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Friday, 11 October 2013

Aging Population in India 2

Traditional Health Systems and Their Role

The following section gives an overview of traditional systems of medicine and examines their role in addressing healthcare challenges of elderly. Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being.” (WHO 2002) Further the term complementary and alternative medicine (and sometimes also non-conventional or parallel) are used to refer to a broad set of healthcare practices that are not part of country’s own tradition, or not integrated into the dominant healthcare system. This is a broad and inclusive definition which makes it difficult to find a region or a country without any form of traditional medicine. It is often known through a variety of names such as traditional medicine, alternative medicine, complementary medicine, natural medicine, herbal medicine, phyto-medicine, non-conventional medicine, indigenous medicine, folk medicine, ethno medicine etc., based on the context and the form in which it is practiced. Chinese medicine, Ayurveda, Herbal medicine, Siddha, Unani, Kampo, Jamu, Thai, Homeopathy, Acupuncture, Chiropractic, Osteopathy, bone-setting, spiritual therapies, are some of the popular, established systems (Payyappallimana 2010).

There is an emergent interest in both developed and developing countries to integrate traditional medicine/complementary and alternative medicine (TCAM) in public health systems. Diversity, flexibility, easy accessibility, broad continuing acceptance in developing countries and increasing popularity in developed countries, relative low cost, low levels of technological input, relatively low side effects and growing economic importance are some of the positive features of traditional medicine (WHO 2002, Payyappallimana 2010).

Though these systems differ in their approach to clinical principles or management methods they share a common worldview. According to this the macrocosm (outside universe) and microcosm (living being) are inherently related and have common elements. These systems also have similar perspectives such as ecological centeredness, an inclusive approach to non-material or non-physical dimensions, and holistic approach to health management considering physical, mental, social emotional, spiritual, ecological factors in health and wellbeing. “Fundamental concept is that of balance - the balance between mind and body, between different dimensions of individual bodily functioning and need, between individual and community, individual/community and environment, and individual and the universe. The breaking of this interconnectedness of life is a source of dis-ease,” (Bodeker 2009: 37). Other unifying attributes are their popular and public domain character and orientation to prevention and self help. Mostly these systems focus on the functional aspects of health and diseases, whole system approach to health, multi-causality, subjective, qualitative, individualized and personalized management and consider both physician and patients both as active agents in healing.

According to WHO between 60-80% of the population in developing countries and a growing percentage in developed countries continue to avail services of traditional medical systems (WHO 2002). However the slow official response shows the lack of correspondence between public choice in health seeking behavior and the policy processes in different countries. Proof of efficacy, quality, safety and rational use continue to be major challenges in the sector. Increase in chronic diseases, better awareness about the limitations of conventional medicine, growing interest in holistic preventive health, increasing evidence of clinical efficacy, better clinical care, easy access especially in rural areas and cost efficacy are some of the key reasons for the resurgent interest in traditional medicine. In countries like India the per-capita ratio of practitioners of TCAM is higher compared to conventional medicine. In rural areas easy access, availability and cost are key aspects of utilizing traditional medicine whereas in urban areas it depends on concerns about chemical drugs and interest in natural medicines, limitation of conventional medicine, greater information access are some of the reasons for accessing traditional medicine. Thus in a public health context availability, accessibility, affordability, utility, quality, efficiency and equity become relevant in accessing healthcare (Payyappallimana 2010).
 
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