Application of

Epidemiology in health care

delivery system
Introduction
• Epidemiology in the basic science of preventive and social medicine.
• Although ancient lineage it made only slow progress upto the start of
20th century.
• Epidemiology has evolved rapidly during the past Few decades .
• It’s ramifications cover not only study of disease distribution and
causation But also health and health related events occurring in
human population
• Modern epidemiology has entered the most existing phases of its
evolution by identifying risk factors of chronic disease evaluating
treatment modalities and health services
Objectives

• Improve health level and equity.

• Protection of disease in early stages.
• Providing financial protection against the cost of ill health.
• Improve quality of life.
Definition
• Epi = among , upon
• Demos = people , population
• Logos = science , study
 ….contd
• Epidemiology has been defined as the study of the occurrence and
distribution of health related events, states ,and process in specified
population, including the study of the determinant influencing such process
and the applications of knowledge to control relevant health problem.
• Objectives :
• To know the distribution of the disease in the community.
• To know the magnitude of the problem.
• To identify the etiological risk factors .
• implement of preventive and control measures.
• Eradicate the disease and evaluate control measures.
 Functions
• Medical care
• Maternal child health and family planning
• Safe water supply and basic sanitation
• Prevention of control of disease
• Education about health
• National health program involvement
• Training of health workers
• Collection and reporting statisic.
Health care delivery system in India
Contd
Contd…
Panchayat Raj
Panchayat (At the village level)
Purpose Of health care
• Improve the health status of the population
• Prevention and control of disease
• Early diagnosis and treatment
• Rehalibition and restorative care
Goals of health care delivery system
• To promote and protect health to alleviate and minimize sufferings
and disabilities and to regain health so as to lead socially useful and
economically productive life
• Preventive approach is the best approach to achieve these goals
because preventive measures can be implemented with the joint
efforts of health personnel and the people at large at the family and
community level.
Types of health care delivery system
Primordial prevention
• This includes prevention of the emergence (or) development of risk
factors in countries ( or) population groups in which they have not Yet
appeared.
• Example
• Many adults health Problems ( obesity, hypertension) have their
origins in the childhood, because this is the time when life style are
formed.
• In primordial prevention, efforts are directed towards discouraging
children from adopting harmful lifestyle. The main intervention is
through individual and mass education .
Primary prevention
• Primary prevention can be defined as ,action taken prior to the onset
of disease, which removes the possibility that the disease will ever
occur.
• Primary prevention is the first level of prevention and associated with
prepathogenesis phase ( or) stage of susceptibility of the disease
process when the epidemiological factors like:
• Agent - host- environment have not yet interacted to cause a disease.
• Primary prevention strategies during pre- pathogenesis phase of
disease are aimed to prevent the interaction of these epidemiological
factors.
Types of primary prevention
• General health promotion
• Specific prevention
• General health promotion
• Health promotive factors includes health education, wholesome
nutritious diet, clean and safe environment to live, healthful life
style, healthful behaviour and adequate resources.
• Health promotive measures encompass activities related to health
education, environmental modification nutritional interventions, life
style and behaviour changes.
 Specific protection
• Specific protection includes those measures which are directed to
intercept causative agents of a particular disease or group of diseases
before these agents effect people.
• These measures includes immunization, use of specific nutrients ,
protection against accident and environmental and occupational health
hazards, use of prophylactic and suppressive drugs , avoidence of
allergic, protection from carcinogens drugs, and genetic theraphy and
counselling.
Secondary prevention
• Secondary prevention can be defined as, action which halts the
process of a disease at its incipient stage and prevents
complications.
• Secondary prevention is associated with pathogenesis phases of the
disease process.
• Objectives of secondary prevention
• Diagnose the disease at early stages
• Controll the process of disease in man.
• Prevent complications and restore health
• Prevent the spread of infectious to other in the community.
Types of secondary prevention
• Early diagnosis and treatment.
• Disability limitations.
• Early diagnosis and treatment.
• Early diagnosis and treatment are the measures which control the
disease process, in case of communicable diseases, prevent
complications and long term disabilities and restore health.
• It helps in reducing the mortality and morbidity due to these
infectious and infectious disease.
 Disability limitations

• Disability interventions are applicable during the late pathogenesis

period (or) clinical stages of the disease process.
• Examples
• Prevent impairment leading to disability and handicap.
• The sequence of events leading to disability and handicap.
• Disease _impairment_ Disability _ Handicap.
Disease:
• Anyone pathogens to produce the disease.
• Any harmful deviating from the normal structure ( or) functional state
of an organisms.
Impairment:
• Any loss ( or) abnormalities of psychological, physiological,( or)
anatomical (or) function.
Examples
Loss of foot
Disability:
• Because of impairment the affected person may be unable to carry
out certain activities considered normal for his age, sex etc.
• Handicap:
• It is a disadvantage for a given individual resulting from impairment
(or) a disability that limits (or) prevent. The fullfillment of a role that is
normal for that individual.
• Examples:
1. Accident is disease.
2. Loss of foot impairment.
 Contd…..
3. Can’ t walk is disability.
4. Unemployed is handicap.
Tertiarry prevention:
• tertiarry prevention can be defined as all measures available to reduce
(or) limit impairment and disabilities, minimize sufferings caused by
the existing departure from good health and to promote the patient
adjustment to irremediable condition.
 Contd….
• Tertiarry prevention helps to attain the highest possible level of
functional ability.
• It involves coordinated efforts of medical personnel, sociologist,
clinical psychologist, nurses etc for training and retraining of and
helping the person to function , lead a useful life as far as possible and
restore a feeling of well-being.
Rehabilitation is with regard to restoration:

• Medical rehabilitation.
• Psychological rehabilitation.
• Social rehabilitation.
• Vocational rehabilitation.
Summary
• I gained more knowledge about health care delivery system in India ,
definition, purpose, function, types of delivery system in primordial,
primary prevention, secondary prevention, tertiary prevention.
Conclusion
• To conclude the three levels of preventive measures to various stages
of natural history of disease, mutually exclusive relationship exists
among all the three levels of prevention .
References:
1. K.park, text book of preventive and social medicine, 23rd edition.
2. Neelam kumari, a text book of community health nursing, 2011.
3. Navdeep Karur Brar, text book of advanced nursing practice, 3rd
edition.
4. Emmess, shebeer. P.basheer.s.yaseen Khan, a text book of advanced
nursing practice 2nd edition.
5. Http;//www.Nhm.gov.in.
6. Http;//www.springer.com.