Policy and Health: Implications for Development in AsiaBMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7244.1281/a (Published 06 May 2000) Cite this as: BMJ 2000;320:1281
- Michel Thuriaux, former medical officer (epidemiologist)
John W Peabody, M Omar Rahman, Paul J Gertler, Joyce Mann, Donna O Farley, Jeff Luck
Cambridge University Press, £30, pp 464
ISBN 0 521 66164 1
Dramatic changes have occurred in the fields of economics and health in recent years—the AIDS crisis in particular has highlighted the interactions between the two. However, there are hardly any books and very few recent articles showing how policy that affects economics also affects health.
This book's title suggests that it should be ideal reading for a politician or a senior health official trying to find out which health policies to implement in Asia. Starting with “The role of governments in the health sector,” the book covers evidence based policy, prioritisation of medical interventions, financing and allocation of resources, equity, and health behaviours and ends with “Implementation of policy objectives.” References occupy nearly 80 pages, and the index shows the names of most Asian countries, fromKazakhstan to Fiji, while a quick dip into the chapters shows boxes listing examples from individual countries. The advance praise for the book quoted on its back cover is lavish, and the foreword states that the book places “international experience at the disposal of national decision-makers and those who advise them.” Both are always in need of information, both often do not know where to find it, and both have little time to digest it
However, I'm afraid they are in for a disappointment if they turn to this text for help. At over 400 pages, this is no quick read, and its style is vague, sometimes to the point of unintelligibility. It is thorough, scrupulously recording “Policy implications” in the one page summary at the start of each chapter. But statements such as “policies … need to be evaluated,” “implementing social insurance … requires that conditions be right,” and “policy makers should … plan and evaluate … strategies at a pilot level” are hardly groundbreaking. The chapter on prioritisation relies heavily on disability adjusted life years (DALYs), which seem to be implicitly accepted (despite a rather perfunctory discussion of objections). The chapter on financing makes particularly heavy reading for the non-economist. Only half of the boxes giving examples from individual countries actually refer to a country of Asia, and about a third of those that do are pretty general: individual stories of success or failure wouldhave had much greater impact.
For academics and researchers, this book is probably a valuable resource, but the authors have missed an opportunity to write a useful guide for those who have to make and advise policy in the daily hurly-burly. A less ambitious series of texts concentrating onone country or on a group of countries with similar problems—rather than the more than 40 very different countries listed here—and written in a more approachable manner would have been preferable.
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