Need for Policy Support
The
approach to universal health coverage and health system development in India is
predominantly based on modern medical approach. In the National Health Mission
programs traditional medicine is integrated marginally and mainly in the form
of dispensable medicines and not as a holistic health care approach. In most
national programs traditional medicine appears in the form of inclusive,
politically correct, tail-end statements. Why are Ayurveda and other traditional
medical systems not called for to address the healthcare challenges of the
elderly? There is a lot that TRM can offer in terms of preventive care, healthy
lifestyles, early detection of likely manifestation through methods such as prakriti analysis, treatment methods
such as panchakarma particularly in
the case of chronic, debilitating conditions. National program for Health Care
of the Elderly is a comprehensive health strategy by Ministry of Health and
Family Welfare. Such programs should integrate holistic practices of AYUSH
systems and their infrastructure not as pilot schemes but as large scale
interventions across the country. This requires creation of traditional
medicine resource centres, capacity building for medical and paramedical
professionals with special focus on the strengths of TRM in chronic care. This
also requires continuous generation and updation of evidence base for the TRM management.
This would enhance the confidence among AYUSH professionals on their relevance
in gerontology. This is important as public health today is an unfamiliar
terrain for AYUSH professionals. It is a welcome move that AYUSH department has
promoted Centres of Excellence in Geriatrics in the recent past. These centres
should actively engage in research and capacity development in the sector. It
is also important to promote geriatrics focused education in undergraduate and
postgraduate AYUSH programs in the existing academies of traditional medicine
in the country.
In
policy discussions on traditional medicine multilateral bodies have given broad
guidelines on how to systematize traditional knowledge with due consideration
to quality, safety, efficacy and rational use. These issues will have to be addressed
for any traditional medicine based public health intervention. One of the hurdles
with respect to traditional medicine is the widespread quackery and cross
system practices that exist in the guise of TRM. Continuous surveillance
systems need to be established for monitoring safety of these practices.
Inorder to assure quality, rational drug use and cost efficiency, essential
drug lists with region specific requirements are a must.
An
important dimension that any traditional medical intervention should create is
self reliance in management of primary healthcare problems of the elderly. It
should also promote a positive approach to health and wellbeing as well as
improve resilience of elderly population. As a rural community based self
reliant healthcare model, India as a biodiversity rich region of the world has
immense potential in developing a locally driven healthcare and nutrition
development model particularly for regions where health access poor, yet are natural
resource rich in the country. Such an approach is especially important for
reducing healthcare costs while assuring self reliance among communities. This
also requires enormous commitments from the professional medical fraternity for
planning, implementing and monitoring of such community centred health delivery
programs.
Finally,
elderly population requires long term, regular care which calls for systems of
care of a longer term basis. In a country like India which is based on family
care taking, home care givers have a significant role to play. Home care
workers need special training in geriatric care through traditional medicine in
particular in the area of neuromuscular, musculoskeletal and other degenerative
conditions. Many studies show also that family continues to be primary care giver
in the country. This calls for better awareness among households about the
various management approaches of elderly care among family members. There
should be capacity both for family members and care givers for systematically
giving feed back to the health system. This will help develop a need based
primary healthcare approach. Adequate knowledge and awareness of health
conditions, their prevention or treatment, healthy lifestyle are necessary for
implementing such public health interventions.
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