Concept of

prevention

Goals of preventive
:medicine
Preventive medicine is the speciality of
medical practice that focuses on the health
of individuals and communities. Its goal is
to protect, promote and maintain health
and well-being and to prevent disease,
disability, and death.
Successful prevetion depends
:upon
1. A knowlage of causation
2. A knowlage of dynamics of transmission
3. Identification of risk factors and risk
groups
4. Availability of prophylactic or early
detection and treatment measures
5. An organization for applying these
measures to appropriate persons
6. Continuous evaluation of and development
of procedures applied
 :Level of prevention

tertiary Secondry Primary Prevention level

Reduce Early detection Remove risk
complication Referal & factors
treatment
:A.Primary prevention
It is defined as action taken prior to the
onset of disease which remove the
possibility that will even occur ( the
disease is stopped before its starts, often by
reducing or eliminating its risk factors)
Primary prevention may be accomplished

by measures designed to promot general

health and well being, or by specific
protrctive measures.
 Primary prevention

Health promotion.1

Specific protection.2
 1.Health promotion:
2.specific protection :
Definition:
The process enabling people to 1.
increase control over their 2.
health and its determinate 3.
and thereby improve their 4.
health
5.
6.
Health promotion is not 7.
directed against any 8.
particular disease, but is
intended to strengthen the
host through a variety of
approaches, the well known 9.
approaches in this area
are :
1. Health education
2. Environmental modification
3. Nutritional intervention
Immunization
use of specific nutrients
Chemoprphylaxis
Protection against
occupational hazards
Protection against accidents
Protection against carcinogen
Avoidance of allergens
The control of specific
hazards in the general
environment, eg, noise
control
Control of consumer product
quality and safty of the food,
drugs
:B.Secondry prvention

The goal of secondry prevention is to :

1. to identify and detect disease in its earliest

stages, before noticable symptoms
develop,when it is most likely to be treated
successfully

2. To prevent the spread of communicable

disease
:Screening
It the practice of investigating apparently
healthy individuals with the object of
detecting unrecognized disease or its
precursors so that measures can be taken
that will prevent or delay the development
of disease or improve the prognosis
Types of screening
:programmes
A)Selective screening
Tests are used to detect specific disease or predisposing condition
in people known to be at high risk of having the condition

1.single disease screening

2.Multiphasic screening

B) Mass screening
Large number of people are tested for the presence of disease or
predisposing condition without specific referance to thei
individual risk of havinng the condition

1.single disease screening

2.Multiphasic screening
:Selective screening.1
Multiphasic
screening
Eg:
1. Antenatal examination
2. Pre-employment medical
examination in high risk
occupation
Single disease
screening
Eg:
1. Chest x,ray for evidance of
pnemoconosis in coalminers
2. Aminocentesis for detection of
chromosomal abnomalities in the
fetus in older women
3. Retinopathy in people with
diabetes
 :Mass screening.2
Multiphasic screening Single disease
screening

Eg: Eg:

Biochemical profile on hospital Test for phenylketonuria and

patients congenital dislocation of hip in
Routine health check ups infancy
c.Tertiary prevention (disability
:limitation and rehabilitation )

Tertiary prevention all measures available to

reduce or limit impairment and disabilities,
minimize suffering prevent the transition of
disability in to handicap, and promote the
patient adjustment to irremediable
conditions
 :Rehabilitation
Rehabilitation programmes are concerned
with helping the diabled person to achieve
his highest level of functional ability
(physical,
mental,psychological,social,educational)
that is consistent with his physiological or
anatomical impairment
 :Types of rehabilitation
Aim to maximize functional ability, improve 1.Medical rehabilitation
quality of life, and avoid or reduce the need services
for long term care like stroke
Offer educational oppotinities for disabled 2.Educational rehabilitation
children eg, special education schools for services
deaf mute, blind and mentally handicapped
Aims to enable temporarily or permanently 3.Vocational rehabilitation
disabled persons to enter, return or remain services
in employment
Aims at restoration of family and social 4.Social rehabilitation
relationships services

Aims at restoration of personal dignityand 5.Psycological rehabilitation

confidence services

Offer informal services for disabled persons 6.residental/community

in residental setting like group homes, rehabilitation services
:Health education

Any designed combination of learning

methods used to facilitate voluntry adaptation
of behavior by individuals or groups of people
in a manner conductive to the promotion,
maintenance and restoration of health.

