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District health care: Challenges for planning, organisation and evaluation in developing countries, 2nd edition
TRANSACTIONS
OF THE
ROYAL
SOCIETY
OF TROPICAL
MEDICINE
1Book Reviews 1 District Health Care: Challenges for Planning, Organisation and Evaluation in Developing Countries, 2nd edition. R. Amonoo-Lartson, G. J. Ebrahim, H. J. Love1 & J. P. Ranken. London and Basingstoke: Macmillan Education Ltd, 1996. vii+296un. Price &lOSO. ISBN O-333-57349-8. The importance of primary health care is increasingly recognized, in both developed and underdeveloped countries, as the one practical way to deliver a reasonable standard of care to the majority of the population. This is a shift away from the traditional hospital and medical oriented models of care which have often been dominant up to now. Primary health care is a less glamourous path but will ultimately deliver greater health benefit at less cost. This book is concerned with the management of primary health care services in a district in developing countries and would be of particular value as a training manual for those who find themselves in this position and who often have little management experience. It contains chapters on the aims of primary care and on the need for leadership in management so as to motivate the community to self reliance. The experience of the authors comes out in the careful identification of the pitfalls which await the unwary manager who fails to integrate his or her health. services with the needs and desires-of the community. It has elements of public health concerned with assessing the health care needs of the community. There are chapters on developing an appropriate health care plan and on how to implement it; these include useful sections on the nature of organizations and why they sometimes go wrong. There is a chapter on how to monitor the success of the management, both in terms of the process and its outcomes (again shading into public health). This is often standard managerial teaching, but it is presented in very accessible form for the non-manager, and tempered by a wealth of hard-won experience. There are few other books which help a professional such as a doctor or nurse make the transition to a successful manager, and therefore this comprehensive book can be recommended. It is at times rather long-winded and not an easy read; despite this I think it is worth the effort, rewarding detailed study rather than casual browsing. T. Wallev Department of Pharmacology and Therapeutics University of Liverpool New Medical Building Ashton Street P.O. Box I47 Liverpool, L69 3BX, UK
AND
HYGIENE
(1996)
90,588
mation. The authors have tackled these problems pretty even-handedly: drugs for all the major parasitic diseases are represented (although the list is not exhaustive), and information is presented in such a way that health-care professionals should be able to access the section required with minimal ‘flicking’. Potential readers should be aware that this is not a textbook of pharmacology and therapeutics: rather, it is an accessible collection of drug monographs arranged alphabetically, each laid out in a standardized manner. The book does not, therefore, primarily set out to provide systematic instruction on drug categories and its usefulness to the revising medical student will be more as a specific reference text (although I have my doubts about its relevance in this setting-few medical schools, even those in endemic countries, would require much detailed knowledge about antioarasitic drugs). Similarlv, the book does n% set out to guide the ieader in the therapeutic use of drugs: the doctor or nurse must know in advance which drug she/he wants to use-only then can she/he find the appropriate part of the book. The main users of this handbook will be either (i) academics with an interest in antiparasitic drugs or (ii) clinicians (using this term in its broadest sense) who treat parasitic infections frequently and are thus familiar with the drugs, but need to look things up from time to time. These 2 groups will be well served by a handy little book. The principal sections within each monograph are preamble, chemical structure, physical properties, mechanism of action, pharmacokinetics, clinical trials, indications, pregnancy and lactation, side effects, contraindications, interactions, dosage, and preparations. In other words, each monograph deals with topics as ‘academic’ as drug disposition and as ‘practical’ as dosage: this is inescapable given the range of disciplines for which the book is written. I did wonder whether ease of reference would be enhanced by including sections on drug resistance and management of poisoning. However, these topics are covered already, where relevant, and the authors are certainly pushed for space. I liked this book’s first edition and I like the present edition too: it has a definite place on the bookshelves of academics and pharmacy departments and at the ‘sharp end’ of patient treatment. Peter Winstanley Department of Pharmacology and Therapeutics University of Liverpool New Medical Building Ashton Street l? 0. Box 147 Liverpool, L69 3BX, UK
Parasitology for the 21st Century. M. Ali Ozcel & M. Ziya Alkan (editors). Wallingford: CAB International, 1996. xx + 287 pp. Price 555.00. ISBN O-85198-977-2. Handbook of Drugs for Tropical Parasitic Infections f2nd edition). Y. Aden Abdi, L. L. Gustafsson, 0. x----m ~~ Ericsson & e. Hellgren. London: Taylor & Francis, 1995. x+182pp. Price U8.50. ISBN 074840168-7. This book sets out to ‘give physicians, pharmacists, health workers, medical students and nurses in developing countries refined and abbreviated information about drugs used for parasitic infections’ and, by and large, it succeeds very well. Although at first glance the topic might seem easy to fit into a 180 pages pocket-sized book, upon reflection it becomes clear that (i) there is an awfully large number of drugs used for tropical parasitic infections and (ii) the various disciplines at whom the book is ‘aimed’ will each want to extract different infor-
This misleadingly titled book contains 25 chapters based on the keynote papers presented at the Eighth International Congress of Parasitology held at Izmir, Turkey, in October 1994. To most parasitologists, the challenges of the 21st century revolve around increasing populations in Africa, interactions between HIV and parasitic infections, global warming and its possible effects on vector transmitted infections, drug resistance, increasing expectations and costs of health, new diagnostic techniques, and the effects of parasites on ventures such as fish farming. The first chapter, by Tore Godal, is an excellent introduction to the present situation with regard to the major parasitic diseases and some tantalizing glimpses into the future, but thereafter the book abandons any pretence at looking into the future and
