Primary prevention: It is directed at avoiding disorders before they begin, e.g.

vaccination, clean water supply and sewage disposal, etc. Secondary prevention: It indicates recognition and elimination of the precursors of the disease, e.g. screening programs for thyroid disorders, anaemia, blindness, etc. Screening is the search for and asymptomatic illness in a defined population, which is usually performed for the purpose of treatment, but is sometimes done for counselling and research also. Ethics demand that screening tests should not be done, unless justified by compensatory benefit and that too after obtaining informed consent. Tertiary prevention: It indicates that the measures for amelioration or halting of the disabilities arising from established disease, e.g. physiotherapy to prevent contractures in patients with chronic neurological diseases. Most successful primary preventive measures require, understanding the cause, pathogenesis and the natural history of diseases. For secondary and tertiary prevention, however, determining the cause is not so essential. Many preventive measures such as tetanus immunization are effective only for the individual recipient. Others are applied to the entire community, e.g. water fluoridation, pulse polio immunization. Thus modern preventive medicine has been defined as the art and science of health promotion, disease prevention, disability, limitation and rehabilitation. It implies a more personal encounter between the individual and health professional than public health. Social medicine: It is the study of man as social being as his or her total environment. The focus is on the health of the community as whole. Epidemiology: It is the scientific study of factors influencing the health, disease and control of disease in populations, rather than in individuals. Why study of Community Paediatrics is needed? i. Vast differences exist is the child health care problem and services among the developed and developing nations. Misdistributions of doctors and poor doctors patient ratio: approximately, 80 percent population lives in rural and tribal areas, whereas, 80 percent of doctors serve the remaining 20 percent population in urban and semi urban areas. Thus, doctors alone cannot copes up with the demands of the child care from difficult rural/tribal areas.

ii.

iii. Inadequate training in paediatrics for the doctors as well as nursing and paramedical staff does not make them feel confident to offer child care services in large community.

iv. Meagre allocation of budget for child care services, improper prioritization and
maldistribuiton of available funds, lack of knowledge and attitude for the effective use of available resources, general proverty, ignorance, traditional cultural taboos/customs, etc. Are some of the other major stumbling blocks for provision paediatrics services in developing countries. Proper training of workers and development of community paediatrics linked with primary health care, offers a viable alternative for improvement of child health services in developing countries.