Featured in Express HealthCare

Akshar, a Himalayan yogi, Founder and Owner, Akshar Yoga, gives an insight on understanding the potential of Yoga and how Government of India has made AYUSH a critical part of NRHM

With history dating back to time immemorial India has a unique advantage as far as healthcare is concerned. While this may sound surprising, it is actually true. India’s health history dates back to centuries and systems like Ayurveda, Yoga, Unani, Siddha and Homoeopathy (AYUSH) are all native to India. Incidentally, AYUSH is a governmental body in India that has been formed under the aegis of the Ministry of AYUSH with the intention to develop, educate and research in ayurveda, yoga, naturopathy, unani, siddha, and homoeopathy, traditional Tibetan medicine and other indigenous medicine systems. The Department of Indian System of Medicine and Homoeopathy (ISM&H) was created in March 1995 and was re-branded as AYUSH in March 2003. AYUSH also means ‘Life’ in Sanskrit and it is the perfect way to integrate all traditional health streams in one platform.

Back to the roots

As per the Ministry of Health & Family Welfare (MoHFW), the Indian systems of medicine have age-old acceptance in India as they have a history of being effective. Inspite of rapid urbanisation, in many places these also form the first line of treatment for several common ailments. This is exactly the reason why MoHFW is now seeking to revitalise and mainstream AYUSH (including manpower and drugs) to strengthen the public health system at all levels in the country. It has been decided that  Accredited Social Health Activist (ASHA) workers will include AYUSH medications in their drug kit. The new mandate is that the additional supply of generic drugs for common ailments at sub-centres, Primary Health Centres (PHCs) and Community Health Centres (CHCs) levels under the mission shall also include AYUSH formulations. At the CHC level, two rooms shall be provided for AYUSH practitioners and pharmacists under the Indian Public Health Standards (IPHS) model. At the same time, single doctor PHCs shall be upgraded to two doctor PHCs by inducting AYUSH practitioners at that level. Naturally this has triggered a debate with both pros and cons of this initiative being discussed.

Special initiatives

The concept of ‘Mainstreaming of AYUSH’ has been mentioned in the policy documents of the Government of India since the Sixth Five Year Plan. The government has taken several steps to mainstream and strengthen Ayush as there is an increase in the number of new age lifestyle diseases. This has caused resurgence in the interest levels towards the AYUSH system of medicine both inside the country and abroad. Understanding the potential of AYUSH, the Government of India has made it to be a critical part of the National Rural Health Mission (NRHM). Before the launch of NRHM in 2005, the Department of AYUSH has been implementing a  ‘Hospitals and Dispensaries’ scheme from the 10th Plan onwards, which has now been subsumed under NRHM. In fact a key aspect is to revive the Local Heath Tradition (LHT) by ensuring that its health promotion, preventive and curative methods start having more general acceptance and prevalence among household of different economic strata. LHT is important to sustain and strengthen the AYUSH system, which is another strategy of NRHM. The vision of this programme is to ensure that there is sustained availability of raw materials as well as continued research and development on the efficacy of the system. The government is working on an awareness creation as well as information dissemination drive among the people highlighting the gentleness, local availability, cost effectiveness and no side-effects aspects of AYUSH. Providing affordable and quality healthcare to the rural population especially the vulnerable section is the key and AYUSH seeks to do the same. The objective of this programme is to provide comprehensive healthcare along with the modern system of medicine and encourage and facilitate to set up speciality as well as AYUSH clinics. These are being aimed in areas of geriatric care (Ayurveda), mother and child (Homoeopathy), psychosomatic disorders (Yoga) and skin problems (Unani). The idea is also to promote the culture of cross referral system and give an integrated healthcare delivery system including the national programme to the public.

Private player push

The move to popularise AYUSH cannot be done by the government alone and so they are seeking private players to play an active role to help integrate Ayush with mainstream health offerings.

We care about individuals and believe in the importance of actual transformation. This is not just limited to physical well being but also mental wellness, which is a vital aspect on which we work on. In the US, the government is spending millions of dollars for psychological well being of its citizens. I feel that the Indian government must work aggressively with the private players  to ensure that they offer holistic health solutions. We work closely with the people including patients to understand how well they are able to reciprocate these lifestyle changes. This in turn will give us insights to alter our programmes to benefit people.

Government initiatives

The vision of Ministry of AYUSH is to position AYUSH as a preferred system of holistic healthcare for all. In order to achieve this, the Ministry has undertaken various public health-related activities. The Group of Secretaries to PM has backed the proposal to allow Ayurvedic, Homeopathic and Unani practitioners to practice at primary healthcare level. They have proposed a bridge course for AYUSH practitioners for primary healthcare and an MoU with IGNOU has been worked out as well to allow AYUSH practitioners and nurses to operate at primary healthcare level. Primary healthcare includes basic medicines, immunisation, elementary drugs for minor ailments, antenatal, natal and postnatal care, common childhood diseases. As part of its ‘Swastha Bharat, Shikshit Bharat’ programme, the government proposes to promote Yoga for promotion of health in schools. Under this programme, two separate modules on health promotion through AYUSH systems will be prepared for school going children, one for the primary and one module for secondary school children. The idea is to drive these measures early on so that it becomes a part of life.

Allopathy and AYUSH

The core question is how to create a cross-referral between allopathic and AYUSH streams effectively as the Indian Medical Association (IMA) has strongly opposed to allow AYUSH doctors into the modern medicine system. The new health policy projects AYUSH as a panacea for  health problems and that the  potential of these alternative therapies is untapped. Our diagnostic and therapeutic methods that complement mainstream medicine has gained global acceptance. AYUSH systems can be exploited to their full potential when they become a part of mainstream medicine. This calls for a clear establishment of the roles of AYUSH practitioners, thumb rules for interactions and referrals and a communication between AYUSH and allopathic doctors.

Usually when people recover from ailments, a relapse is common as there are no lifestyle changes, even as a part of the recovery solution. One of the essential ways is to change your food habits and turn vegetarian. Unless the nature of compassion towards animals is adopted, things will not change.

Ayush – A way to increase healthcare access

Statistics have repeatedly indicated that there is a severe shortage of doctors in India with a mere 80 doctors per lakh population. A recent World Health Organisation (WHO) report states that close to 57 per cent allopathic doctors in the country did not have a medical degree which makes the number of doctors per lakh fall to a mere 36. According to WHO, 53 per cent of AYUSH doctors had degrees in their respective fields as compared to 43 per cent for allopathic ones and this is where the government can work to expand its AYUSH programme across all segments. India has a unique advantage as far as traditional system of medicines are concerned being one of the 17 countries in the world having rich biodiversity with varied medicinal plants. The Central government has committed to provide medicines at reasonable rates and creation of better healthcare infrastructure facilities. This is also being done through the Jan Aushadhi programme. The Central government under the National AYUSH Mission (NAM) is also setting up AYUSH educational institutions in states and Union Territories where such facilities are not available. Upgradation of state government AYUSH hospitals and dispensaries and setting up of integrated AYUSH hospital are other initiatives under the NAM. The Ministry of AYUSH spends around Rs 20 crore annually on its five research centres. The Union Minister of State for AYUSH (Independent Charge) recently issued a statement that the Centre is committed to propagate AYUSH system in the field of healthcare and will move in the right direction to achieve the goal.