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Prevention paradox and causes in preventive health services

Nuri Mehmet Basan, Nazmi Bilir.

Abstract
During the second half of the last century, world achieved major success in the prevention and control of communicable diseases. As deaths in early life were successfully prevented and more people could live longer, health problems of the adults and the old age groups emerged. In line with the industrial developments, the life style of the communities changed, namely change of eating habits, exercise and tobacco use. Thus, the non-communicable diseases (NCD) have become the more common health problems of the “modern” societies. Non-communicable diseases have multifactorial etiology and no definitive treatment. Therefore, the need for prevention of NCD’s have become a major challenge. Although the preventive approaches for the NCD’s are successful at the community level, their benefit for the individuals do not take much attention. This phenomenon is called as “paradox of prevention”. In this article, causes of prevention paradox are discussed at society, health professionals and government levels, which are the main parties to the health services. The major factors at the society level are low health literacy level, invisibility of success in preventing disease, need to change of attitude and behavior, under estimation of prevention by employers and price rates system. Factors at the health professional’s level are inability to identify the needs of the community clearly, lack of knowledge and motivation, inadequacy of incentive mechanisms for preventive health services, shift to therapeutic services and missing inequalities. At the government level, giving attention to the requests of society rather than needs and lack of supervision are important factors.

Key words: preventive health services, preventive medicine, prevention paradox


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