can contribute to a social divide in health outcomes.

11. FIVE MAJOR DISEASE CAUSATIVE FACTORS
4. Behavioral and Lifestyle Factors:
1.Social norms, cultural practices, and lifestyle choices significantly impact
health.
2.Factors such as smoking, diet, physical activity, and substance abuse are
often influenced by social environments.
3.Educational campaigns and community interventions can play a role in
promoting healthier behaviors.
1.Social Stigma and Mental Health:
1.The social stigma associated with certain diseases, such as mental health
conditions, can hinder individuals from seeking help and accessing proper
care. Addressing societal attitudes and fostering understanding is crucial for
creating an environment where individuals feel comfortable seeking
assistance for their mental health.

12. FIVE MAJOR DISEASE CAUSATIVE FACTORS
5. Social Stigma and Mental Health:
1.The social stigma associated with certain diseases, such as mental health
conditions, can hinder individuals from seeking help and accessing proper
care. Addressing societal attitudes and fostering understanding is crucial for
creating an environment where individuals feel comfortable seeking
assistance for their mental health.

13. SOCIAL PROBLEMS OF THE SICK
The social problems faced by individuals who are sick or dealing with health issues
can be diverse and impactful.
Here are five major points that highlight some of these social challenges:
1. Stigmatization and Discrimination:
People with certain illnesses often face social stigma and discrimination.
This can result in isolation, strained relationships, and difficulties in various aspects of
life, including employment.
Stigmatization can also discourage individuals from seeking necessary medical care
and support.

14. SOCIAL PROBLEMS OF THE SICK
2. Financial Strain:
Illness can lead to significant financial burdens.
High medical costs, loss of income due to inability to work, and the need for ongoing
treatment can strain financial resources.
Individuals may face challenges in affording medications, treatments, and other
healthcare-related expenses, potentially leading to long-term economic
consequences.

15. SOCIAL PROBLEMS OF THE SICK
3. Limited Social Support:
Chronic illness or severe health conditions can strain social relationships.
Friends and family might struggle to understand the challenges faced by the sick
individual, leading to a lack of emotional support.
Social isolation can exacerbate the mental health impact of the illness.

16. SOCIAL PROBLEMS OF THE SICK
4. Access to Healthcare:
Disparities in access to healthcare can be a significant social problem for those who
are sick.
Limited access to quality healthcare services, lack of health insurance, and
geographical barriers can hinder individuals from receiving timely and adequate
medical attention, leading to prolonged suffering and potentially worsened health
outcomes.

17. SOCIAL PROBLEMS OF THE SICK
5. Employment and Career Challenges:
Being sick can impact an individual's ability to work, potentially leading to job loss or
difficulty in career advancement.
Employers may be less understanding of health-related limitations, and individuals
may face discrimination or dismissal due to their health condition.
This can result in financial instability and a sense of loss of identity and purpose.
Addressing the social problems faced by the sick requires a comprehensive
approach, including destigmatization efforts, financial assistance programs, improved
access to healthcare, workplace accommodations, and community support networks.
By recognizing and addressing these social challenges, society can contribute to
creating a more inclusive and supportive environment for individuals dealing with
health issues.

18. Food in relation to nutrition and health:
1.Macronutrients:
1.Carbohydrates: These are the body's primary source of energy. They are
found in foods like grains, fruits, vegetables, and legumes.
2.Proteins: Important for building and repairing tissues, proteins are present in
meat, dairy products, beans, and nuts.
3.Fats: Fats are essential for various bodily functions, including hormone
production and nutrient absorption. Healthy fats can be found in avocados,
nuts, seeds, and olive oil.
2.Micronutrients:
1.Vitamins: Essential for various physiological processes, vitamins are present
in fruits, vegetables, dairy, and whole grains.
2.Minerals: Important for bone health, fluid balance, and other functions.
Sources include dairy products, leafy greens, nuts, and seeds.
3.Antioxidants:
1.Found in fruits and vegetables, antioxidants help protect the body from
damage caused by free radicals, which can contribute to aging and diseases.
4.Fiber:
1.Found in whole grains, fruits, vegetables, and legumes, fiber supports
digestive health, helps control blood sugar levels, and contributes to a feeling
of fullness.

