Science and Practice of Public Health: A manual for the developing world

At a time when the world is grappling with public health challenges, this book is an easy-to-read handbook for policymakers, connecting theory to the practice of public health

The Science and Practice of Public Health: Perspectives from the Developing World

by T Sundararaman, Sitanshu Sekhar Kar and Daksha Parmar

Published by 

Routledge

270 Pages    ₹4,430

 

The Covid years refocused the general discourse on public health measures. The importance of the discipline was felt worldwide, and responses were often based on limited scientific evidence. Although textbooks on public health exist, a comprehensive practitioner’s guide that incorporates sensitivity toward citizens was needed. T Sundararaman, Sitanshu Sekhar Kar and Daksha Parmar have brought together decades of their experiential learning in handling public health challenges to this volume. Without losing sight of the science of public health, the authors successfully managed to write a volume that addresses concerns across multiple developing countries. Its strength lies in its citizen-centricity, passionate plea for science and evidence, and an ability to link good theory with good practice. It is often difficult to do justice to both the macro challenges and the micro interventions in the same volume with equal ease. That is what makes this volume stand out.

 

At a time when the world is grappling with public health challenges that have the power to disrupt economic activity and social development, this easy-to-read style of connecting theory to the practice of public health makes the book unique. The book has three sections — the basics of health, re-thinking disease control and health policy, and health system strengthening. Each section has five chapters around the theme.

 

The treatment of theory and methods of public health are not designed to enable the researcher to conduct a study. There are public health textbooks that do that. Here the effort is directed towards providing an introduction to enable a practitioner or policymaker to read and interpret studies, since the authors do not wish to make the book complex and complicated. However, in doing so, they do not miss out on the political economy of health and health care. Considering the role of globalisation in public health interventions, the book includes a separate chapter on this issue. It highlights the hierarchies of global decision-making and shows how an unequal world often challenges developing nations and their public health needs.

 

The section on re-thinking disease control is very contemporary as it builds on the learning from the Covid pandemic. In fact, there is an exclusive chapter on pandemics — prevention, preparedness and response that updates public health measures for health systems in periods of pandemics. Its relevance is for the entire developing world. Written with empathy for citizens and the need to ensure equity in access, the chapter makes very strong plea for crafting credible public systems in health to meet the emerging public health challenges.

 

The real value of the book is in the third section and its insights on strengthening health systems. The learnings from the theory of public health are infused in this section’s focus on health policy and systems. It is often difficult to connect the recommendations rooted in science with the pragmatic challenges that health systems face in developing countries. There are no perfect solutions as health systems in the developing world always have some limitations, unique to nations.

 

The chapter on public health informatics is a very useful one. In many developing countries, it is a challenge to have reliable health data that could become the basis of policymaking and programme interventions. Its absence leads to non-evidence-based decision-making. The ability to gather credible data with systems of community vetting of data feeding is an issue that needed attention. The chapter raises many new innovations and practices that would serve community-led public action on health.

 

The chapter on health care financing rightly raises the issue of optimal public resources for health in developing countries. It brings out the need for investing in public systems to enable impactful response on scale. The inadequacy of financing and governance reforms are also highlighted.

 

Critics of this volume may say that the science of public health has been treated in an “applied” manner, where the linkages with public health systems has received attention but not the discipline of public health itself. The authors have responded to these likely responses early in the book by saying that the need is to understand public health challenges and their wider dimensions of impact on health systems. The other criticism that more technical areas of public health research could have been covered is answered by pointing out that treatises on the science of public health abound; what is difficult to lay one’s hand on is a practitioner’s prescriptions for management of public health. This volume does exactly that. There will be interest in the book across developing countries as the pragmatic solutions discussed in the second and third sections of the book can have practical value in system strengthening.

 

---

The reviewer is a student of human development