OF THE
ROYAL
SOCIETY
OF TROPICAL
MEDICINE
1Book Reviews 1 District Health Care: Challenges for Planning, Organisation and Evaluation in Developing Countries, 2nd edition. R. Amonoo-Lartson, G. J. Ebrahim, H. J. Love1 & J. P. Ranken. London and Basingstoke: Macmillan Education Ltd, 1996. vii+296un. Price &lOSO. ISBN O-333-57349-8. The importance of primary health care is increasingly recognized, in both developed and underdeveloped countries, as the one practical way to deliver a reasonable standard of care to the majority of the population. This is a shift away from the traditional hospital and medical oriented models of care which have often been dominant up to now. Primary health care is a less glamourous path but will ultimately deliver greater health benefit at less cost. This book is concerned with the management of primary health care services in a district in developing countries and would be of particular value as a training manual for those who find themselves in this position and who often have little management experience. It contains chapters on the aims of primary care and on the need for leadership in management so as to motivate the community to self reliance. The experience of the authors comes out in the careful identification of the pitfalls which await the unwary manager who fails to integrate his or her health. services with the needs and desires-of the community. It has elements of public health concerned with assessing the health care needs of the community. There are chapters on developing an appropriate health care plan and on how to implement it; these include useful sections on the nature of organizations and why they sometimes go wrong. There is a chapter on how to monitor the success of the management, both in terms of the process and its outcomes (again shading into public health). This is often standard managerial teaching, but it is presented in very accessible form for the non-manager, and tempered by a wealth of hard-won experience. There are few other books which help a professional such as a doctor or nurse make the transition to a successful manager, and therefore this comprehensive book can be recommended. It is at times rather long-winded and not an easy read; despite this I think it is worth the effort, rewarding detailed study rather than casual browsing. T. Wallev Department of Pharmacology and Therapeutics University of Liverpool New Medical Building Ashton Street P.O. Box I47 Liverpool, L69 3BX, UK
AND
HYGIENE
(1996)
90,588
mation. The authors have tackled these problems pretty even-handedly: drugs for all the major parasitic diseases are represented (although the list is not exhaustive), and information is presented in such a way that health-care professionals should be able to access the section required with minimal ‘flicking’. Potential readers should be aware that this is not a textbook of pharmacology and therapeutics: rather, it is an accessible collection of drug monographs arranged alphabetically, each laid out in a standardized manner. The book does not, therefore, primarily set out to provide systematic instruction on drug categories and its usefulness to the revising medical student will be more as a specific reference text (although I have my doubts about its relevance in this setting-few medical schools, even those in endemic countries, would require much detailed knowledge about antioarasitic drugs). Similarlv, the book does n% set out to guide the ieader in the therapeutic use of drugs: the doctor or nurse must know in advance which drug she/he wants to use-only then can she/he find the appropriate part of the book. The main users of this handbook will be either (i) academics with an interest in antiparasitic drugs or (ii) clinicians (using this term in its broadest sense) who treat parasitic infections frequently and are thus familiar with the drugs, but need to look things up from time to time. These 2 groups will be well served by a handy little book. The principal sections within each monograph are preamble, chemical structure, physical properties, mechanism of action, pharmacokinetics, clinical trials, indications, pregnancy and lactation, side effects, contraindications, interactions, dosage, and preparations. In other words, each monograph deals with topics as ‘academic’ as drug disposition and as ‘practical’ as dosage: this is inescapable given the range of disciplines for which the book is written. I did wonder whether ease of reference would be enhanced by including sections on drug resistance and management of poisoning. However, these topics are covered already, where relevant, and the authors are certainly pushed for space. I liked this book’s first edition and I like the present edition too: it has a definite place on the bookshelves of academics and pharmacy departments and at the ‘sharp end’ of patient treatment. Peter Winstanley Department of Pharmacology and Therapeutics University of Liverpool New Medical Building Ashton Street l? 0. Box 147 Liverpool, L69 3BX, UK
Parasitology for the 21st Century. M. Ali Ozcel & M. Ziya Alkan (editors). Wallingford: CAB International, 1996. xx + 287 pp. Price 555.00. ISBN O-85198-977-2. Handbook of Drugs for Tropical Parasitic Infections f2nd edition). Y. Aden Abdi, L. L. Gustafsson, 0. x----m ~~ Ericsson & e. Hellgren. London: Taylor & Francis, 1995. x+182pp. Price U8.50. ISBN 074840168-7. This book sets out to ‘give physicians, pharmacists, health workers, medical students and nurses in developing countries refined and abbreviated information about drugs used for parasitic infections’ and, by and large, it succeeds very well. Although at first glance the topic might seem easy to fit into a 180 pages pocket-sized book, upon reflection it becomes clear that (i) there is an awfully large number of drugs used for tropical parasitic infections and (ii) the various disciplines at whom the book is ‘aimed’ will each want to extract different infor-
This misleadingly titled book contains 25 chapters based on the keynote papers presented at the Eighth International Congress of Parasitology held at Izmir, Turkey, in October 1994. To most parasitologists, the challenges of the 21st century revolve around increasing populations in Africa, interactions between HIV and parasitic infections, global warming and its possible effects on vector transmitted infections, drug resistance, increasing expectations and costs of health, new diagnostic techniques, and the effects of parasites on ventures such as fish farming. The first chapter, by Tore Godal, is an excellent introduction to the present situation with regard to the major parasitic diseases and some tantalizing glimpses into the future, but thereafter the book abandons any pretence at looking into the future and