19. 1.Hydration:
1.Water is essential for various bodily functions, including digestion, nutrient
absorption, and temperature regulation. Staying properly hydrated is crucial
for overall health.
2.Balanced Diet:
1.A balanced diet includes a variety of foods from different food groups to
ensure that the body receives all the necessary nutrients in the right
proportions.
3.Nutrient Density:
1.Choosing nutrient-dense foods, which provide a high amount of nutrients
relative to their calorie content, is important for maintaining health without
consuming excess calories.
4.Individualized Nutrition:
1.Nutritional needs vary among individuals based on factors such as age, sex,
activity level, and health status. It's important to tailor nutrition plans to meet
individual requirements.
5.Impact on Health:
1.Poor nutrition is linked to various health issues, including obesity,
cardiovascular diseases, diabetes, and deficiencies. On the other hand, a
balanced and nutritious diet can contribute to disease prevention and overall
well-being.

20. 1.Nutrient Density:
1.Choosing nutrient-dense foods, which provide a high amount of nutrients
relative to their calorie content, is important for maintaining health without
consuming excess calories.
2.Individualized Nutrition:
1.Nutritional needs vary among individuals based on factors such as age, sex,
activity level, and health status. It's important to tailor nutrition plans to meet
individual requirements.
3.Impact on Health:
1.Poor nutrition is linked to various health issues, including obesity,
cardiovascular diseases, diabetes, and deficiencies. On the other hand, a
balanced and nutritious diet can contribute to disease prevention and overall
well-being.

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Food in relation to nutrition and health:
Balanced Diet:
Consuming a balanced diet is crucial for maintaining good health.
This involves eating a variety of foods from all the major food groups, including fruits,
vegetables, whole grains, lean proteins, and dairy products.
Each food group provides essential nutrients such as vitamins, minerals, proteins,
carbohydrates, and fats, which play unique roles in supporting overall health.
Portion Control:
Controlling portion sizes is important to prevent overeating and maintain a healthy
weight. Consuming large portions, even of healthy foods, can lead to an excess
intake of calories, contributing to weight gain and related health issues.
Being mindful of portion sizes helps regulate calorie intake and promotes better
digestion.

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Food in relation to nutrition and health:
Nutrient Density:
Choosing nutrient-dense foods ensures that you get more essential nutrients per
calorie consumed. Nutrient-dense foods include fruits, vegetables, whole grains, lean
proteins, and nuts.
Prioritizing these foods over those high in added sugars, saturated fats, and empty
calories supports optimal health and helps prevent nutrient deficiencies.
Hydration:
Staying hydrated is vital for overall health. Water is essential for various bodily
functions, including digestion, nutrient absorption, and temperature regulation.
Limiting the intake of sugary drinks and excessive caffeine is important for
maintaining proper hydration levels. Water-rich foods like fruits and vegetables also
contribute to overall fluid intake.

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Food in relation to nutrition and health:
Nutrient Density:
Choosing nutrient-dense foods ensures that you get more essential nutrients per
calorie consumed. Nutrient-dense foods include fruits, vegetables, whole grains, lean
proteins, and nuts.
Prioritizing these foods over those high in added sugars, saturated fats, and empty
calories supports optimal health and helps prevent nutrient deficiencies.
Hydration:
Staying hydrated is vital for overall health. Water is essential for various bodily
functions, including digestion, nutrient absorption, and temperature regulation.
Limiting the intake of sugary drinks and excessive caffeine is important for
maintaining proper hydration levels. Water-rich foods like fruits and vegetables also
contribute to overall fluid intake.

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Moderation and Variety:
Consuming a variety of foods ensures a diverse range of nutrients and helps prevent
nutritional imbalances.
No single food provides all the nutrients your body needs, so a varied diet is
essential.
Moderation is key to enjoying a wide range of foods without overindulging in any
particular type.
This approach supports a balanced intake of nutrients and helps prevent the negative
effects of excessive consumption of certain foods.
Remember, individual nutritional needs can vary, and it's always advisable to consult
with a healthcare professional or a registered dietitian for personalized advice based
on specific health conditions, lifestyle, and dietary preferences.

