Health Education Research, Vol. 17, No. 4, 483-484,
August 2002
© 2002 Oxford University Press
BOOK REVIEW |
The Evaluation Handbook for Health Professionals
Anne Lazenbatt Routledge, London, 2002 275 pp. ISBN 0 415 24858 2 (pb)
Clinical Lecturer in Public Health Medicine Nuffield Institute for Health University of Leeds
We as health professionals live in a very changing world. Most recently, a heavy emphasis has been placed on us to critically evaluate the services we offer and, more importantly, involve service users in such evaluations. Anne Lazenbatt, in her evaluation handbook, aims at the `world of healthcare'. In doing so, she may underestimate the book's strength in that it draws upon a holistic theory of health that should allow her book to blend easily into the wider health arena.
The title of the book initially conjures up a more restrictive healthcare approach to evaluation; however, I was pleasantly surprised on the emphasis placed on public health as opposed to healthcare theory in its opening chapters. Of note is the ease with which such theories are integrated into the evaluation process. The book lends itself both to the novice and to the more expert. Difficult concepts are explained with clarity and in manageable chunks, hence allowing the reader to see that simple, effective and very enlightening evaluations are possible even with limited resources.
The book is conveniently divided into three sections. The first section introduces the reader to the theory behind health evaluation, the second section discusses how to carry out a health evaluation and the final section gives examples of evaluation in practice.
With regard to the first section, the chapter on inequalities in health provides a comprehensive, although somewhat uncritical, review of an area that many healthcare professionals may be unfamiliar with. The chapter on evidence-based healthcare provides a comprehensive introduction to this topic and also constructs a base for many of the concepts that are to be discussed in the latter sections of the book. From Chapter 4 onwards, i.e. the end of the first section, Lazenbatt shows the reader a view of the true complexities of health evaluation and introduces us to the many possible settings for health evaluation field work. She presents the areas that we as modern health evaluators must consider, i.e. health as a holistic concept, interagency working, empowerment, the research base, multidisciplinary working, needs assessment, community development, and audit and evaluation.
The second section of the book provides a very clear and systematic approach to health evaluation. Here, Lazenbatt helps both the inexperienced and experienced health evaluator. The simplicity and clarity by which she presents what in other hands would be difficult concepts is refreshing. She uses tables, diagrams and examples to great effect.
Overall, the framework for health evaluation is the model of Structure, Process and Outcome, with Needs Assessment being added to this triad. The reader is taken step-by-step through the evaluation process (nine stages) over three chapters. On the way, the author brings alive many of the concepts introduced in the earlier chapters and introduces many other concepts, including qualitative and quantitative research methods, triangulation, rapid participatory appraisal, and health measurement tools. Brief examples that enhance the learning experience are given, although quality, specifically its multidimensional nature, is an area that could have been elaborated upon.
The final section of the book addresses evaluation techniques in practice and really allowed this reader to leave the book feeling that not only had I gained a good understanding of health evaluation, but, more importantly, I had understood the importance of a holistic model of health for evaluation.
From my own perspective as a Public Health Specialist a future edition of this book might benefit from a more critical discussion of the area of inequalities, and a critical discussion of the principles of effectiveness, efficiency, equity and equality specifically in relation to access to and use of health services. A separate chapter on Health Impact Assessment would be useful because its presentation rather inhibits the flow of an otherwise well-written text. Further, the readership of the book may be widened if more emphasis was placed on the benefits offered by evaluation to other health/healthcare professionals, as currently there is a focus on those from a nursing background. It should be noted that economic analysis is not discussed in any detail and that the majority of examples described use qualitative research techniques.
This is a book for present and future health professionals, and should serve to educate and broaden the perspective of healthcare professionals who have not yet had the opportunity to evaluate a health service from a wider public health perspective. My advice is to read it.
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