B.SC-CHN-1-SEM-5-UNIT-1-Concepts of Community Healthand Community Health Nursing
🌍 Definitions: Public Health, Community Health, and Community Health Nursing
🩺 1. Public Health – Definition
Public Health is the science and art of preventing disease, prolonging life, and promoting health through organized efforts and informed choices of society, organizations, public and private sectors, communities, and individuals.
🔍 Key Points:
Focuses on population-level health, not individuals
Emphasizes health promotion, disease prevention, sanitation, and epidemiology
Involves policy-making, education, vaccination programs, health laws, and environmental safety
Community Health is a branch of public health that focuses on the health status, needs, and problems of specific populations or communities, and implements strategies to improve their health and well-being.
🔍 Key Points:
Concerned with healthcare delivery to people living in a defined geographic area (urban/rural)
Addresses local health issues, such as malnutrition, sanitation, immunization, maternal-child care
Encourages community participation and empowerment
📌 Example:
Organizing school health programs in a rural village
Running health education camps for slum dwellers
Monitoring TB cases in a district
👩⚕️ 3. Community Health Nursing – Definition
Community Health Nursing is a field of nursing that combines nursing knowledge, public health principles, and social science to provide preventive, promotive, curative, and rehabilitative services to individuals, families, and communities.
🔍 Key Points:
Works at home, schools, clinics, and community centers
Promotes health education, immunizations, home visits, antenatal care, etc.
Encourages self-care, family involvement, and use of local resources
Acts as a link between the health system and the community
📌 Example:
A nurse conducting postnatal home visits
Health worker educating mothers about exclusive breastfeeding
Community nurse organizing deworming and nutrition days
Involves local leaders, NGOs, and healthcare workers
Involves family education, direct care, and follow-ups
🎯 Summary:
🧠 Public Health = Big picture of population health
🏘️ Community Health = Health of specific groups in specific places
👩⚕️ Community Health Nursing = Nursing role in community-based health promotion and care
🇮🇳 Public Health in India and Its Evolution
“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” – WHO
🌍 What is Public Health in India?
Public Health in India refers to organized efforts—by the government, health agencies, and society at large—to protect and promote the health of entire populations through:
Prevention of diseases
Prolongation of life
Promotion of healthy living conditions
Access to essential healthcare services
It includes a comprehensive approach that covers:
🏥 Primary health care
💉 Immunization programs
👶 Maternal & child health
🧼 Sanitation and safe water
🦠 Communicable disease control
📢 Health education and awareness
🕰️ Evolution of Public Health in India
Explained in Five Distinct Phases
📜 1. Ancient Period (Before 1000 AD)
Health practices rooted in Ayurveda, Yoga, and Naturopathy
Key texts:
Charaka Samhita – concepts of digestion, immunity, and balance
Sushruta Samhita – ancient surgical techniques and wound care
Emphasis on personal hygiene, sanitation, balanced diet, and mental well-being
Community wells, hospitals, and herbal medicine used in ancient civilizations (e.g., Indus Valley)
Emperor Ashoka promoted public health by building hospitals, rest houses, and planting medicinal trees
🕌 2. Medieval Period (1000–1800 AD)
Decline of organized public health infrastructure
Healthcare managed by local vaidyas, hakims, and traditional healers
Unani medicine introduced by Arab and Persian influence
Some kings (e.g., during Mughal rule) supported construction of hospitals and water systems
🔸 However, this period lacked a centralized public health policy
🇬🇧 3. Colonial Period (1800–1947)
This period laid the foundations of structured public health systems, mainly to serve the British military and civil administration, not native populations.
🔹 Key Events and Reforms:
1864: First Sanitary Commissioner appointed
1869: Establishment of the Public Health Department
1881: First Indian Factories Act to ensure worker safety
1897:Epidemic Diseases Act to control plague outbreaks
1920: Establishment of Local Self-Government in health
1946:Bhore Committee Report (milestone)
Recommended universal health coverage
Introduced idea of Primary Health Centres (PHCs)
Advocated integration of preventive and curative services
🇮🇳 4. Post-Independence Period (1947 Onwards)
India made public health a development priority through planned strategies and national programs.
