Prevention and management of diseases can be categorized into three levels. The three levels are developed based on the type of diseases that these prevention methods target. These levels include primary prevention, secondary prevention, and tertiary prevention.
This is considered the true prevention of diseases and other medical conditions. It is also referred to as the specific kind of protection. Practitioners use this strategy to provide specific prevention measures against illnesses so that they do not occur (Potter & Perry, 2004, p. 78). The methods are applied ahead of disease symptoms and in most cases they are applied to emotionally and physically healthy individuals (Edelman & Mandle, 2002, p. 12). The prevention strategy includes measures that are applicable to specific diseases or groups of disease so as to intercept their causal agents before they cause problems.
These efforts save the client of expenses, discomfort, and the threat to life that comes with diseases. They also help to reduce the onset of diseases considerably. The measures taken here include counseling, educating the people, and behavior change (Potter & Perry, 2004, p. 78). Examples of these measures include health education on management of diabetes, immunization of children, and conducting health risk assessment for specific diseases. The goal is to prevent disease occurrence hence reducing incidence and disease prevalence.
This is a compromised and direct assessment of educating the general public so that early diagnosis can be attained and begin intervention in a timely manner. Such timely intervention can efficiently reduce or halt disease progress. This therefore means that secondary prevention is applied after the disease has occurred and just before the patient begins to suffer the consequences of the illness (Potter & Perry, 2004, p. 78). When a physician inspects a suspicious skin disease to ascertain if it is cancerous or not, this is an example of such prevention.
To administer such care, the prevention concentrates on people who are suffering health problems and those at risk of experiencing adverse situations. This level offers treatment whereby the goal is to halt the progress of the disease that has already begun to prevent complications or severity. The patient can hence enjoy health life, and normal functionability. This way, permanent injuries and deaths resulting from disease complication be prevented (Potter & Perry, 2004, p. 79). Examples include screening of particular illnesses like cancers or cardiovascular illnesses, provision of medication to halt complication and to initiate diet change (Potter & Perry, 2004, 79).
This type of care is provided to patients who have already suffered the health condition and who have experienced permanent damage or an irreversible condition. This level of prevention entails strategies that seek to manage the disabled or disillusioned people. The goal is to try and bring back hope to them so that they can get move on with their lives as before the sickness (WHO, 2010). The measure undertaken aims at reducing the impact of chronic disease of disabilities where deterioration is delayed and complications prevented (Edelman & Mandle, 2002, p. 12). The strategies involved therefore are individual- oriented and are aimed at modifying the environment. This level deals with consistent taking of medication so that the therapeutic impact is optimized. Movement and positioning are modified to prevent complications that could cause immobility and exercises that prevent disability development. All this seeks not to heal but restore the performance of individuals. Therefore, this care in more of a rehabilitative strategy, and not a form of treatment (Potter & Perry, 2004). Tertiary prevention services include provision of training facilities, educating the community, rehabilitation and counseling to help the patient to live positively (Kozier & Erb, 2004, p. 34).
Health Concern and Ways These Specific Levels of Preventions Might Be Addressed At the Community Level
Domestic violence against women has been a topic for debate for a while now in the healthcare and legal sectors. This is because it has very bad implications on the moral rights, society welfare and health of the people (Ervin, 2002, p. 23). They include the family members of these individuals and the immediate community where these people belong. The World Health Organization and the Pan American Health Organization (WHO/PAHO) declared this to be a public health problem. As a result, they also recommended to the world the need to develop policies to address this issue, for purposes of its prevention and control (Ervin, 2002, p. 23).
Most of the government laws in the United States and Europe demand that states should implement intervention measures against violence on women based on the international standards of basic human rights. They should also focus on the indivisibility and the duty of the government to value and make obligatory the respect of these rights (Ervin, 2002, p. 23). The issue of domestic violence has been a real problem in the society since many communities are traditionally patriarchal and women have been considered lesser beings compared with men (World Health Organization, 2001). To handle this, there needs to be strategies in place to handle the violation of human rights resulting from domestic violence, For instance, the right to freedom, right to health, and right to have physical and emotional integrity, among others (Edelman & Mandle, 2002, p. 62).
