Year : 2017 | Volume
: 37 | Issue : 2 | Page : 55--56
Primary healthcare based on the framework of Indian traditional medicine
Subrahmanya Kumar Kukkupuni
Centre for Ayurveda Biology and Holistic Nutrition, The Institute of Trans-disciplinary Health Sciences and Technology, Bengaluru, Karnataka, India
Subrahmanya Kumar Kukkupuni
Centre for Ayurveda Biology and Holistic Nutrition, The Institute of Trans-disciplinary Health Sciences and Technology, Bengaluru, Karnataka
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Kukkupuni SK. Primary healthcare based on the framework of Indian traditional medicine.Ancient Sci Life 2017;37:55-56
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Kukkupuni SK. Primary healthcare based on the framework of Indian traditional medicine. Ancient Sci Life [serial online] 2017 [cited 2019 Oct 19 ];37:55-56
Available from: http://www.ancientscienceoflife.org/text.asp?2017/37/2/55/258455
Gradual change in health-seeking behavior and increasing awareness and demand for complementary and alternative medicine (CAM) around the globe is an equally encouraging scenario for Indian Systems of Medicine (ISM) including Ayurveda. People started to include alternative medicine along with conventional healthcare for both therapeutic and promotive purposes. Although such pluralism in the context of medicine is comparatively a new development in the western part of the globe, in the Indian subcontinent, medical pluralism involving biomedicine and ISM is well known, even before independence. Recent surveys showed that more than half of the Indians are of the opinion that they should have access to more than one system of healthcare that is appropriate to the specific condition. It is estimated that close to 7% of people suffering from common ailments consistently seek out patient care of ISM. Such studies emphasize the need to bring ISM in mainstream healthcare and integrate it with biomedicine-based healthcare system.
Ayurveda and other ISM are relevant in the management of diseases of multiple categories or stages including acute illness. The current practices and researches also proved possible role of ISM in the management of some of the emergency conditions as well. Fundamental classification of Ayurveda into eight themes (aṣtānga-āyurveda) including surgery (śalyatantra) and toxicology (agadatantra) is the best example of inclusiveness in the philosophy (tattva), science (śāstra), and practice (vyāvahāra) of Ayurveda. However, the irony is ISM being branded by the contemporary world as suitable for the management of only chronic ailments and as preventive and wellness approaches. Even the best healthcare institutes and hospitals of ISM try to place themselves in this category, with a focus on the management of chronic and systemic disorders.
Unlike common belief, the philosophies and practice of ISM have tremendous untapped potential to be used in primary healthcare and public health. Concepts of preventive medicine (like svasthavrtta) are very relevant in public health but left unnoticed grossly.
Primary healthcare or the essential healthcare is a coordinated approach of societies and governments toward well-being of a defined population. It is a commitment to social justice and equity focused toward the fundamental right to the highest attainable standard of health by any individual. It is people centered; therefore, efficient medical management methods that are acceptable to the individuals, families, and communities are the inseparable concepts of essential healthcare. Primary healthcare attempts to achieve physical, mental, and social health of an individual with the ultimate aim of whole-person care throughout life. Comprehensive healthcare of promotive, preventive, and therapeutic treatments, including rehabilitation, is the subject of primary health.
In spite of coordinated efforts of international agencies and individual nations for decades, we are way behind providing basic coverage of essential health services to every individual in our society. The WHO estimates that about 50% of the global population is still lacking access to essential health services. In terms of workforce trained in convention biomedical care, we face a shortfall of 18 million workers across the globe. A workforce of trained health workers is the crucial component of the western biomedical healthcare system. Apart from simple reason of financial hurdles, there are complex and sensitive issues spanning across the societal belief systems in the developing counties that pose challenges in providing essential health services to all.
Only significant reforms in the existing healthcare systems of developing counties are capable of bringing desired changes in the scenario. Considering the entire situation, it is desirable to look at the multiple options including local health practices that are accessible and acceptable to the societies and governments as well. Introduction of pluralism in primary healthcare certainly require changes at existing public health policies. Changes at the mindset of practitioners and the consumers are another requirement, which will be achieved only by changes in medical education. A participatory mode of integrative primary healthcare system is anticipated to be efficient compared to the currently existing system. It is worthwhile considering the efforts made in China to reform its primary healthcare systems, incorporating the traditional medicine of its own. Apart from the direct efforts of the government, China also encourages private investment in traditional Chinese medicine and institutes that combine traditional and Western medicine.
The WHO reports that about 70% of the global population has faith in CAMs including Chinese medicine, Yoga, Homeopathy, Ayurveda, Unani, Siddha, acupuncture, aromatherapy, dietary supplements, and faith healing. As far as ISM is concerned, availability of large number of documented medicinal formulations is the biggest advantage. The Traditional Knowledge Digital Library has already documented that > 250,000 medicinal formulations dealt in various classical literature of Ayurveda, Unani, and Siddha sourced across the Indian subcontinent. Individual and coordinated research initiatives are also gradually producing scientific evidence about the therapeutic benefits of documented medicinal formulations.
However, one of the problems with several plant drugs and plant-based formulations in the ISM is compromised quality standards. It is important to consider quality parameters right from the process of collection of the plants, plant parts, primary processing, and method of usage. Some of such efforts including detailed studies made to optimize the quality of Yavaksara (alkali prepared from the plant drug Hordeumvulgare L.), and studies to determine the purification technique of Semecarpusanacardium Linn. to achieve thrombolytic activity are detailed in this issue.
Although there is consistent increase in the allocation of government funds for the ISM, overall fund available for AYUSH is only about 3% of national health budget, which is one of the factors needs our attention. India has about 24,000 AYUSH dispensaries, but the bed strength is limited to about 60,000.
The integration of the ISM in primary healthcare essentially involves knowing the gaps in the present system of healthcare, understanding the philosophies and concepts of traditional medicine about primary health, generating adequate evidence about the activity the activity of the traditional medicine and policy changes on public health of the country, and bringing awareness to the healthcare professionals about the need of such an integration and attempts toward production of quality medicament. Such comprehensive efforts will bring confidence in the consumer to accept ISM-based primary healthcare.
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