🔹 Key Milestones by Decade:
1950s–60s
First Five-Year Plan (1951): Focused on rural health services
1953: Launch of National Malaria Control Programme
1962: Start of National Family Planning Programme (world’s first)
1970s–80s
Expanded Program on Immunization (EPI) → later became UIP
1978: India signed Alma-Ata Declaration (Health for All)
1983: First National Health Policy (NHP) – aimed at equitable health care
1990s–2000s
1997: Revised National Tuberculosis Control Programme (RNTCP)
2005:National Rural Health Mission (NRHM) launched
Introduced Accredited Social Health Activists (ASHAs)
🏥 5. Modern Era: Health for All and Universal Health Coverage
India’s current public health strategy emphasizes universal access, digital innovation, and health equity.
🔹 Recent Initiatives:
2017: Launch of National Health Policy 2017
Emphasis on preventive and promotive care
Strengthening primary healthcare
2018: Launch of Ayushman Bharat with two pillars: 1️⃣ Health and Wellness Centres (HWCs) – strengthening primary care 2️⃣ PM-JAY – free secondary and tertiary hospital care for poor families
2021 onward: Integration of digital health mission
ABHA ID, e-Hospitals, telemedicine
Ongoing programs:
National AIDS Control Program (NACP)
National Mental Health Program (NMHP)
National Programme for Non-Communicable Diseases (NP-NCD)
🧠 Public Health Infrastructure in India
Level
Facility
Population Covered
Sub-Centre
Auxiliary Nurse Midwife (ANM)
3,000–5,000
Primary Health Centre (PHC)
Medical Officer, 24×7 services
20,000–30,000
Community Health Centre (CHC)
Specialist-based services
80,000–1.2 lakh
District Hospital
Secondary level care
District population
📌 Public Health Challenges in India Today
Burden of non-communicable diseases (NCDs)
Maternal and child mortality in some states
Malnutrition and anemia
Pollution and climate change effects
Inequity in rural vs. urban health access
Shortage of healthcare professionals
Managing epidemics/pandemics (e.g., COVID-19)
✅ Summary: India’s Public Health Journey
Phase
Focus
Ancient
Ayurveda, hygiene, holistic wellness
Medieval
Localized care, Unani medicine
Colonial
Foundations of public health, Bhore Committee
Post-Independence
National programs, policy reforms
Modern
Universal health coverage, Ayushman Bharat, digital health
👩⚕️ Scope of Community Health Nursing
Community Health Nursing (CHN) integrates nursing practice and public health principles to care for individuals, families, and communities with the goal of health promotion, disease prevention, and quality life improvement.
🧭 Overview:
The scope of Community Health Nursing extends beyond clinical care. It involves:
Direct nursing care in homes, schools, and clinics
Health education and awareness
Disease prevention and health promotion
Community empowerment and family-centered care
Policy advocacy and public health planning
📚 Detailed Areas of Scope in Community Health Nursing
1️⃣ Individual and Family Health Care
Conducting home visits for assessment, care, and follow-up
Managing acute and chronic illnesses at the community level
Providing maternal and child care
Promoting safe motherhood and family planning
Educating on personal hygiene, nutrition, immunization, etc.
📌 Example: A community health nurse visits a newborn for postnatal care and advises the mother on breastfeeding and immunization.
2️⃣ Maternal and Child Health (MCH) Services
Antenatal, intranatal, and postnatal care
Monitoring growth and development of children
Conducting nutrition programs and anemia prevention
Promoting exclusive breastfeeding and child immunization
📌 Example: Organizing a nutrition day and distributing iron-folic acid tablets to adolescent girls.
3️⃣ School Health Nursing
Health screening and assessment in schools
Health education on personal hygiene, puberty, nutrition, and safety
First aid and referral for illness or disability
Monitoring mental health and behavior issues
📌 Example: A CHN organizes a deworming day and teaches children about hand washing.