Public healthcare provision to the community is a very good way of delivering institutionalized services (WHO, 2001). It has been found that many women resort to these services as they seek to gain justice or when acting as true guardians to the health needs of their families. As a result, there are three basic levels of prevention already highlighted above that can be applied to this problem- The primary, secondary and tertiary levels of prevention (WHO, 2001).
Primary prevention can be attended to through coordination among the health and education departments, and the community in general. This way, the primary prevention will strengthen the detection or recognition of violence against women as a violation of moral law and hence a problem (social health problem) (WHO, 2001). Under this level of prevention, the implementers seek to enhance strategies of diagnosing the risk of domestic violence, strategies of preventing it from happening, promotion of self-esteem or empowering the women to stand up for their rights (Ervin, 2002, p. 39). With such measures in place, women are more likely to be shielded from such violence.
Most of the strategies that dealt with domestic violence in the past have only been preventative by promoting the rights of women. This is especially the case in community based strategies by reaching out to families and couples, developing community awareness, and changing the attitude towards violence on women (WHO, 2001). Many laws are designed based on the concept of ensuring that they have full control over their health. Health promotion is also supposed to promote gender and human rights balance so that women too can be able to gain confidence to fight for their control (Ervin, 2002, p. 38).
Secondary Prevention aims at stopping violence against women as soon as it is detected or diagnosed by the health service providers or other players. This will help in keeping the victims and other people in the community from experiencing further violation of their right or further injury, either emotionally or physically (WHO, 2001).
There are a number of institutions in place for tackling the problem of violence against women and they need to be strengthened. These institutions are able to modify the attitude and behavior of the people at a community level and critically, they are able to comprehend the framework of implementing their intervention strategies. These institutions are hence very essential in the prevention of violence against women (Edelman & Mandle, 2002, p. 12).
It is also the responsibility of the existing facilities and service providers in the communities to ensure that they can detect when the domestic violence has happened , such as by looking at the family relationship, the impact on the children, and the issue of hospital attendance. Any sign that could suggest possible violence should be investigated. Both law enforcers and health practitioners and the community service should work together since the provision of these services require a great deal of coordination (Edelman & Mandle, 2002, p. 45). The impact of domestic violence against women has children as the victims and this is why the issue has to be addressed with stringiest laws and seriousness of their violation. Children need to be protected because they may not be in a position to stand up for their rights but could suffer silent and the implication of these psychological suffering could have dire consequences in their future lives (Edelman & Mandle, 2002, p. 52).
Tertiary prevention on the other hand deals with the problem of violence against women when the consequences are becoming excessive. The goal is to reduce further injury to the victims like the women and children by providing supportive care. These services may include treatment of the physical injuries, guiding and outselling session to address the psychological torment. There are times when specialized treatment can be recommended (Edelman & Mandle, 2002, p. 52). However, support groups play a very important role in facilitating rehabilitation of the victims. The perpetrators also get to be taken for correction in correction facilities and other to prisons where they can be dealt with accordingly.
Reasons Why a Comprehensive Health Program Should Address All Three Levels of Prevention
In health care service provision, most diseases can now be managed by prevention or their effects can be postponed by immunization, adopting healthy lifestyles, and chemoprophylaxis. Some diseases can even be detected early enough before even they begin showing symptoms (Clark, 2008, p. 34). The healthcare service providers such as physicians and nurses have the opportunity, medical resources and the expertise to prevent adverse implications of diseases, promote healthy living and also to totally cure some diseases. In community healthcare provision, health service goals are designed to conform to wellness promotion, prevention of illnesses. All these are properly understood at the levels of prevention. These levels are primary, secondary and tertiary as developed by Clark, 2008, p. 45. These various levels correspond to specific problems.