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Nutritional deficiencies occur when the body doesn't receive an adequate amount of
essential nutrients.
Common Deficiencies:
Iron: Iron deficiency can lead to anemia, causing fatigue, weakness, and impaired
cognitive function.
Vitamin D: Insufficient vitamin D can result in weakened bones, muscle pain, and an
increased risk of fractures.
Calcium: A lack of calcium can lead to weakened bones and teeth, increasing the risk
of osteoporosis.
Vitamin B12: Deficiency in B12 may cause anemia, fatigue, weakness, and
neurological issues.
Iodine: Inadequate iodine can lead to thyroid problems, affecting metabolism and
growth.

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Symptoms and Health Impacts:
Symptoms of nutritional deficiencies vary but may include fatigue, weakness,
cognitive impairment, hair loss, brittle nails, skin issues, and impaired immune
function.
Prolonged deficiencies can lead to serious health problems, affecting growth and
development, cardiovascular health, bone density, and neurological function.
Causes of Deficiencies:
Poor Diet: Inadequate intake of nutrient-rich foods, such as fruits, vegetables, whole
grains, and lean proteins.
Malabsorption: Conditions that affect the absorption of nutrients, such as celiac
disease or certain gastrointestinal disorders.
Increased Needs: Life stages like pregnancy, breastfeeding, or intense physical
activity may increase nutrient requirements.

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Medical Conditions: Certain health conditions or medications can interfere with
nutrient absorption or utilization.
Prevention and Treatment:
Balanced Diet: Eating a varied and balanced diet is crucial for preventing nutritional
deficiencies.
Supplementation: In some cases, supplements may be recommended to address
specific deficiencies, but this should be done under the guidance of a healthcare
professional.
Regular Health Checkups: Monitoring nutrient levels through regular health checkups
helps identify and address deficiencies early.
Global Impact:

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Global Impact:
Nutritional deficiencies are a global health concern, affecting individuals in both
developed and developing countries.
Lack of access to diverse and nutritious foods, poverty, and limited healthcare
resources contribute to the prevalence of nutritional deficiencies, especially in certain
populations.
Addressing and preventing nutritional deficiencies require a comprehensive
approach that includes education, access to diverse and nutritious foods, and
healthcare interventions.
Individuals should strive to maintain a well-balanced diet and seek medical advice if
they suspect a deficiency.

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Multiple Determinants
of Health
Individual
Biology
Behavior
Physical
Environment
Social
Environment
Access to Quality Health Care
Policies and Interventions
Source: U.S. Department of Health and Human Services, Health People 2010

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Health Disparities
Access and Outcomes
•Infant Mortality
•Cancer Screening and Management
•Cardiovascular Disease
•Diabetes
•HIV Infection/ AIDS
•Immunizations

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Ten Great Achievements in
Public Health, 1900-1999
1.Vaccination.
2.Motor-vehicle safety.
3.Safer workplaces.
4.Control of infectious diseases.
5.Decline in deaths from coronary heart disease and stroke.
6.Safer and healthier foods.
7.Healthier mothers and babies.
8.Family planning.
9.Fluoridation of drinking water.
10.Recognition of tobacco use as a health hazard.

32. WHO Definition
“Health is a state of complete physical, mental and social
wellbeing and not merely an absence of disease or infirmity.”
now added
“the ability to lead a socially and economically productive life.”
•The concept of health as defined by WHO is broad and
positive in its implications; it sets out the standard, the
standard of “positive” health.

33. •Traditionally health has been considered as an absence
of the diseases and if someone was free from disease,
then that person was considered healthy.
This concept is known as biomedical concept, and it has
a basis on the
“germ theory of the disease.”