4️⃣ Occupational Health Nursing
Promoting health and safety among workers in factories, offices, and fields
Educating caregivers on fall prevention, nutrition, and rehabilitation
Supporting palliative and end-of-life care
📌 Example: Teaching a caregiver how to manage pressure sores and feed an elderly stroke survivor.
6️⃣ Prevention and Control of Communicable Diseases
Identifying and managing diseases like TB, malaria, HIV, COVID-19
Supporting vaccination campaigns and contact tracing
Health education on handwashing, sanitation, and safe practices
Promoting early reporting and referral
📌 Example: Conducting community awareness on dengue prevention and distributing mosquito nets.
7️⃣ Non-Communicable Disease (NCD) Control
Screening for diabetes, hypertension, cancer
Counseling on lifestyle modifications (diet, exercise, substance abuse)
Monitoring compliance with treatment
Supporting mental health awareness and stress reduction
📌 Example: Running a hypertension camp and checking BP of villagers above 40 years.
8️⃣ Disaster Nursing and Emergency Care
Providing first aid, triage, and psychological support in disasters
Participating in relief operations during floods, earthquakes, epidemics
Educating community on disaster preparedness
📌 Example: Assisting in flood relief camp with wound care and health surveillance.
9️⃣ Rehabilitation and Special Needs Support
Physical and psychosocial rehabilitation after accidents, strokes, disabilities
Assisting families with disabled children or mental illness
Liaison with physiotherapists and counselors
📌 Example: Teaching exercises to a stroke survivor’s family for home rehabilitation.
🔟 Health Education and Behavior Change Communication
Promoting healthy behaviors using tools like charts, role play, puppet shows
Conducting IEC (Information, Education, and Communication) activities
Using mass media and local influencers for wider impact
📌 Example: Educating a group of mothers on oral rehydration solution (ORS) using flip charts.
🔁 Administrative and Research Roles
Planning and conducting health surveys and family health records
Supervising ASHA workers and health assistants
Participating in research and evaluation of community health programs
📌 Example: A CHN supervises ASHAs during the Village Health and Nutrition Day (VHND).
🌈 Summary of the Scope of Community Health Nursing
Area
Focus
Preventive
Immunization, health education, screening
Promotive
Nutrition, hygiene, lifestyle promotion
Curative
Treatment of common illness, minor ailments
Rehabilitative
Care for disabled, elderly, mental health
Administrative
Supervision, planning, reporting
Educational
Teaching individuals and groups
Research
Community surveys and program evaluation
🌿 Concepts of Health
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” – World Health Organization (WHO), 1948
🌈 What is Health?
Health is a dynamic, multidimensional concept that includes physical, mental, social, emotional, spiritual, and economic well-being. It is not just the absence of illness but the ability to lead a productive life.
✅ Main Concepts of Health
1️⃣ Biomedical Concept
Health = Absence of disease or illness
Body is seen like a machine — fix the part that is not working.
Focus is on diagnosis and treatment
🔎 Limitation: Ignores social, psychological, and environmental aspects.
2️⃣ Ecological Concept
Health is seen as a balance between the person and their environment
Disease occurs when there is an imbalance between the host (person), agent (disease-causing factor), and environment
📌 Used in epidemiology Example: Poor sanitation → cholera outbreak
3️⃣ Psychosocial Concept
Health is influenced by social, psychological, cultural, and economic factors
Mental health, family support, income, and education affect overall well-being.
