Ted Lankester, Nathan J Grills Oxford University Press, 2019, PB, 538pp, £24.99, 978-0198806653
Around half of the global population lack access to full basic health care. The sheer burden of health needs and challenges facing many low- and middle-income countries can seem insurmountable. Global health has received increasing attention within medical training, yet the gap between awareness of need and ability to confront health inequalities through primary care remains.
This book aims to provide an introduction to starting, developing, and sustaining community-based healthcare programmes within low-resource settings. Both clinical and structural aspects of health system development are covered using a ‘back to basics’ style. Topics are practical and realistic, often born through the authors’ lived experiences of what does and doesn’t work within different settings. A significant emphasis is placed on the importance of community empowerment and partnership in identifying and meeting local needs. This goes beyond health provision, considering the importance of wider community and environmental factors, identifying and meeting social needs, working with traditional and faith-based community groups, and supporting the development of civil society. Often neglected topics are given much needed attention, including physical disabilities and rehabilitation, mental health, domestic violence, and palliative care.
Refreshingly, attention is given to the sustainability and resilience of healthcare systems, including management of personnel, finance, and potential risks stemming from natural or man-made disasters. Strategies to monitor and evaluate the impact of health programmes receive due attention, with direction for improvement over time.
In terms of limitations, the breadth of topics covered results in theory tending to be generalised at points. Furthermore, the majority of contributors are based within the UK, US, and other anglophone nations.
Nevertheless, this is an engaging read and a worthwhile resource. Whether you are considering an overseas work placement, are involved in global health policy, planning, or research, or simply want to widen your horizons on the delivery of community-focused health care for vulnerable populations, each chapter provides sound food for thought. Who knows what it might inspire you to do?
- © British Journal of General Practice 2020
