Concept of Prevention of Health

Problems and Diseases and

Their Control in Developing
Countries and Bangladesh

D R. SN ITA D AS
PH D (JN U , N EW D ELH I),M PH (JN U , N D ),
M BBS(BD )

D isease,illness & sickness

Disease-

Professionally

physiological

or

defined

as

psychological

dysfunction.
Illness-

Subjective

state

of

the

individuals who feels aware of not being

well.
Sickness- State of social dysfunction

based

on

professional-social

Illness
illness Subjective sense of feeling unwell
illness is a subjective state of a person

who feels aware of not being well

It does not define a specific pathology,

but refers to a persons subjective

experience (e.g. tiredness, discomfort
or malaise etc.)

Sickness
Sickness Impairment of normal physiological

function affecting part of all of an

organism
Refers to a state of social dysfunction
Sickness

is

state

dysfunction

i.e.

individual

assumes

role

of

social

that

the

when

ill

(according to Susser)
It can also regarded as a concept that

D isease
Disease is a disorder or malfunction of

the mind or body, which leads to a

departure from good health.
Can be a disorder of a specific tissue or

organ due to a single cause

e.g.

malaria.
May have many causes. Often referred

to as multifactorial e.g. heart disease.

D isease
Disease diagnosed by a doctor analysing the

symptoms (physical and mental signs).

Disease morbus (latin), nosos, pathos (greek)
Injury health failure, usually caused by one-

off or short-acting harm of organism

Defect physical or mental defect, usually

permanent in nature (congenital, acquired effect of disease or injury)

H ow does disease occur

Theories of disease causation Germ theory i.e. by disease agent
Epidemiological triad of agent, host and

environment
Multi-factorial

causation

causation

or

web

of

G erm theory ofdisease

This concept is generally referred to

as a one to one relationship between

causal

agents

and

disease.

disease model accordingly is:

Diseases--- agent--- Man----disease

The

Epidem iologicalTriad
HOST

AGENT

ENVIRONMENT

H ost-agent-environm ent
m odel
In

the

paradigm,
through

hostagentenvironment
a

harmful

agent

sympathetic

comes

environment

into contact with a susceptible host,

causing a specific disease.
The host is the person who has or is at-

risk for a specific disease.

H ost-agent-environm ent
m odel
The agent is the organism or direct

cause of the disease.

The environment includes the external

factors which influence the host, his or

her susceptibility to the agent, and the
vector which transmits or carries the
agent to the host from the environment.

M ultifactorialCausation or,
W eb ofCausation
According

to this concept multiple

factors are responsible for a disease
process to occur
It de-emphasize the concept of germ
theory i.e. concept of disease agent
causation
Examples: TB is not merely due to
tubercle bacilli; other factors such as
poverty,
over
crowding
and
malnutrition also contribute to its

Levels/stages/Phases of
prevention

Primordial prevention

Primary prevention
a. Health Promotion
b. Specific Protection

Secondary prevention

Tertiary prevention

Prim ordialPrevention
This is a new concept, used to prevent the

chronic diseases. The main intervention here

is through individual and mass education.
ExampleOutlawing alcohol in certain countries
Prevention of smoking in childhood
Development of exercise habit in childhood
Efforts are directed towards discouraging
children from adopting harmful lifestyles.

Prim ary Prevention

Primary prevention: Preventing a disease

from occurring.
Examples:
Pregnancies prevented by contraception
program
Coronary heart disease prevented by
smoking cessation
Vaccination etc.
Involves two types of modes of intervention.
a. health promotion and b. specific
protection

Prim ary Prevention

Health promotion: Fostering individual and

community
conducive

standards
to

legislative,
conditions

good

social,
that

of

behavior

health,

promoting

or

reduce

environmental
individual

and

community risk, and creating a healthful

environment.
Examples:
Feeding programs for mother and children
Education and motivation for healthy life style

Prim ary Prevention

Specific protection: these include

measures to prevent the initiation of

specific diseases or a group of
diseases
Examples Immunization to protect against specific

diseases
Fortification of foods with specific
nutrients (as salt with iodine)
Use of helmets to protect against head
injuries etc.

Secondary Prevention
Secondary prevention: involves the early

detection of disease in an asymptomatic

period before it progresses, and the
treatment to stop progress or shorten the
duration and prevent complications from
an already existing disease process.
ExampleScreening Test
Routine blood sugar testing
Routine blood pressure checkup

Tertiary prevention
Tertiary

prevention: attempts to reduce

complications or disability by treatment and
rehabilitation, once the disease process has
stabilized. It is carried out primarily by the
existing health care system. i.e., promoting
functional rehabilitation.
ExampleCardiac or stroke rehabilitation programs
Chronic pain management programs
Patient support groups

Thank You All