🧠 Recognizes stress, anxiety, poverty as health-affecting factors
4️⃣ Holistic Concept
Combines biomedical, ecological, and psychosocial approaches
Emphasizes total well-being: body, mind, spirit, and society
Promotes preventive, promotive, curative, and rehabilitative care
💡 Used in modern community health and nursing care
🧩 Dimensions of Health
Dimension
Description
🧍 Physical
Efficient body functioning and freedom from disease
🧠 Mental
Ability to cope with stress, emotions, and relationships
🫂 Social
Ability to form satisfying interpersonal relationships
✝️ Spiritual
Harmony, purpose of life, inner peace
📖 Intellectual
Ability to think clearly, learn, and use knowledge effectively
💼 Occupational
Satisfaction with one’s job and work-life balance
🌎 Environmental
Living in a clean, safe, and sustainable environment
🎯 Summary
Concept
Focus
Key Idea
Biomedical
Disease
Health = No illness
Ecological
Environment
Balance of host–agent–environment
Psychosocial
Mind + Society
Mental, emotional, social roles
Holistic
Whole person
Complete well-being in all dimensions
🌿 1. Definition of Health
Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. — World Health Organization (WHO), 1948
✅ Expanded Explanation:
Health is a positive concept emphasizing well-being rather than just the absence of illness.
It includes the ability to:
Perform daily activities efficiently
Maintain relationships and fulfill social roles
Cope with physical, emotional, and environmental challenges
Live a productive and meaningful life
🔹 Key Dimensions of Health:
Dimension
Description
Physical
Body’s ability to function efficiently (e.g., no pain, strength, fitness)
Mental
Emotional well-being, ability to handle stress, stability
Social
Ability to form and maintain healthy relationships
Spiritual
Inner peace, purpose of life, values and beliefs
Environmental
Safe surroundings, clean air/water, access to healthcare
📌 Example:
A healthy person not only has no fever or pain, but also feels happy, sleeps well, and socializes actively.
🤧 2. Definition of Illness
Illness is the subjective experience of feeling unwell, which may or may not be associated with a diagnosable disease.
✅ Expanded Explanation:
Illness reflects how the individual perceives and responds to symptoms or discomfort.
It is influenced by culture, emotions, lifestyle, and personal understanding of health.
Two people with the same disease may experience illness differently.
🔹 Key Characteristics:
It is subjective — only the person experiencing it can describe it
It may occur with or without the presence of a disease
It affects behavior (e.g., withdrawing from work, seeking help)
📌 Example:
A person may feel tired, dizzy, or low even if all medical tests are normal.
🧪 3. Definition of Disease
Disease is an objective abnormality in the body’s structure or function, usually identified through clinical signs, symptoms, and diagnostic tools.
✅ Expanded Explanation:
Disease involves pathological changes at the tissue, organ, or system level.
It can be:
Acute or chronic
Infectious or non-infectious
Congenital or acquired
May be symptomatic or asymptomatic
🔹 Key Features:
Measurable through medical tests (lab, imaging, physical exams)
May not be felt or noticed immediately by the individual
Can affect any system in the body — nervous, respiratory, cardiovascular, etc.
📌 Example:
A person may have hypertension or diabetes (disease) but not feel unwell (no illness yet).
🔄 Difference Between Health, Illness, and Disease
Feature
Health
Illness
Disease
Meaning
Complete well-being
Feeling unwell
Pathological condition
Nature
Positive and dynamic
Subjective experience
Objective condition
Detected by
Individual’s functioning and satisfaction
Self-reported symptoms
Clinical diagnosis/tests
Presence of symptoms
No symptoms
May have symptoms
May or may not have symptoms
Example
Energetic, balanced life
Nausea, fatigue without test findings
Diabetes, TB, cancer
🧠 Summary:
Health is a state of balance and full well-being.
Illness is how one feels when that balance is disturbed.
Disease is a medical condition causing structural or functional change, whether symptoms are felt or not.
🤒 Concept of Illness and Disease
🩺 Definition of Disease:
Disease is a pathological or biological abnormality in body structure or function, usually identifiable by signs, symptoms, and diagnostic tests.
It often involves an organic or functional disturbance.
Disease may or may not be experienced by the person (can be asymptomatic).
📌 Example: Diabetes mellitus, tuberculosis, cancer
🤧 Definition of Illness:
Illness is the personal experience of feeling unwell, which may or may not be due to a diagnosable disease.
Illness is subjective and includes physical, emotional, and social suffering.
A person can feel ill without having a disease (e.g., fatigue, anxiety) or have a disease without feeling ill (e.g., early hypertension, early HIV).