It motivate the person to take information and

do something with it to keep him healthier by
avoiding action that are harmful and forming
habits that are beneficial.
:NB
The terms health promotion and health education
are not inchangeble

Health promotion is an any combination of

organizational, economic , environmental supports
and conditions of living conductive to better
health

Health promotion is much broader than health

education. It more structural, financial,
technological and controling interventions to
influence health. It included health education.
:NB
Changes of pattern of disease in the 20 th
century from infectious disease to chronic
disease , from disease being caused by
infectious agent to being more influenced by
life style issue (CHD, DM, AIDS, CANCER ) result
in shift from public health which was concern
with sanitation and hygien to health education
which concern with awarness of risk behavior
which are made by the public and cause a large
portion of disease . Those diseases can now be
prevented or successfully treated by
improvement of health related behavior.
:Area of health education
Any component of health can be an area of
health education ( nutrition, reproductive
health, communicable and non
communicable disease , mental health ,
injuries , addiction )
:Aim of health education
The aim of health education is to change
negative behavior and maintain positive
one.
:Health behaviors
Health behaviors are behaviors that a
person engages in to prevent a disease
occuring( health maintainance) or to
prevent an existing disease from getting
worse (health restoration). Behavior is an
action that has a specific frequency,
duration, and purpose.
 Categories for health
:behavior
It involve any activity undertaken by 1. Preventive health behavior
healthy individuals for the purpose of
preventing illness as :use seat belt,
washing hands befor eating
It involves taking actions to improve 2.Self health behavior
ones health.
It include self treatment if definable
health problems either befor seeking
medical attention or complete home
treatments ,eg, eating chicken soup,
drinking liquids or wound dressing
It include the use of health services 3.Health care utilization behavior
either for preventive services such as
immunization or early detection or
treatment
It refers to eating pattern, shopping, 4.Consumption behavior
eating out
It focuses on the use of drugs include tobacco, substance use.5
alcohol, coccain and prescription medication taken behavior
improperly. Substance abuser occure when substance
use behavior is at an extreme and unsafe level

Taking precautions or avoiding sexual contact with Sexual behavior.6

multiple partener can help prevent STDs and
unwanted pregnancies.
Mostly observed in aldoscents and youg adults 7.Risk taking
( drinking,carrying waapos) behavior
How do we achieve this change
?of a behavior
This is done by studying the different factors
that affect behavior and deal with factors
that affect behavior : -
1. Predisposing factors
2. Enabling factors
3. Reinforcing factors
:A. Predisposing factors
These are factors that make people want to
engage in a specific behavior . This include :

1. belief : it is a statement or sense or feeling

accepted as true by person or group

2. Attitude: it is a relatively constant feeling ir set

of beliefs directed toward an object, person or
sitiuation (to like positive attitude ) or not to
like negative attitude to do somthing )
3. Perception :it is the process of attaining
awarness or understanding of sensory
information
:B. Enabling factors
They are the factors that enable that enable
a client to engage in a behavior he was
predisposed to practice . This include :
personal skills, resources and barriers as
limited access to health care, inadequate
resources, income or restrictive lawsrules
regulations
:C. Reinforcing factors
These are factors which either contribute to
its persistance extinction. As these
include :attitude and behavior of health
providers, peers, parents and family
members, employers, teachers
:Health education setting
Health education can be conducted in
different setting : at schools, university,
occupational health, care setting and
primary health care facilities as well as in
the community and homes
:Health education activities
They can be one of :

