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Book Review
Promoting Health: The Primary Health Care Approach - Second Edition
Andrea Wass
2000 Harcourt/Saunders
Bodil Rasmussen
Lecturer, Deakin University, Burwood Campus, VIC
It is the author's hope that this book will reflect the spirit of primary health care. This will contribute to a growing understanding among health workers of health promoting work, both at local and international levels. This hope is achieved because the book is based on principles of effective, balanced, appropriate and just health system. It focuses on barriers for implementing primary health care and health promotion strategies and in particular why these are looking increasingly at odds against economic rationalism. The latter is very useful to the reader to gain an understanding on why the commitment to primary health approach is weakening despite its principles being more challenged. This book is designed to provide both a theoretical introduction and practical strategies for action.
The reader is expected to have a basic understanding of sociology, psychology, health and illness, however, it is based on an examination of skills and issues addressed in undergraduate nursing and health science courses. It is an essential book for students in the field and an excellent guidebook for the more experienced.
The second edition has been improved by an excellent reference list at the end of each chapter. The reader is also encouraged to further readings by directions to references entwined in the text. This makes it very easy to seek more information on particular issues. Also, compared to first edition, major historical developments have been up dated and more emphasis is placed on barriers to implementation of the primary health approach.
The book consists of ten chapters, which starts with an examination of the development of primary health care at both Australian and International levels. The first chapter discusses the development of the new public health movement and gives examples of major barriers in implementing primary health care. Some major policy development processes in Australia are discussed in relation to the extent to which these policies embrace the primary health approach.
Chapter two defines health and health promotion and contains related discussions of value-based issues within the two concepts. The discussions raise questions, which force the reader to reflect on the complexities of the health promotion activities, in particular the concept of participation has been examined and provides the reader with a good understanding of this concept.
Chapter three introduces research in the areas of health promotion and examines the major issues in community needs assessment. The chapter argues successfully about the importance of research for an ongoing integrated health promotion practice. It focuses on two methodologies namely; feminist research and participatory action research and explains how those methods are particularly appropriate in health promotional work.
Chapter four explores the issues in evaluation of primary health and health promotion. It argues that community assessment and evaluation ought to be a recurring process in good health promotional work and explains why the lines between the two concepts can be very fine. The discussion emphases, faithfully to the primary health approach, that participatory evaluation must be a key feature in practice. The planning, component and process in evaluation is described and the Australian health and community service standards are suggested as a framework for helping with this process.
Chapters 5 to 9 explore a number of strategies useful in promoting health - working with mass media, community development, working for public policy change, group work and health education. The four chapters can be read independent of each others as each chapter is based on primary health care approach explained in the first four chapters in the book. Most importantly to successful health promotional work is that of working in-groups and understanding group dynamics. Chapter eight offers a very good insight and is (again) full of useful advice.
Chapter nine is of great importance, in particular to the novice practitioner, as it assists excellently to understand why the choice of educational methods is critical for successful outcomes of health promotional work.
Chapter ten makes a number of suggestions about how to incorporate the range of material presented in the book into own practice of the reader. It provides a very useful guide for anyone considering "doing project". It gives practical suggestions to how to implement health promotion activities and concludes by pulling it all together. It also raises some critical questions for the reader to consider in relation to future activities.
This is an excellent dictionary for the experienced health practitioner and encourages to continuing education. Reading this book makes you feel like you have "spoken" to some one who has spend for a long time in the field. A great gift to all of us involved in primary health care at all levels.
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