📌 Example: Feeling weak, headache, nausea, even if test results are normal
🔄 Key Differences Between Illness and Disease
Aspect
Disease
Illness
Nature
Objective, biological
Subjective, personal experience
Diagnosis
Can be diagnosed by tests
May not show in tests
Seen By
Doctor or healthcare system
Felt by the patient
Example
Asthma, TB, diabetes
Feeling tired, pain, dizziness
📈 Stages of Illness
Symptom Experience
Person notices physical or mental discomfort
Assumption of Sick Role
Accepts being ill, decides to seek help
Medical Care Contact
Consults a healthcare professional
Dependent Role
Accepts treatment and depends on the system
Recovery/ Rehabilitation
Returns to normal or adjusts to chronic condition
🧪 Types of Diseases
🔹 Based on Duration:
Acute Disease – Sudden onset, short course (e.g., influenza, diarrhea)
Income level, education, occupation, and social status
Poverty → limited access to healthcare and good nutrition
🔹 5. Health Services Determinants
Availability, accessibility, affordability, and quality of health services
Includes vaccination, hospitals, maternal care, and emergency services
🔹 6. Cultural and Religious Determinants
Beliefs and practices related to health, food, hygiene, and illness
Influence acceptance of treatment or health education
📌 Example: Some communities may avoid vaccination due to myths.
🔹 7. Political/Policy Determinants
Government health policies, health insurance, public health laws
National programs (e.g., Ayushman Bharat, Swachh Bharat)
📊 Summary Table
🔹 Dimensions of Health
🧭 Determinants of Health
Physical
Biological factors
Mental
Lifestyle behaviors
Social
Environment and sanitation
Emotional
Socioeconomic conditions
Spiritual
Culture and religion
Environmental
Health policies/services
Occupational
Education and employment
⚠️ Dimensions and Determinants of Disease
📐 I. Dimensions of Disease
A disease is not just a physical abnormality. It affects multiple dimensions of a person’s life. These dimensions explain how disease manifests, progresses, and impacts an individual.
🔹 1. Physical Dimension
Biological or structural abnormality in organs or tissues
Measurable changes: pain, fever, lesions, abnormal labs/tests 📌 Example: Cough in TB, paralysis in stroke
🔹 2. Psychological Dimension
Emotional and mental effects of disease
Anxiety, depression, denial, stress due to illness 📌 Example: Depression after cancer diagnosis
🔹 3. Social Dimension
Effect of disease on personal relationships, social roles, and stigma
Isolation, family stress, unemployment, social exclusion 📌 Example: Leprosy or HIV leading to stigma and social rejection
🔹 4. Economic Dimension
Financial burden of treatment, job loss, decreased productivity 📌 Example: A daily-wage worker with a chronic illness loses income
🔹 5. Spiritual Dimension
Emotional suffering or existential distress
Questioning life purpose, fear of death, loss of faith 📌 Example: Terminally ill patient experiencing spiritual grief
🔬 II. Determinants of Disease
Determinants of disease are the various factors that cause or influence the occurrence and severity of disease in individuals or populations.
These determinants can be biological, behavioral, environmental, social, or economic in nature.
Poor access to healthcare and nutritious food 📌 Example: Malnutrition in children of low-income families
🔹 6. Cultural and Belief Systems
Myths and misconceptions about diseases and treatment
Preference for traditional healers or stigma around disease 📌 Example: Refusal of vaccination due to cultural beliefs
🔹 7. Health System Factors
Availability and accessibility of quality healthcare services
Efficiency of disease surveillance, immunization, and follow-up 📌 Example: Delayed treatment due to poor rural health access
🧠 Summary Table
🔹 Dimensions of Disease
🔬 Determinants of Disease
Physical
Agent (bacteria, virus, toxin)
Psychological
Host (age, immunity)
Social
Environment (housing, water)
Economic
Lifestyle (diet, smoking)
Spiritual
Socioeconomic status, culture
🧩 Example – Tuberculosis (TB):
Dimension:
Physical: cough, weight loss
Psychological: anxiety, fear
Social: isolation due to stigma
Economic: job loss due to illness
Determinants:
Agent: Mycobacterium tuberculosis
Host: malnutrition, low immunity
Environment: overcrowded housing
Socioeconomic: poverty, poor access to health care
🧬 Natural History of Disease
📘 Definition:
Natural history of disease refers to the course or progression of a disease process in an individual from its onset (beginning of pathological changes) to its resolution, either through recovery, disability, or death — without medical intervention.