1. The primary prevention activities to change

behavior and promote preventive behavior as
attending for immunization or exclusive breast
feeding
2. The secondary prevention activities which
focuses on treatment behavior as compliance
to treatment regimen
3. Tertiary prevention aim to promote treatment
behavior related to rehabilitation
Approaches to health
:education
Health education can be directed to :

1. individuals
2. Groups
3. community
Health education with. 1
:individuals

A. One to one consultation can be use din the following

occasions :
1. when an individual has a special health problem which
is sensitive one that can not be dealt with in a group setting
as STDs
2. when an individual has a problem that is not shared by
the group or is not the focus of the discussion or lecture
3. when a resistant person refuses to join group activity
for certain health behavior
4. during visits to different health services whether
preventive or curative

B. Counseling
:Health education with groups.2

A group is gathering of two or more persons who have common

interests. Groups can be forma (pupils, local commities) or informal as
client attending a clinic.

The educational methods for groups are numerous :

1. health talks
2. Group discussion

3. Demonstration

4. Case studies :to enable clients to obtain thinking skill eg : diagnosing

dehydration in child with diarrhea
5. Role playing
:Example of methods

*health talks:
They are the most common way for sharing knowledge and
facts with groups or individuals

It bis similar to a lecture but it is of a short duration (20-30

minutes ) and must be followed by group discussion of at least
15 minutes for responding to questions

The use of visual electronic media , posters, flipchart can

improve the effectiveness of the talk
Talks can be given over the radio to whole nation
limitations utilities

1.Success depends al most 1. Inexpensive

entirely on the ability of the
speaker to communicate skillfully
and attract the audience
2. The speaker must have the 2.Allow for immediate response
accurate information to questions

3.The audience member must 3.Allow tailoring of message to

come to the speaker specific audience needs
 :Group discussions

To ensure participation the group should not exceed 6

persons
The size of the group depend on the purpose of
carrying group discussion

I. to solve a problem the size should be 2-3 persons

only
II. To solve a problem and change attitude the size
should be 4-6 persons
III. To share information and change attitudes the size
should be 7-15
 Rules for group discussion
1.It is should be held in a place that is
comfortable and allaw privacy
2.The size of the group should be
decided according to the purpose of
the discussion
3. The time allowed for discussion
should be convinent for all members
4. The leader should not dominate the
group
5.The role of the leader is to help in
the discussion , clarify certain points
and summarize final ideas
6. Each member should be respected
and encouraged to take some part
7. The group should put its own goals
and plans for action
Utilities of group discussion
1. Ensure active participation and
involvement
Members of the group are able.2
to present their opinions and ask
questions
3. Group discussion indicate
group approval to if member feel
that the group will not contradict
the behavior they will not resist
or refuse the change
4. Group discussion can affect
attitudes of group member
 Demonstration (training
strategy )

It is a mixture of theoretical teaching and

practical work

The purpose of the methode is to help

people learn new manual skills as giving
insulin injection

The method can be used with individuals

and small groups.
The Steps of
:demonstrations
1. Step 1: explain ideas and skills that you will
be demonstrating . You can use photographs,
pictures, real objectsor models, encourage
questions
2. step 2 : do the demonstration carrying out
the procedure slowly step by step
3. Step 3: ask one person to repeat the
demonstration. Then,Ask the group to
comment
4. Step 4: give every one the chance to practice
. Give feedback immediatly
Health education with. 3
:communities
Purpose of community health
education :
1. when a problem affect many or all people
in the community, and when the
cooperation of every one is required to
solve the problem
2. In emergencies
3. When a problem requires pooling of
resources and efforts
Essential steps for health
:education with communities
1. Get support from key people and opinion
leaders in the community
2. Make sure that members of the
community are informed about the
problem and are kept up to date on plans
and progress
3. Involve as many as possible so that the
community strengthens its capacities to
promote its health
4. Use community organization methods
Opinion leaders are respected
:because they are
Good at their profession
Have long experience
Able to lead
Able to work well with certain groups such

as women or youth, or are very well known

like religious and political leaders
Thank you
;( ;(
D: