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Bringing AYUSH Systems intoPublic Health Mainstream:Vision and a Possible Roadmap <br />Presentation during a WHO initiated Consultation at Raipur <br />organised by Directorate of AYUSH, Chhattisgarh<br />on 07.10.2009<br />V R Raman, Public Health Resource Network<br />Consultant, ICICI Centre for Child Health and Nutrition<br />For Setting up SHRC Jharkhand<br />
Vision<br />Positioning AYUSH systems on the public health mainstream towards Comprehensive Primary Health Care and for achieving Health for All, with:<br />Equitable identity and parity with modern systems<br />Better outreach, access and coverage, <br />Indigenous knowledge streams are seen, studied and examined in scientific terms, according due attention and dignity, <br />Proper political and administrative environment as well as supportive measures <br />Time-bound plans of action<br />
Why Mainstreaming Emerged as a need ?<br />Almost all systems under AYUSH got a strong structure, still they are to be mainstreamed and internally strengthened: but why?<br />The growth of modern systems negated the footage and the legacy of existing systems<br />AYUSH systems too, negated the necessary learning from modern medicine- how had it updated itself through self-correction, diagnostics, biochemistry, and many other developments<br />Interesting read: Bandopadhyay, Tarashankar: ArogyaNiketan, a novel <br />
Mainstreaming: are the objectives clear?<br />Different perspectives:-<br />Mainstream Health Services lookout: a stop gap arrangement, to provide at least an “underqualified physician”, for the underserved areas<br />GoI: a cafeteria approach to give choices to the clientele<br />Modern Medicine Doctor: a useless initiative for them, as no understanding of these systems<br />AYUSH outlook: sheer showcasing measure<br />People: No idea, as nothing has reached them so far; however, they welcome and need holistic approach, if provided<br />Private (vested) AYUSH establishments: don’t want it, as it may finish off many of their golden egg hen avenues.. <br />
Mainstreaming: Possible Goals or Positive Meanings<br />Getting proper space within Health Acts, Policies and Programmes<br />Securing well-deserved identity amongst system leaders as well as people<br />Attaining parity in terms of position with other systems<br />Identifying Priority/ effective interventional areas for AYUSH<br />Ensuring scope for advanced learning of these system<br />Initiating advanced research and documentation for standardisation, accreditation and dissemination of knowledge<br />Rebuilding the community trust and inclination<br />Creating comradeship with practitioners of modern system<br />Achieving trust within- amonst different components of AYUSH systems themseleves<br />
Mainstreaming: Strategies<br />2 way convergence with modern systems<br />Departure from traditional teaching-learning processes: Revise AYUSH systems curricula to include modern diagnostic approaches, technologies- also develop language, IT skills in students<br />Introducing AYUSH system briefs in MBBS curricula, from the very beginning- Yoga etc, however with care not to project them as a solution for each and every health problem<br />Introducing concurrent research guided by experts both in modern and AYUSH systems- not the traditional research which gets a full stop at a PhD award or a wage hike or promotion<br />Comparative medicine to be taught and holistic medicine in practice<br />Joint Diagnosis in place of cafeteria approach which takes care of patient’s choices only, not their need (KottakkalAryaVaidyaShala)<br />
Strategies Contd..<br />Clinical / House Surgeon posting: cross-posting from AYUSH to modern and vice-versa<br />Capacity building of AYUSH HRH, to reduce the inferior feeling<br />Equipping AYUSH facilities with advanced communication and computing systems, technologies<br />CME, journals, knowledge repositories<br />Regulatory measures: control of magical remedies a must to regain the trust on AYUSH as a systems of medicine<br />Accreditation of Traditional Healers with documentation and validation of their existing knowledge, identifying gaps and training<br />
Strategies Contd..<br />Uniform classification of diseases in line of ICD, though based on the school of thought represented by each systems<br />Computerised diagnostics (Rog-Nidan) Protocols, like the ones already available for Homoeo<br />Comparative, symptom based treatment protocols, indicating cross-referrals<br />Standardised pharmacopeia reforms: production based on new technologies and combinations are largely controlled by private players and profit interests<br />Coordination to be established with patents and IPR procedures- no idea on how are the things evolving and patented<br />Essential Drug Lists, procurement and storage procedures, <br />Drug formularies, including old as well as new formulations<br />
Strategies Contd...<br />Promotion of SwasthaVrutha or similar measures, updated based on changed life-styles and surroundings<br />Defining clear boundaries for Home remedies, traditional care and for systemic care- what to do and what not and when- with suggestions on when to refer for advanced or specialised care<br />
Priority Intervention Areas, where acceptance will be immediate and high..<br />Geriatric Care<br />Life-style diseases control and life style modifications: YOGA etc<br />Mental Health Care<br />Antenatal and Post-natal mother care: GarbhaRaksha<br />Malnutrition Management<br />Anaemia Management<br />Community Eye Care<br />Community Dental Care<br />Community Skin care <br />Control of Non-communicable Diseases: Diabetics, Asthma, Liver disorders, Rheumatic care, etc<br />Supplementary role in TB, Leprosy, HIV management <br />
Mainstreaming: Pre-conditions<br />Priority to be accorded- beyond current prominence<br />Not lucrative, but sufficient resources to be allocated<br />Equity/parity issues<br />Orientation and fellow-travelling of modern systems in mainstreaming efforts<br />Survival of the sickest too, within AYUSH systems, kept in focus... Not just AYURVEDA and YOGA<br />
Mainstreaming: Conclusions<br />The Roads are ahead....<br />Thanks<br />