LEVELS OF ILLNESS PREVENTION

“Prevention is better than cure” -Desiderius Erasmus (1500)

According to American Nursing Association (ANA) nursing personnel have four

responsibilities, they are

 Promotion of health
 Prevention of illness
 Restoration of health
 Alleviation of sufferings
Prevention is group of activities designed to protect the patient and members of community
from illness and its harmful effects.

Levels of prevention

There are mainly four levels of prevention, they are

 Primordial prevention
 Primary prevention
 Secondary prevention
 Tertiary prevention
1. Primordial prevention

The primordial prevention strategy is applied to reduce the development of risk factors before
their appearance. Adequate attention is given to prevent chronic disease. The main action in
primordial prevention is providing health education and awareness to people on how to live a
healthy lifestyle.

Primordial prevention is a among new concept and getting acceptance. It aims at preventing
chronic diseases.

It has been seen that some chronic condition has rooted in childhood which can be
preventable. Chronic conditions like diabetes, hypertension and obesity are preventable
through the adoption of a healthy lifestyle. A child can be made habitual to a healthy lifestyle
from the beginning. Parent, teacher, peer group and society play a major role in changing the
lifestyle of a child.

“Genes load the gun. Lifestyle pulls the trigger” -__Dr. Elliot Joslin

For example, Primordial prevention focuses on a healthy lifestyle, it educates on taking

nutritious food, avoiding smoking alcohol, exercising regularly etc.

Examples of primordial prevention are:

 Avoiding smoking, alcohol and drugs

 Taking healthy nutritious food
 Regular exercise
 Making major changes in lifestyle like taking adequate sleep.

2. Primary prevention

Primary prevention is the action taken to prevent the development of disease. It removes the
possibility of the occurrence of disease. In this, action is taken before the onset of illness.

Primary prevention based on the “positive health” concept, It encourages achievement and
maintenance of the health of every individual and enables him to lead a socially and
economically productive life.

Primary prevention executed through two ways i.e., health promotion and specific protection.

Health promotion is the process of adoption of healthy behaviour and a positive attitude for
maintaining a healthy lifestyle. Health promotional activities are environmental modification,
health education, nutritional intervention, lifestyle and behavioural changes.
Health promotion does not provide full protection to health. Targeting specific group and
specific diseases also important in prevention measures. Specific protection provides
protection against specific disease and group. Specific protection achieved by immunisation,
chemoprophylaxis, environmental modification, use of specific nutrition and supplements,
the safety of food, drugs and control of environmental hazards.

Difference between primordial prevention and primary prevention: Primordial prevention

prevents the development of risk factors and Primary prevention modifies existing risk
factors and prevents them to become a disease.

Approaches for Primary prevention

WHO recommends two approaches for primary intervention and prevention of chronic
diseases, are- a) Population strategy b) High-risk strategy.

a) Population strategy

As the name says, population strategy covers the whole population or mass irrespective of
individual risk levels. For example, A study has shown that the average reduction in blood
pressure and cholesterol level reduces the risk of cardiovascular disease. In population
strategy, a mass of the population will be made aware of the effectiveness of behavioural and
lifestyle changes for the risk of cardiovascular disease.

b) High-risk strategy

This strategy identifies high-risk people by screening and other clinical methods. Special
education and attention are provided to these group.

3. Secondary prevention

It is the action taken to stop the progress of the disease at the initial stage and prevent
complication. Secondary prevention is the step taken to stop the disease process and restore
health by seeking out unrecognised disease and treating it before it reaches the irreversible
pathological stage.

Objectives of secondary prevention

 Completely cure or cease the progression of the disease.

 Preventing the spread of disease by providing treatment to known cases.
 Prevent complication
 Reduces the degree of disability by shortening the period.
This prevention is taken up by early diagnosis and screening. Early diagnosis recognises the
disease at early stages and help to provide adequate treatment.

4. Tertiary prevention

It comes into action when disease advances beyond early stages.

Tertiary prevention is defined as “all the measures taken to reduce or limit, impairment,
disability and promote patient adjustment to the current situation.”

This stage aims at disability limitation and rehabilitation. Disability is the prevention of the
transition of the disease process from impairment. Despite taking measures, if any type of
disability occurs, rehabilitation is required to retain the individual’s highest level of
functioning.

To remember easily the activity of three levels of prevention, one can use Primary =
Prevention, Secondary = Screening and Tertiary = Treatment.