34. CHANGING CONCEPTS OF HEALTH
•Health is perceived in different ways giving rise to
various concepts of health. Health has evolved over
the centuries as a concept from an individual concern
to a worldwide social goal.
Biomedical Concept
•Health means “absence of disease.”
•It was felt that human body is a machine and disease is
an outcome of the breakdown of the machine, and one
of the doctor’s tasks was to repair the machine.
•Developments in medical and social sciences led to the
conclusion that the biomedical concept of health was
inadequate.

35. Ecological Concept
•Ecologists viewed health as a dynamic equilibrium
between man and his environment, and disease –a
maladjustment of the human organism to environment.

36. Psychosocial Concept
•Advances in social sciences showed that health is not only
a biomedical phenomenon, but one which is
influenced by social, psychological, cultural, economic
and political factors of the people concerned. Thus
health is both a biological and social phenomenon.
Holistic Concept
•Holistic concept recognizes the strength of social,
economic, political and environmental influences on health.
•It has been variously described as multidimensional
process involving the wellbeing of the person as a whole
•The emphasis is on the promotion and protection of
health.

37. Health
Social
economic
Envirnmental
Political
Health
promotion
Health
protection
Holistic concept

38. DIMENSIONS OF HEALTH
•Health is multidimensional and are interrelated, each has
its own nature
Physical Dimension
•“Perfect functioning” of the body.
•It conceptualizes health biologically as a state in which
every cell and every organ are functioning at optimum
capacity and in perfect harmony with the rest of the
body.
Mental Dimension
•Ability to respond to many varied experiences of life with
flexibility and a sense of purpose.
•Mental health has been defined as “a state of balance
between the individual and the surrounding world, a
state of harmony between oneself and others

39. Social Dimension
•Harmony and integration with the individual, between each
individual and other members of society, and between
individuals and the world in which they live.
“quantity and quality of an individual’s interpersonal ties
and the extent of involvement with the community.”
Spiritual Dimension
•Spiritual health refers to “something” that transcends
physiology and psychology.

40. Emotional Dimension
•Relates to “feeling.” it reflects emotional aspects of
humanness.
Vocational Dimension
•Work often plays a role in promoting both physical and
mental health.
•Physical work is usually associated with an improvement
in physical capacity, while goal achievement and self-
realization in work are a source of contentment and
enhanced self-esteem.
Others
•A few other dimensions have also been suggested such as
philosophical dimension, cultural dimension,
socioeconomic dimension, environmental dimension,
educational dimension, nutritional dimension, and so on.

41. CONCEPT OF WELLBEING
Standard of Living
•As per WHO, “Income and occupation, standards of
housing, sanitation and nutrition, the level of provision of
health, educational, recreational and other service and
collectively as an index of the ‘standard of living’.”
Level of Living
•As per United Nations documents “level of living”
consists of nine components: health, food consumption,
education, occupation and working conditions, housing,
social security, clothing, recreation and leisure, and
human rights.

42. Quality of Life
•Quality of life as defined by WHO, “The condition of life
resulting from combination of the effects of the complete
range of factors such as those determining health, happiness
, education, social and intellectual attainments, freedom of
action, justice and freedom of expression.”
Physical Quality of Life Index
•It includes three indicators such as
Infant mortality
Life expectancy at age one
Literacy.
For each component, performance of individual countries is
placed on a scale of 0 to 100,

43. Human Developmental Index
•It includes
longevity (life expectancy at birth)
knowledge (adult literacy rate)
income (real GDP per capita)
The HDI value ranges from 0 to 1.

44. SPECTRUM OF HEALTH
•This concept of health emphasizes that health of an
individual is a dynamic phenomenon and a process of
continuous change, subject to repeated, fine variations
•Transition from optimum health to ill health is often gradual,
and where one state ends and other begins is a matter of
judgment.
•Different stages are positive health, better health, freedom
from sickness, unrecognized sickness, mild sickness, severe
sickness, and death.

45. Positive health
Better health
Freedom from sickness
Unrecognised sickness
Mild sickness
Severe sickness
Death
SPECTRUM OF HEALTH

46. DETERMINANTS OF HEALTH
Health
Biological
Gender
Environment
Health services
Behavioral &
sociocultural condition
Socioeconomic
Aging
Other
factor

47. Biological Determinants
•Physical and mental traits of every human being are to some
extent determined by the nature of his genes at the moment of
conception.
Behavioral and Sociocultural Conditions
•Health requires promotion of healthy lifestyle. Modern health
problems especially in the developed countries and in
developing countries are mainly due to changes in lifestyles.
Healthy lifestyle includes adequate nutrition, enough sleep,
sufficient physical activity etc.
Environment
•Environment has a direct impact on the physical, mental and
social wellbeing of those living in it.

48. •Environmental factors range from housing, water supply,
psychosocial stress and family structure
Socioeconomic Conditions
●Economic status: Economic situation in a country is an
important factor in morbidity, increasing life expectancy
and improving quality of life, family size and pattern of
disease
●Education: Illiteracy correlates with poverty, malnutrition,
ill health, high infant and child mortality rates.
●Occupation: Productive work provides satisfaction,
promotes health and improves quality of life.
●Political system: timely decisions concerning, resource
allocation, choice of technology etc

49. Health Services
•To be effective, the health services must reach the
masses, equitably distributed, accessible at a cost the
country and community can afford and social acceptable.
Aging of the Population
•A major concern of rapidly aging population is increased
prevalence of chronic diseases and disabilities that deserve
special attention.
Gender
•Women’s health is gaining importance in areas such as
nutrition, health consequences of violence, aging, lifestyle
related conditions and the occupational environment.
•There is an increased awareness among policy makers of
women’s health issues, and encourages their inclusion in
all development as a priority.

50. INDICATORS OF HEALTH
•Indicators should be valid, reliable and objective, sensitive,
specific, feasible and relevant.
•The indicators are:
1. Morbidity indicators
2. Disability rates
3. Nutritional status indicators
4. Health care delivery indicators
5. Utilization rates
6. Indicators of social and mental health
7. Environmental indicators
8. Socioeconomic indicators
9. Health policy indicators
10. Indicators of quality of life
11. Other indicators

51. Mortality Indicators
•Mortality indicators represent the traditional measures of health status:
●Crude death rate: It is defined as the number of deaths per 1000
population per year in a given community.
●Expectation of life: “the average number of years that will be lived”
An increase in the expectation of life is regarded, inferentially, as an
improvement in health status. It can be considered as a positive health
indicator. It is a global health indicator.
●Infant mortality rate: It is the ratio of deaths under 1 year of age in a given
year to the total number of live births in the same year; usually expressed as
a rate per 1000 live births.
It is one of the most universally accepted indicators of health status.

52. Child mortality rate: It is defined as the number of deaths at
ages 1-4 years in a given year, per 1000 children.
It is related to insufficient nutrition, low coverage by
immunization, etc.
Under-5 proportionate mortality rate: It is the proportion of total
deaths occurring in the under-5 age group. This rate can be
used to reflect both infant and child mortality rates.
Maternal mortality rate: Maternal mortality accounts to the
greatest proportion of deaths among women of reproductive
age.
Disease-specific mortality rate: Mortality rates can be computed
for specific diseases.

53. Morbidity Indicators
•Morbidity indicators supplement mortality data to describe
the health status of a population.
•Morbidity rates are incidence and prevalence, notification
rates, attendance rates at outpatient departments, health
centres, admission, readmission and discharge rates,
duration of stay in hospital, and spells of sickness or
absence from work or school etc.

54. Disability Rates
•Disability rates related to illness and injury supplement
mortality and morbidity indicators.
•The commonly used disability rates are:
(i)event-type indicators:
(ii)person-type indicators.
.

55. Sullivan’s index. It is calculated by subtracting from the life
expectancy the probable duration of bed disability and
inability to perform major activities.
HALE (Health adjusted life expectancy). HALE is based
on life expectancy at birth but includes an adjustment for
time spent in poor health.
DALY (Disability –adjusted life year). DALY is a measure
of the burden of disease in a defined population and the
effectiveness of the interventions.

