Box 3.3Intervention Categories with Examples

The figure illustrates how interventions are related to a health event. The definitions of these categories are given below.

Image ch3fu1

Population-based interventions all aim at primary prevention (as defined below), are directed to entire populations or large subgroups, and fall into three categories:

  • Promoting personal behavior change (diet, exercise, smoking, sexual activity)
  • Control of environment hazards (air and water pollution, disease vectors)
  • Medical interventions (immunization, mass chemoprophylaxis, large-scale screening, and referral)

Personal interventions are directed to individuals, and can be intended for the following:

  • Primary prevention—to reduce the level of one or more risk factors, to reduce the probability of initial occurrence of disease (medication for hypertension to prevent stroke, or heart attack), or to reduce the likelihood of disease when the risk factor is already present (prophylaxis for sickle-cell anemia).
  • Secondary prevention following the occurrence of disease—to prevent another event of the same kind (medication to reduce the likelihood of a second coronary event) or to reduce the risk of a different but related event (medication to reduce the likelihood of a first heart attack after stroke).
  • Cure—to remove the cause of a condition and restore function to the status quo ante (surgery for appendicitis).
  • Acute management—to provide short-term activity to decrease the severity of acute events or the level of established risk factors, to minimize their long-term impacts (thrombolytic medication following heart attack, angioplasty to reduce stenosis in coronary arteries).
  • Chronic management—to provide continued activity to decrease the severity of chronic conditions or prevent deterioration (medication for unipolar depression, insulin for diabetes). Chronic management can include some secondary prevention.
  • Rehabilitation—to provide full or partial restoration of physical, psychological, or social function that has been damaged by a previous disease or condition (therapy following musculoskeletal injury, counseling for psychological problems).
  • Palliation—to reduce pain and suffering from a condition for which no cure or rehabilitation is currently available (analgesics for headache, opiates for terminal cancer).
    Source: DCP2, chapter 15, box 15.1.

From: Chapter 3, Cost-Effectiveness Analysis

Cover of Priorities in Health
Priorities in Health.
Jamison DT, Breman JG, Measham AR, et al., editors.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.

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