The reasoning: map interventions to the natural history
| Level | Phase targeted | Modes of intervention | Examples |
|---|---|---|---|
| Primordial | Before risk factors emerge in a population | Policy, environment, social norms | Salt/trans‑fat limits, smoke‑free laws, school activity, urban design |
| Primary | Risk present, pre‑pathogenesis | Health promotion + specific protection | Vaccines, iodised salt, chlorination, helmets, LLINs, PrEP |
| Secondary | Early pathogenesis (DPCP) | Early diagnosis and adequate treatment | Screening for HTN/DM/cancer, active case finding for TB, contact tracing |
| Tertiary | Clinical disease with sequelae | Disability limitation + rehabilitation | Treating diabetic foot, stroke rehab, MCR footwear, self‑care in leprosy |
| Quaternary | Across all levels | Protection from overmedicalisation | Avoiding unnecessary imaging, overdiagnosis, polypharmacy |