56. Nutritional Status Indicators
•Nutritional status is a positive health indicator.
•It consists of anthropometric measurements of preschool
children (e.g., weight and height, mid-arm circumference),
heights and weights of children at school entry and
prevalence of low birth weight (less than 2.5 kg).
Health Care Delivery Indicators
•Frequently used indicators of health care delivery are
doctor-population ratio, doctor-nurse ratio, population bed
ratio, population per health/subcentre and population per
traditional birth attendant.

57. Utilization Rates
•Proportion of people in need of a service who actually
receive it in a given period, usually a year.
•Utilization rates give some indication of the care needed
by a population, and therefore, the health status of the
population such as immunization, deliveries supervised by
a trained birth attendant, methods of family planning etc.

58. Indicators of Social and Mental Health
•Indirect measures
•These include acts of violence and other crime, road traffic
accidents, juvenile delinquency, alcohol and drug abuse,
smoking etc.
Environmental Indicators
•Environmental indicators reflect the quality of physical and
biological environment in which diseases occur and in
which the people live.
•They include indicators relating to pollution of air and
water radiation, solid wastes, noise, exposure to toxic
substances in food or drink.

59. Socioeconomic Indicators
•indirect indicators of health.
•These include rate of population increase, level of
unemployment, dependency ratio, literacy rates, especially
female literacy rates, family size, etc.
Health Policy Indicators
•The most important indicator of political commitment is
“allocation of adequate resources.”
•The relevant indicators are proportion of gross national
product (GNP) spent on health services, proportion of GNP
spent on health-related activities and proportion of total
health resources devoted to primary health care.

60. Health Care
•It is defined as “a multitude of services rendered to
individuals, families or communities by the professions,
for the purpose of promoting, maintaining, monitoring or
restoring health.”
•Health care should be appropriate, comprehensive,
adequate, available, accessible, affordable and feasible.
•It can be delivered by appropriate planning of health
systems with the aim of health development.
•Health systems are based on contemporary ideas and
concepts and available resources.

61. Levels of Health Care
•Primary health care. It is the first level of contact
between the individual and the health system where
essential or primary health care is rendered.
•Secondary health care. At this level, more complex
problems are dealt with. This care comprises essentially
curative services and is provided by the district hospitals
and community health centres.
•This level serves as the first referral level in the health
system.

62. Tertiary health care.
•This level offers super specialist care.
•This care is provided by regional/central level
institutions.
•These institutions provide not only highly specialized
care, but also planning and managerial skills and
teaching for specialized staff.

63. Health Team Concept
•Practice of modern medicine has become team of many
groups of workers, both professional and non-professional.
•Health team has been defined as “a group of persons who
share a common health goal and common objectives,
determined by community needs and toward the
achievement of which each member of the team contributes
in accordance to her/his competence and skills.”
•The auxiliary is an essential member of the team. It is
recognized that many functions of the physician can be
performed by auxiliaries, given suitable training.

64. •Primary health care approach is based on principles of
social equity, nationwide coverage, self-reliance,
intersectoraI coordination, and people’s involvement in the
planning and implementation of health programs in pursuit
of common health goals.
•Primary health care includes at least:
●Education about prevailing health problems and
methods of preventing and controlling them
●Promotion of food supply and proper nutrition
●An adequate supply of safe water and basic sanitation
•●maternal and child health care, including family
planning

65. ●Immunization against infectious diseases
●Prevention and control of endemic diseases
●Appropriate treatment of common diseases and injuries
●Provision of essential drugs.

66. Health Goals
•
●Eradicate extreme poverty and hunger
●Achieve universal primary education
●Promote gender equality and empower women
●Reduce child mortality
●Improve maternal health
●Combat HIV/AIDS
●Malaria and other diseases
●Develop global partnership for development.

67. CONCEPTS OF PREVENTION
•Successful prevention depends upon a 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,
and continuous evaluation and development of procedures
applied.
•The objective is to intercept the “cause” and thereby the
disease process .

