Dr Lankester packs this manual for community health workers with practical advice on how to help a community tackle causes of ill health, and treat disease cheaply and effectively using home-grown community health workers.
He starts by explaining the philosophies of Community Based Health Care, and the practicalities of working as partners with the community, and raising awareness about health. Motivation to change comes from understanding the importance of an action, and also from the action becoming 'the fashion'.
In the section of the manual covering management, evaluation and sustainability, his detailed advice is worth heeding. 'Setting up a project is difficult and expensive. It takes many years. It is better not to start at all than to start, then run out of funds and have to stop. The developing world is full of projects that have been abandoned, and people whose hopes have been disappointed.'
If you are thinking of setting up a programme training community health workers or a community health clinic this manual will be a joy to you. The middle section of the book deals with this in detail following the latest WHO guidelines for interventions. Pointers for further reading are helpfully included. There is also a chapter on AIDS by Ian Campbell and Alison Rader of the Salvation Army, which I found interestingly different from the WHO guidelines.
What I looked for and didn't find, was the sections on expanding our health programmes to include agriculture and animal husbandry for better nutrition, land and tree conservation for greater productivity, and improved housing. Dr Lankester tells us that these should be included in our programmes as soon as we are able.
This book is full of easy-to-read headings, catchy ideas in boxes such as 'cured patients make good teachers', and cartoons which speak a thousand words. If you were wondering how your team could afford to attend the next CBHC conference in your area, maybe you could buy them all a copy of this manual instead, and go through it together.
Reviewed by:
Janet Lefroy
General Practitioner in Staffordshire