It explains what happens to a person if no preventive or curative measures are taken.
🧭 Phases of the Natural History of Disease
The process is divided into two major phases:
1. Pre-Pathogenesis Phase (Before disease onset)
2. Pathogenesis Phase (After disease onset)
🔹 I. Pre-Pathogenesis Phase
The stage where the disease has not yet entered the body, but the factors that can lead to disease are present.
⚙️ Characteristics:
Interaction of agent, host, and environment occurs
Individual is not yet sick, but is at risk of developing disease
Focus is on health promotion and primary prevention
📌 Example:
A healthy person living in a dengue-prone area with poor sanitation
A person with unhealthy lifestyle habits at risk for diabetes
🔹 II. Pathogenesis Phase
This stage begins when the disease process starts inside the body, even if no symptoms are present.
It is divided into three substages:
🧬 A. Early Pathogenesis (Subclinical Stage)
Disease process has started, but no signs or symptoms yet
Pathological changes can occur silently (can be detected by screening)
📌 Example:
HIV positive but asymptomatic
High blood sugar in prediabetes
Cancer cells forming without symptoms
✅ Target for Secondary Prevention (early diagnosis)
🤒 B. Clinical Stage
Onset of signs and symptoms
Disease is now diagnosable through clinical tests
May include acute, chronic, or recurrent symptoms
📌 Example:
Cough, fever, weight loss in active TB
Pain and swelling in arthritis
✅ Target for Secondary and Tertiary Prevention
🧓 C. Outcome Stage
Depending on the disease and treatment, the outcome may be:
Recovery
Disability (temporary or permanent)
Death
📌 Example:
Stroke leading to paralysis (disability)
Pneumonia cured by antibiotics (recovery)
Untreated cancer leading to death
✅ Target for Tertiary Prevention (rehabilitation and supportive care)
🌈 Summary of Stages & Prevention Levels
Stage
Characteristics
Prevention
Pre-pathogenesis
No disease yet
Primary (health education, vaccination)
Early pathogenesis
Disease started, no symptoms
Secondary (screening, early detection)
Clinical stage
Symptoms appear
Secondary & Tertiary (diagnosis, treatment)
Outcome
Recovery, disability, or death
Tertiary (rehabilitation, palliative care)
📌 Example – Natural History of Tuberculosis (TB)
Stage
What Happens
Pre-pathogenesis
Person exposed to TB bacteria but not infected
Early pathogenesis
TB bacteria present, latent TB infection (no symptoms)
Clinical stage
Active TB disease – cough, fever, weight loss
Outcome
With treatment → recovery; without treatment → disability or death
🎯 Why Is This Important?
Helps plan effective prevention strategies
Understands where interventions are most needed
Used in public health program planning and epidemiology
Guides screening programs and health policy
🛡️ Levels of Prevention
The concept of prevention in healthcare refers to actions taken to prevent the occurrence, progression, or complications of disease.
🌟 Three Main Levels of Prevention
Level
Goal
Target Stage
Primary
Prevent disease before it occurs
Pre-pathogenesis
Secondary
Detect and treat disease early
Early pathogenesis
Tertiary
Limit disability and promote rehabilitation
Late pathogenesis/outcome
🟢 1. Primary Prevention
Aim: To prevent the onset of disease by removing risk factors or enhancing resistance before the disease starts.
