(a) Primary prevention (b) Secondary prevention (c) Tertiary prevention.
(1) Primary Prevention:
Primary prevention may be defined as “action taken prior to the onset of disease which removes the possibility of ever occurrence of a disease”. The action taken mainly includes all those factors which raise the standard of living of community and promote the general well being of the society. These factors can be studied under two headings i.
e. (a) Health promotion measures. (b) Specific protective measures (a) Health Promotion Measures: These include: (i) Maintenance of a healthy environment.
(ii) Maintenance of personal hygiene. (iii) Eating of adequate balanced diet. (iv) Provision of safe water supply. (v) Provision of proper disposal of human excreta and domestic wastes. (vi) Provision of well managed sewer system.
(vii) Isolation of infected persons. (viii) Immunisation. (ix) Maintenance of healthy and clean sex life.
(x) Motivation of the people to avoid the use of tobacco, alcohol and drugs. (b) Specific Protective Measures: Specific diseases can be prevented by taking specific measures against these diseases. For example tuberculosis, diphtheria, pertusis, tetanus,’ polio, measles etc. can be prevented by immunisation at proper age and time. Since children are more susceptible to these diseases, so all the children should be vaccinated so as to get immunity from these diseases. In fact most of the children’s diseases can be prevented by vaccination.
Ricketsia and scurvy can be prevented by administration of Vitamin D and Vitamin C respectively. Similarly industrial accidents can be prevented by using specific protective devices like goggles, gloves or shields against carcinogens, allergens and occupational hazards etc. It is worthwhile to mention that many developed countries have succeeded in eliminating most of the infectious diseases by primary prevention and efforts are being made to prevent chronic diseases by primary prevention e.
g. stoppage of smoking, drinking, dietary control and physical exercise etc. Primary prevention is less expensive, safe and more effective way of preventing diseases in comparison to secondary and tertiary preventive techniques. Nature has provided some defence mechanisms in our body which will prevent the entry of disease producing microorganisms in the body or destroy them. These defence mechanisms include white blood cells (W.B.
C.), skin hair, eye lids, eye lashes, and tears etc.
(2) Secondary Prevention:
Secondary prevention may be defined as “action which halts the progress of a disease at its initial stage and prevents complications”. Although all precautions and care is taken to prevent the diseases but even then the causative factor succeeds in inducing the diseased state in the person.
Now-a-days a number of vaccines have been developed to prevent various diseases but we do not have vaccines for preventing all types of diseases. For diseases like cancer, diabetes, epilepsy, leprosy, syphilis and malaria etc. there is no vaccine available. In such cases early diagnosis and treatment is the only solution. The earliest identification and diagnosis of the disease will be in the benefit of the patient as well as doctor. Earlier diagnosis will help the physician in preventing the disease with proper treatment and to control further progress of the disease. Some of the methods by which early diagnosis or identification of the disease can be made include screening surveys, periodic examination and special examination of people who are at high risk of disease. Secondary prevention is often more expensive and less effective than primary prevention in controlling the transmission of diseases.
(3) Tertiary Prevention:
If primary prevention fails the person gets disease. The early diagnosis and proper treatment helps the patient for early recovery. But in certain cases due to typical nature of the disease, it cannot be diagnosed at its early stages.
Under such circumstances if the disease is not handled properly or the patient is not attended properly it may lead to various complications which may result in permanent disability or death of the patient. The aim of the tertiary prevention is to reduce further complications or permanent disability in the patient. It includes disability prevention and rehabilitation of the patient. Permanent disability can be prevented by immunising the infants, against polio, tuberculosis etc. Disability due to industrial accidents can be prevented by wearing goggles, gloves, hoods etc. Surgical operations can limit the disability to a great extent. Adequate treatment and physiotherapy alone can reduce the duration of disability.
Rehabilitation of the handicapped persons is very important which can be brought about by medical, social, educational and vocational measures. He should be rehabilitated in such a way that he does not feel ignored, earns his livelihood and becomes a useful member of the society. It can be done through physiotherapy, occupational therapy, vocational rehabilitation, sheltered workshops, colonies, selective changes in occupation, opening of hostels and schools for handicapped children and attachment of artificial limbs to an accident victim etc.