Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
From UPSC perspective, the following things are important:
Prelims level: Particulars of the AYUSH.
Mains level: The newscard discusses the relevance of the AYUSH practitioners in solving issues, related to India’s primary health care system.
Contentious element of the National Medical Commission (NMC) Bill 2017
- Section 49, Subsection 4 of the bill
- It proposes a joint sitting of the Commission, the Central Council of Homoeopathy and the Central Council of Indian Medicine
- The debates around this issue have been ranging from writing-off the ability of Ayurveda, yoga and naturopathy, Unani, Siddha and homoeopathy (AYUSH) practitioners
- Currently, AYUSH practitioner can’t cross-practise allopathy due to restrictions
How can AYUSH help?
- India’s primary health system 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
- Therefore, there is an urgent need for a trained cadre to provide accessible primary-care services
- AYUSH practitioners can help to improve this situation
Issue of AYUSH cross-prescription
- The issue 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(important for primary health care system)
- Efforts to gather evidence on the capacity of licensed and bridge-trained AYUSH physicians to function as primary-care physicians have been under way
The 4th Common Review Mission Report 2010 of the National Health Mission
- It 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 rationalisation 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 utilisation in primary-care settings
What should be done?
- The focus should be on deploying a capacity-building strategy using AYUSH physicians upskilled through a bridge-training programme
- This will help to deliver quality, standardised primary health care to rural populations
- Example: The Maharashtra government has led the way in implementing bridge training for capacity-building of licensed homoeopathy practitioners to cross-prescribe
Is capacity-building of licensed AYUSH practitioner enough?
- AYUSH is only one of the multi-pronged efforts required to meet the objective of achieving universal health coverage set out in NHP 2017
- Current capacity-building efforts also include other non-MBBS personnel such as nurses, auxiliary nurse midwives and rural medical assistants, etc.
- AYUSH is an acronym that is used to refer to the non-allopathic medical systems in India. It includes the Indian medical system of Ayurveda, Yoga, Unani, Siddha, and also Homeopathy.
- In the current terminology of the Ministry of Health in India, non-allopathic doctors are now referred to as AYUSH ( meaning “life” in Sanskrit) doctors
- Department of Indian Systems of Medicine and Homoeopathy (ISM&H) was created in March,1995 and re-named as Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) in November, 2003 with a view to providing focused attention to development of Education & Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy systems
- Department of AYUSH come under Ministry of Health and Family Welfare
- This is to imply that the AYUSH systems of medicine and its practices are well accepted by the community, particularly, in rural areas
- The medicines are easily available and prepared from locally available resources,economical and comparatively safe
- With this background, it will be more useful for the mainstreaming/integration of AYUSH systems in National Health Care Delivery System under “ National Rural Health Mission (NRHM)”
- Presently, approx. 23,630 dispensaries are functioning and about 6,91,470 registered practitioners are available under AYUSH in the country.
Objectives of the AYUSH
- To upgrade the educational standards in the Indian Systems of Medicines and Homoeopathy colleges in the country
- To strengthen existing research institutions and ensure a time-bound research programme on identified diseases for which these systems have an effective treatment.
- To draw up schemes for promotion, cultivation and regeneration of medicinal plants used in these systems.
- To evolve Pharmacopoeial standards for Indian Systems of Medicine and Homoeopathy drugs