🔍 Focus:
Promote general health
Reduce exposure to risk factors
Strengthen the body’s defense (immunity)
🧰 Types of Primary Prevention:
Health promotion: Education, lifestyle change, nutrition
Specific protection: Vaccination, use of PPE, safe drinking water
📌 Examples:
Immunization against measles or hepatitis B
Health education about balanced diet and exercise
Use of mosquito nets to prevent malaria
Fortification of food (e.g., iodized salt)
Providing safe drinking water and sanitation
🟡 2. Secondary Prevention
Aim: To detect disease early and treat promptly to prevent complications or spread.
🔍 Focus:
Screening and early diagnosis
Prompt treatment to halt progression
Limit disability or spread
🧰 Methods of Secondary Prevention:
Screening tests
Periodic medical check-ups
Early case finding
Isolation (for infectious diseases)
📌 Examples:
Pap smear screening to detect early cervical cancer
Checking blood pressure to detect early hypertension
Mammography for breast cancer screening
Testing blood sugar for early diabetes
Contact tracing and early treatment in TB
🔴 3. Tertiary Prevention
Aim: To reduce the impact of an existing disease by limiting disability, rehabilitation, and restoring function.
🔍 Focus:
Prevent complications
Restore optimal function
Provide support for chronic illness or disability
🧰 Methods of Tertiary Prevention:
Physical therapy
Vocational rehabilitation
Psychological counseling
Assistive devices (wheelchairs, prosthetics)
📌 Examples:
Rehabilitation of stroke patient with physiotherapy
Insulin therapy and diabetic foot care in diabetes
Cardiac rehab after heart attack
Occupational therapy for children with cerebral palsy
Palliative care for terminal cancer patients
📊 Comparison Summary Table
Feature
Primary Prevention
Secondary Prevention
Tertiary Prevention
Purpose
Prevent disease occurrence
Detect and treat early
Reduce complications and restore function
Stage
Before disease begins
Early disease
Established disease
Action
Health promotion, immunization
Screening, early diagnosis
Rehabilitation, supportive care
Example
Tetanus vaccination
Blood sugar testing
Stroke rehabilitation
🧠 Why Is It Important to Know the Levels of Prevention?
Helps design health programs and policies
Guides nurses and public health workers in intervention planning
Enhances cost-effective disease management
Promotes population-based health care
🇮🇳 Health Profile of India
India faces a complex mix of communicable diseases, non-communicable diseases, nutritional deficiencies, environmental hazards, and population challenges—often coexisting in both rural and urban settings.
🧠 I. Major Health Problems in India (with Details & Examples)
🦠 1. Communicable Diseases
Still a significant cause of morbidity and mortality, especially in rural and low-income populations.
🔹 Key Diseases:
Tuberculosis (TB):
India accounts for over 26% of the world’s TB cases (WHO Global TB Report 2023)
Rise in MDR-TB (multi-drug-resistant TB)
Diarrheal Diseases:
Second leading cause of death in children under 5
Linked to poor sanitation, hygiene, and water quality
Vector-Borne Diseases:
Malaria, Dengue, Chikungunya, Filariasis
Outbreaks occur seasonally, particularly during monsoons
HIV/AIDS:
Estimated 2.4 million people living with HIV in India
Stigma and lack of awareness remain barriers
Acute Respiratory Infections (ARI):
Major killer of under-five children
Often caused by pollution and poor nutrition
🧬 2. Non-Communicable Diseases (NCDs)
Now responsible for over 63% of all deaths in India (ICMR-NCDIR 2023).
🔹 Leading NCDs:
Cardiovascular Diseases (CVDs):
Leading cause of adult deaths
Rising due to hypertension, stress, poor diet
Diabetes Mellitus:
Over 77 million diabetics (IDF 2023)
“Diabetes Capital of the World”
Cancer:
~14 lakh (1.4 million) new cases annually
Breast, oral, cervical, and lung cancers most common
Chronic Respiratory Diseases:
COPD, Asthma increasing due to air pollution and tobacco use
Mental Health Disorders:
~10% of population has mental illness
Depression, anxiety, suicide rates rising, especially in youth
👶 3. Maternal and Child Health Problems
Despite improvements, India still faces challenges in reproductive and child health.