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Role of People's knowledge in Health Care

          South Asian Dialogues on Ecological Democracy (SADED)-Lecture Series

Date: 16th May 2013

Time: 4.45 pm

Place: Gandhi Peace Foundation (GPF), Delhi.

                            

                                                                                                                            G. Hariramamurthi                                                                                                                           

Background

India, the lowest in the world in public spending on health and highest in private spending, ranks among the poorest performers in health indicators globally. In India, over 35 per cent of all who are hospitalized fall below the poverty line because of the health expenses; and over 40 per cent have to borrow or sell assets to pay for healthcare. The role of private sector is rising at an alarming rate, from 8 per cent in 1947 to as high as 93 per cent of all hospitals, 64 per cent of all beds, 80 to 85 per cent doctors, 80 per cent of all outpatients and up to 57 per cent inpatients.

Indian Medical Heritage

Indian Medical Heritage consists of both the codified stream where AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) is sophisticatedly practiced and taught through institutional training, and non-codified stream where mostly oral, community and ecosystem specific local health traditions are practiced all over India. A national health system survey in India in 2009 reported that moderate to very high levels of households’ use of traditional medicine where more than 6200 plant species were in use for managing a range of simple to complex conditions in India alone. Several policies like: Alma Ata Declaration (WHO, 1978); National Policy on Indian Systems of Medicine, India – 2002; Five Year Plan Documents, India, 2007 and 2012, etc. exist but lack of new recruits and shrinking social and policy legitimacy explains severe erosion of traditional medicine.

There are about one million community supported traditional health practitioners spread across almost all the villages of India. But there are no public health strategies to engage them in delivering primary healthcare related services in their villages. It is also alarming to note that most of these local health practitioners are aged above 50 years, meaning that there is an emerging threat of losing their precious knowledge which will be a loss of rich indigenous knowledge. India could certainly make a paradigm shift in its approach by involving local health practitioners who are reportedly available in every village of India.

AYUSH Policy statement 2002, National Rural Health Mission statement 2005 and Tenth and Eleventh Five Year Plan documents 2007 and 2012 recommend the mainstreaming and involvement of AYUSH as well as Local Health Practitioners to make healthcare accessible to everyone.

There is serious need to identify and promote safe and efficacious local health traditions (LHTs) which could be attained by undertaking the following steps:

1. Prioritization of health conditions

2. Identification of LHTs

3. Analysis of repeated documented remedies supported with literature review

4. Rapid assessment of LHTs

5. Promotion

For instance, storing drinking water in copper pots is traditional Knowledge for purifying drinking water, application of turmeric on wound acts as an antiseptic, etc.

Conclusion

Universal health coverage in India is feasible only through recognition and strengthening of our people’s knowledge in healthcare. This requires very little investment in identifying, assessing and promoting their knowledge and does not need any external investment to be mobilized. Community supported traditional health practices need to be recognized as legitimate and paramedical AYUSH health workers should be trained to provide their services in more effective ways.

 

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Mr. G. Hariramamurthi works as a Senior Programme Officer in the Community Health Education and Outreach Unit at the Foundation for Revitalization of Local Health Traditions (FRLHT), Bangalore, India. He Graduated from the Jawaharlal Nehru University, New Delhi.