Give Suggestions, Comments, Feedback on the Draft National Health Policy 2015

healthInteract for giving Suggestions, Comments, Feedback on the Draft National Health Policy 2015

Homeobook to bring your attention to an important development relevant to our areas of work – many things mentioned regarding AYUSH systems of medicine.

Please review the document; discuss at appropriate levels within your institutions and elsewhere; and provide your inputs. Some of you may have reservations about the limitations and implications of a policy document, and the implementation challenges. Yet, let us not forget that once the final version is out, this will be a guiding document on health in the country for the coming few years if not a decade.

Last Date for Sending Comments is February 28, 2015

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para on AYUSH professionals, talks about “mandatory bridge course” to attain “competencies of mid-level care provider with respect to allopathic remedies”; and continuing education in their respective systems (page 34)

para deals with faculty shortage and human resource issues in tertiary care medical college hospitals and centres of excellence (page 35)

para deals with financing issues in HPE including private sector (page 36)

para 5.3 tries to address the shortage of doctors particularly in the context of public health needs (page 37)

para 5.12 is about public health management education. (page 40)

para 9.7 includes clinical and non-clinical education among areas that can benefit from health informatics and IT based solutions (page 49-50)

Realizing the Potential of AYUSH services Page : 10,34
 With this experience a National AYUSH Mission has been launched for overall strengthening of AYUSH network in the public sector with focus on AYUSH services, development of infrastructural facilities of teaching institutions, improving quality control of drugs, capacity building, and community based preventive and promotive interventions. In addition, there is need to recognize the contribution of the large private sector and not-for-profit organizations providing AYUSH services, conducting research for growth of the knowledge base of the AYUSH systems and their services.   A third development in the past decade globally, has been the emergence of integrative medicine as a frontier and India has the potential to become a world leader in this sphere, given adequate support for research and institution building.

Research and Challenges:
India‟s strengths in AYUSH can also be leveraged for becoming a world leader in drug discovery as also in integrative medicine and this needs not only research as pure and applied science but also creating institutional structures for documentation, validation and accreditation of community health practices and practitioners.

Pluralism: Patients who so choose and when appropriate, would have access to AYUSH care providers based on validated local health traditions. These systems would also have Government support and supervision to develop and enrich their contribution to meeting the national health goals and objectives. Research, development of models of integrative practice, efforts at documentation, validation of traditional practices and engagement with such practitioners would form important elements of enabling medical pluralism. Child and Adolescent Health
AYUSH doctors supporting healthy local home and community practices and the mainstreaming of AYUSH interventions at primary level will further strengthen primary care. Non-Communicable Diseases & AYUSH A large part of the population uses AYUSH remedies and prefers to do so, choosing this for reasons that include perceived lower side effects, costs and/or considerations of it being more natural. The first and most important consideration in public policy with respect to AYUSH is ensuring that persons who so choose have access to these remedies. The strategy of co-location in public facilities providing allopathic care as well will continue.

Another strategy is investing more on making AYUSH drugs available and standardising drugs and treatment protocols. A third is good propagation of the potential of AYUSH remedies in a number of conditions. Further disciplines like Yoga would be introduced much more widely in the school and in work places as part of promotion of good health. These latter strategies are brought together in the recently adopted National AYUSH Mission. This policy recognizes that principles of care differ for AYUSH systems of medicines and mainstreaming would involve „nurturing‟ these individual system of medicines through development of infrastructural facilities of teaching institutions, improving quality control of drugs, capacity building of institutions & professionals, building research and public health skills of practical utility and initiating community-based AYUSH interventions for preventive & promotive healthcare. Initiating community-based AYUSH interventions for preventive & promotive healthcare, and linking them with the ASHAs and VHSNCs would be an important plank of this policy. The second important meaning of mainstreaming, which was accelerated with NRHM, was training of AYUSH professionals to help them perform “national program” functions. In many primary health centers however they are the only medical professionals available and therefore take care of both ayush and allopathic curative care. Given human resource constraints, the National Health Policy would continue with this but with the addition of a mandatory bridge course that gives them at least the competencies of mid-level care provider with respect to allopathic remedies. Simultaneously, continuing education for upgrading of knowledge and skills in their own systems as regular in-service capacity strengthening would be instituted, just as for the modern medical system doctors. This policy further support the integration of AYUSH systems at the level of knowledge systems by validating processes of health care promotion and cure and sensitizing practitioners of each system (Allopathic and AYUSH) to the strengths of the others. Such validation would lead to greater acceptability and even use of AYUSH remedies by all practitioners- and there is potential for such use in NCDs care and geriatric care and promotive health. This is also needed for integration across the different streams within AYUSH and for cross-referrals as appropriate across systems. This is also required for systemic validation evidence pertaining to safety, efficacy and quality of AYUSH drugs and therapies. Promotion of further research in this field will be actively pursued, and application of available integrative knowledge through development of appropriate clinical protocols for primary, secondary and tertiary levels will be part of this approach.  . To better regulate the AYUSH drugs market the policy would also support establishment of separate Central Drug Controller for AYUSH drugs and strengthening of quality enforcement mechanism in the States for application to mass manufactured drugs.

5.7. The expansion of primary care from selective care to comprehensive care requires a complementary human resource strategy.  Another option is to develop such mid-level providers and through bridge courses and short courses by which graduates from different clinical and paramedical backgrounds, like AYUSH

9.8 ICT would similarly be used for generation and sharing of information about AYUSH services and AYUSH practitioners, the traditional community level healthcare providers, and household level preventive, promotive and curative practices. This will strengthen the management and quality of AYUSH services in the public system and also provide an outreach component for prevention and promotion of health.

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