Monday, 17 June 2013

Mainstreaming of AYUSH under National Rural Health Mission

Feature

Health





   Dr. H. R.Keshavamurthy*

In India, we have a pluralistic health care delivery system where the Government provides opportunity to every recognized medical system to develop and be practiced with a view to provide integrated and holistic health care services. That is why there is a peaceful co-existence of Allopathy with Ayurveda and Siddha, which are traditional and indigenous systems of medicine with Unani which originated from Persia and Homoeopathy which is from Germany.

AYUSH is the acronym for Ayurveda, Yoga & Naturopathy, UnaniSiddha & Sowa, Rigpa, and Homoeopathy. AYUSH systems of medicines are a group of Indian systems of medicine and Homeopathy. Ayurveda is the oldest system practiced since more than 5000 years, whereas Homeopathy is being practiced since last 100 years. These systems are being practiced in the country with diverse preferences of people and infrastructural facilities. Ayurveda is more prevalent in the states of Kerala, Maharashtra, Himachal Pradesh, Gujarat, Karnataka, Madhya Pradesh, Rajasthan, Uttar Pradesh, Delhi, Haryana, Punjab, Uttarkhand, Goa and Orissa. The practice of Unani System could be seen in some parts of Andhra Pradesh, Karnataka, Jammu & Kashmir, Bihar, Maharashtra, Madhya Pradesh, Uttar Pradesh, Delhi and Rajasthan. Homoeopathy is widely practiced in Uttar Pradesh, Kerala, West Bengal, Orissa, Andhra Pradesh, Maharashtra, Punjab, Tamil Nadu, Bihar, Gujarat and the North Eastern States and theSiddha system is practiced in the areas of Tamil Nadu, Pondicherry and Kerala.

Recently recognized Sowa Rigpa system of medicine is among the oldest surviving health traditions of the world with a living history of more than 2500 years. It has been in vogue and practiced in Himalayan regions throughout particularly in Leh andLaddakh (J&K) Himachal Pradesh, Arunachal Pradesh, Sikkim, Darjeeling, etc. Sowa-Rigpa is effective in managing chronic diseases like Asthma, Bronchitis, Arthritis, etc. the basis theory of Sowa-Rigpa is explained in terms of (i) The body and the mind as the locus of treatment; (ii) Antidote, i.e. the treatment; (iii) The method of treatment though antidote; (iv) Medicines that cure the disease; and lastly (v) Pharmacology. Sowa-Rigpa emphasizes the importance of the five cosmological physical elements in the formation of the human body, the nature of disorders and the remedial measures. There are few educational institutes of Sowa Rigpa in UP and Karnataka.

AYUSH services are provided by public, private and voluntary sector organizations and the range of their distribution varies from state to state. All these medical systems are being utilized in the national health care delivery system, each to its potential and availability in different parts of the country. Although “health” is a state subject, the Central Government has transformed the health sector by providing huge amounts of additional financial resources, equipment and machinery, manpower and material as well as training and technical aid to facilitate the State Governments in provisioning of comprehensive healthcare services, particularly for the marginalized and vulnerable sections of the population in the remotest areas; development of human resources and tertiary care facilities; encouraging health research and for promotion and integration of the Indian Systems of Medicine among other things .

Mainstreaming of AYUSH, including Homoeopathy has been one of the important strategies envisaged under the National Rural Health Mission. During the last four years grant-in-aid amounting to Rs 553.00 crore has been given to the State / UT Governments for mainstreaming of AYUSH under the NRHM .As a result new AYUSH facilities have been set up in 803 Primary Health Centres, 113 Community Health Centres, 24 District Hospitals and up-gradation done in 379 Exclusive AYUSH hospitals and 415 Dispensaries. Department of AYUSH has also supported the setting up of six 50 bedded Integrated AYUSH Hospitals at Mizoram, Manipur, Tripura, Himachal Pradesh, Jammu & Kashmir and Uttarakhand and five 10 bedded Integrated AYUSH hospitals at Assam, Arunachal Pradesh, Meghalaya, Nagaland and Sikkim. A total number of 11,478 AYUSH doctors and 4,894 AYUSH para-medics have been appointed on contract basis at Primary Health Centres and Community Health Centres under NRHM across the country.

The Government of India has also made sustained efforts for growth and development of human resources in all traditional medicine systems. A highly commendable infrastructure in the form of 496 medical colleges offering quality education to 37,234 UG and 3,311 PG students and over 7 lakh 20 thousand registered AYUSH medical practitioners now exist in the country. Department of AYUSH implemented various schemes in the eleventh plan for development of all the four core areas of education, research, drug development and health care delivery.

 During 12th plan period stress is likely to be given on Integration of AYUSH systems in health care delivery and their incorporation in National Health Programmesthrough co-locating such facilities at sub-centres and primary health care centres. Some of the new initiatives which are under consideration during 12th Plan include, setting up of aNational Commission for Human Resource in; Referral hospitals in 8 National Institutes to provide world class treatment facilities; a National Institute of Medicinal Plants ;Research and Quality Control Laboratories in 8 National Institutes; a Central Drugs Controller for AYUSH drugs to facilitate standardization of ASU products; 5 Hi-Tech Quality Control Labs under the Research Councils at regional levels; setting up of a Homoeopathic Medicines Pharmaceutical Corporation Limited to provide facilities for manufacturing of Homoeopathic medicines and to set up an All India Institute of Homoeopathy to fulfill the emerging interest of scientists for research in homoeopathy.

In fact, all the systems of medicine should be geared up by utilizing their unique strengths and proven abilities to contribute to need based health planning.  Importance of traditional systems of medicine vis a vis conventional streams can be seen in the epoch making statement of Mahatma Gandhi, ‘Homeopathy ….. cures a larger percentage of cases than any other method of treatment and is beyond doubt safer and more economical and most complete medical science.

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