This provision of the three levels of prevention is very important for a comprehensive health program. Essentially, the three levels will offer services to individuals, families, and the community at large. The comprehensive program should unite each of the levels so that the patients can be freed from disease. Healthcare settings all address these levels from the clinics to homes from small health centers to major hospitals. The three levels will address health maintenance, health promotion, and education. Therefore, as primary levels allows stopping of the health problems before they happen, secondary level allows detection of the health problem so that appropriate measure can be put in place to halt the adverse consequence of the health problem. The tertiary level of prevention on the other hand provides rehabilitation and supportive services even when the problem has already happened so that the patient can still achieve they normal functionality and enjoy good quality of life even when sick of still suffering injury (Clark, 2008, p. 46).
The other reason is that by implementing the three levels of prevention, there is the likelihood that there will be the benefit of cost effectiveness which comes from the primary care. This is because the strategies used here actually help prevent the problems from occurring in the first place. Secondary prevention strategies included in the health program will institute something that is long-term, a change of attitude and behavior so that the occurrence of the problem in future is curbed or the horrible consequences are reduced. This is slightly costly and hard to achieve but it deals with the affected people directly to help them adapt or survive through their situation (Ervin, 2002, p. 39).
The tertiary prevention is almost like the secondary one since it deals with the problem when it has already happened and also seeks to revitalize people and train on behavior change. The main advantage of this is that it addressed the long-term illnesses and permanent injuries. The strategy also provides better rehabilitation services to the victims especially for those at risk of deterioration (Clark, 2008, p. 46). This could be more costly as it strives to reverse damage already done to individual in terms of physical, emotional and sometimes spiritual health. Sometimes the victims could be at a level where they are experiencing terminal illnesses of permanent injuries.
Explanation of Whether the Health Concern, At Which Level of Prevention, Is Most Cost Effective
The primary prevention is the most cost efficient strategy of addressing health problems, including the domestic violence issue. Under this level, on can be able to assess the individual needs of the people and the magnitude of the problem and from these, providers can be able to determine the other factors which causes more serious problems (Potter & Perry, 2004, p. 78). This level of prevention is always available for any kind of health problem and therefore can be applied to all conditions unless people just choose to neglect it. The primary level is a cheap solution to the providers, to the individual patients, to the family members and the community at large. This provides solutions to the providers who are able to recognize and implement assistance to the patient (Potter & Perry, 2004, p. 78: Clark, 2008, p. 46).
Nonetheless, the three levels of prevention are very important but the cost efficient of the primary level comes as a result of being able to stop a disease or a condition that could possibly have happened. The client benefits as he/she does not suffer the signs and symptoms of the diseases, and the damage to the body that comes with the illness or medical condition (Kozier & Erb, 2004, p. 34). Prevention means are very cheap and simple and implementation is easier. For instance, taking a child for basic immunization. This is free in most health care systems in different countries. Failure can cause a child to develop a number of diseases hence leading the problems to require secondary prevention. Once they happen, some diseases become permanent and consequently, progress to require tertiary prevention (Kozier & Erb, 2004, p. 34).
Clark, M. (2008). Community Health Nursing: Advocacy for Population Health (5th Ed.). Upper Saddle River, NJ: Prentice Hall.
Edelman, C.L., & Mandle, C. L. (2002). Health Promotion Throughout the Life Span. Sydney: Mosby.
Ervin, N. (2002). Advanced Community Health Nursing Practice. Upper Saddle River, NJ: Prentice Hall.
Kozier, B., & Erb, G. (2004). Fundamentals of Nursing: Concepts, Process, and Practice 7th Edition. New Jersey: Pearson Education Inc.
Potter, P., & Perry, A. (2004). Fundamentals of Nursing. Sydney: Mosby.
World Health Organization. (2001). The World Health Report 2001 – Mental Health: New Understanding, New Hope. Web.