68. Levels of Prevention
•Prevention can be achieved in terms of four levels:
(1)Primordial prevention
(2)Primary prevention
(3) Secondary prevention
(4) Tertiary prevention.
1.Primordial prevention: Prevention of emergence or
development of risk factors in countries or population
groups in which they have not yet appeared.
In primordial prevention, efforts are directed towards
discouraging children from adopting harmful lifestyles.
The main intervention in primordial prevention is through
individual and mass education.

69. Primary prevention:
A desirable goal relies on holistic approach that signifies
intervention in the prepathogenesis phase.
•“action taken prior to the onset of disease, which
removes possibility that a disease will ever occur.”
•Intervention, promote general health and wellbeing and
specific protective measures.
•It concerns an individual’s attitude towards life and
health and the initiative he takes about positive and
responsible measures for himself, his family and his
community.

70. •WHO has recommended :
a.Population (mass) strategy: Take whole population
irrespective of individual risk levels and is aimed at
towards socioeconomic, behavioral and lifestyle
changes.
b. High-risk strategy: to bring preventive care to individuals
at special risk.
This requires detection of individuals at high risk by the
optimum use of clinical methods.

71. Secondary prevention:
“Action which halts the progress of a disease at its
incipient stage and prevents complications.”
•Interventions are early diagnosis and adequate treatment.
•Health programs initiated by governments are usually at the
level of secondary prevention.
•Drawback of secondary prevention is that the patient has
already been subjected to mental anguish, physical pain, and
the community to loss of productivity.
•These situations are not encountered in primary prevention.

72. Tertiary prevention:
“All measures available to reduce or limit impairments and
disabilities, minimize suffering caused by existing departure
from good health.”
Interventions are disability limitation and rehabilitation.

73. Modes of Intervention
•Five modes of intervention have been described which
form a continuum corresponding to the natural history of
any disease:
(i)Health promotion
(ii)Specific protection
(iii)Early diagnosis and treatment
(iv) Disability limitation
(v) Rehabilitation.

74. Health Promotion
•“The process of enabling people to increase control over and
improve health.”
•It is not directed against any particular disease, but is
intended to strengthen the host through a variety of
approaches such as :
●Health education: A large number of diseases could be
prevented with little or no medical intervention
if people were adequately informed about them
if they were encouraged to take necessary precautions
in time.
Targets for educational efforts may include general public,
patients, priority groups, health providers, community leaders
and decision makers.

75. ●Environmental modifications: Provision of safe water;
installation of sanitary latrines; control of insects and
rodents; improvement of housing, etc. promote health.
●Nutritional interventions: This refers to food distribution
and nutrition improvement of vulnerable groups; child
feeding programs; nutrition education, etc.
●Lifestyle and behavioral changes:

76. Specific Protection
•Some of the currently available interventions aimed at
specific protection are: immunization, use of specific
nutrients, chemoprophylaxis, protection against accidents,
protection from carcinogens, avoidance of allergens,
control of specific hazards in general environment etc.

77. Early Diagnosis and Treatment
•A WHO defined early detection of health impairment as
“the detection of disturbances of homeostatic and
compensatory mechanism while biochemical,
morphological, and functional changes are still reversible.”
•Early detection and treatment are the main interventions of
disease control. Earlier a disease is diagnosed and treated
the better it is from the point of view of prognosis and
preventing the occurrence of further cases or any long-term
disability.

78. Disability Limitation
•Objective of this intervention is to prevent or halt the
transition of the disease process from impairment to
handicap.
•Intervention in disability will often be social, environmental
as well as medical. While impairment which is the earliest
stage has a large medical component, disability and
handicap which are later stages have large social and
environmental components in terms of dependence and
social cost.

79. Rehabilitation
•“The combined and coordinated use of medical, social,
educational and vocational measures for training and
retraining the individual to the highest possible level of
functional ability.”
Rehabilitation includes
•Medical rehabilitation (restoration of function),
•Vocational rehabilitation (restoration of the capacity to earn a
livelihood),
•Social rehabilitation ( restoration of family and social
relationships),
•Psychological rehabilitation (restoration of personal dignity
and confidence).