AYUSH: Benefits and Challenges

AYUSH is the acronym of the medical systems that are being practiced in India such as Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy.
These systems are based on definite medical philosophies and represent a way of healthy living with established concepts on prevention of diseases and promotion of health.
The basic approach of all these systems on health, disease and treatment are holistic.
Because of this, there is a resurgence of interest on AYUSH systems. Yoga has now become the icon of global health and many countries have started integrating it in their health care delivery system.
The Department of Indian Medicine and Homeopathy (ISM & H) was created in the Union Ministry of Health and Family Welfare. In 2003, this Department was re named as Department of AYUSH.

Benefits of AYUSH system are:

• It addresses gaps in health services.
• It provides low cost services in far-flung areas.
• AYUSH can provide best care to elderly.
• Problem of tobacco and drug abuse can be tackled by AYUSH especially through Yoga.
• Useful in lifestyle diseases like diabetes and hypertension.
• Large part of the population prefers AYUSH as it is perceived to have lower side effects, costs and considerations of it being more natural.

Challenges in the AYUSH system:
• The ability of Ayurveda, yoga and naturopathy, Unani, Siddha and homoeopathy (AYUSH) practitioners to cross-practice to highlighting current restrictions on allopathic practitioners from practicing higher levels of caregiving. However, these debates miss the reality: which is a primary health system that is struggling with a below-par national physician-patient ratio (0.76 per 1,000 population, amongst the lowest in the world) due to a paucity of MBBS-trained primary-care physicians and the unwillingness of existing MBBS-trained physicians to serve remote/rural populations. Urban-rural disparities in physician availability in the face of an increasing burden of chronic diseases make health care in India both inequitable and expensive.
• Quality standards of Medicines – Scientific validation of AYUSH has not progressed in spite of dedicated expenditure in past.
• Lack of human resources – Practitioners are moving away from traditional system for better opportunities
• The existing infrastructure remains under-utilized.
• The 4th Common Review Mission Report 2010 of the National Health Mission reports the utilisation of AYUSH physicians as medical officers in primary health centres (PHCs) in Assam, Chhattisgarh, Maharashtra, Madhya Pradesh and Uttarakhand as a human resource rationalization strategy. In some cases, it was noted that while the supply of AYUSH physicians was high, a lack of appropriate training in allopathic drug dispensation was a deterrent to their utilization in primary-care settings.
• The 2013 Shailaja Chandra report on the status of Indian medicine and folk healing, commissioned by the Ministry of Health and Family Welfare, noted several instances in States where National Rural Health Mission-recruited AYUSH physicians were the sole care providers in PHCs and called for the appropriate skilling of this cadre to meet the demand for acute and emergency care at the primary level.

The way forward for capacity building in the AYUSH system are:
• Capacity-building of licensed AYUSH practitioners through bridge training to meet India’s primary care needs is only one of the multi-pronged efforts required to meet the objective of achieving universal health coverage set out in NHP 2017.
• There is an urgent need for a trained cadre to provide accessible primary-care services that cover minor ailments, health promotion services, risk screening for early disease detection and appropriate referral linkages, and ensure that people receive care at a community level when they need it.
• The issue of AYUSH cross-prescription has been a part of public health and policy discourse for over a decade, with the National Health Policy (NHP) 2017 calling for multi-dimensional mainstreaming of AYUSH physicians. There were 7.7 lakh registered AYUSH practitioners in 2016, according to National Health Profile 2017 data. Their current academic training also includes a conventional biomedical syllabus covering anatomy, physiology, pathology and biochemistry. Efforts to gather evidence on the capacity of licensed and bridge-trained AYUSH physicians to function as primary-care physicians have been under way in diverse field settings, and the call for a structured, capacity-building mechanism is merely the next logical step.

 

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