Local Health Traditions Research Articles

Medicinal Plants in Local Health Traditions (LHTs)

Aim: Tripura is a small state of the northeastern part of India. The floral biodiversity is playing an important role in the traditional system of treatment in tribal and rural population. The research pertaining to the use of medicinal plants in ethnomedico-botany and formulations of study area is limited. The Medico-Ethno-Botanical Survey (MEBS) team of Regional Ayurveda Research Institute (RARI), Itanagar, documented the local health traditions (LHTs) from traditional healers of rural and tribal pockets of Dharmanagar subdivision, North district, Tripura. Materials and methods: The MEBS has been conducted in tribal pockets and villages of Dharmanagar Range, Damchera Range, and Panisagar Ranges of Dharmanagar subdivision of Forest, North Tripura district, Tripura. Local health traditions (LHTs) were documented through discussion and interview with traditional healers in the prescribed format along with global positioning system (GPS) location and digital photography of healer and plant raw drugs used in the traditional medicine and also prepared formulations. Medicinal plants were identified by using local and regional flora followed by processing, mounting, and preservation. Documented information has been processed for scientific validation and Ayurvedic names were provided to medicinal plants. Results and discussion: The MEBS conducted and documented six folk claims with six medicinal plants in prescribed formats to conserve traditional knowledge. The data presented systematically as botanical name, family, Sanskrit name, part used, morphological description of the plant, method of formulation, indication, and information of folk healer. Conclusion: Folk healers of Dharmanagar subdivision, Tripura, collects and use medicinal plants from surrounding area in the treatment of Sarpa Danstra (snake bite), Kamala (jaundice), Stanyajanan (galactagogue), Udarasula (acute abdomen), Alpamutrata (oliguria), and Vrana (fresh wound) popularly. Further, scientific validation is required to understand the useful therapeutic benefits and large-scale medicine production for the treatment. Clinical significance: The MEBS team noticed that some medicinal plants are used in the treatment of human diseases, such as Alstonia scholaris (L.) R. Br. in snake bite, Cuscuta reflexa Roxb. in jaundice, Euphorbia herita L. in galactagogue, Scoparia dulcis L. in acute abdomen, Sida acuta Burm. f. for oliguria, and Mikania micrantha Kunth for fresh wound. These plants need to be studied in detail in order to harvest the maximum benefit for the mankind.

Local Health Traditional Practices of Koppal District, Karnataka, India

Aim: The present study is to document the information on local health traditions used for various human and animal diseases by traditional healers of Koppal district, Karnataka, India. Materials and methods: Seasonal ethnomedicobotanical (EMB) Survey has been conducted in Koppal district Karnataka during 2013 to 2014 to document the local health traditions (LHTs) knowledge related to human and animal. Results: The EMB survey team documented 24 LHTs claims in Koppal district, Karnataka, which were related to joint pains, bone fracture, psychiatry, gastrointestinal disorders, skin disease, hemorrhoids, diabetics, aphrodisiac, infections, eye disease, neurological disorders, gynecological disorders, jaundice, migraine, and inducing of vomiting in human beings and few veterinary practices such as diarrhea, loss of appetite, stomatitis, and bone fracture. Conclusion: Traditional healers are sheltered in the remote rural and tribal pockets. This is the time to identify effective formulations to manage or treat human ailments and spread the awareness in public for use. Scientific society has to work to introduce modern techniques in traditional system, identify unique properties that are playing very important role in the treatment of health issues, and validate scientifically and recommend the formulations for large-scale production by pharmaceutical industry for the benefit of the common people.

Documentation of Local Health Traditions of Yadgir District, Karnataka

Aim: The traditional medicinal practice in India includes different aspects of health such as prevention, promotion, and healing. Since there is need for documenting this traditional medicinal practice prevalent in different parts of the country for the preservation of the knowledge, the present study was undertaken to record the traditional knowledge of medicine from Yadgir district of Karnataka. Materials and methods: A Medico-Ethno Botanical survey was undertaken in the Yadgir district of Karnataka between September and December 2017. Data were collected from traditional healers and locals by means of personal interviews using a prescribed format. Results: A total of 20 folk claims used for the treatment of 16 different disease conditions were recorded. The remedies were mostly prepared in the form of decoction, paste, poultice, juice, etc. and were mainly taken orally. Eczema, paralysis, toothache, wound obesity, diabetes, fever, jaundice, fracture, cough, anemia etc. are some of the diseases usually treated by traditional practitioners. Only single ingredient was used in 16 documented claims whereas remaining 4 are compound preparations having more than one ingredient. It is observed that, most of the medicinal plants are used in fresh form, after collecting from their natural habitat whenever necessary. Conclusion: Since the documentation of traditional knowledge on medicinal uses of plants is vital for the future generation, this study could serve an important role in fulfilling this purpose. Clinical significance: The documented data can also serve as a base for the development of new medicines by scientific studies.

Use of local health traditions for prevention and cure of diseases by households in northern India

Introduction: “Traditional” medicine is a system of medicine that has been practiced in its country of origin for many years. More emphasis is being given to include the Traditional Systems of Medicines into the National Health System. Local Health Traditions (LHT) where household food items and plants are used as medicine is widespread in India. Objectives: To determine the knowledge about medicinal plants and food items used as medicine. To document the use of LHT for specific disease conditions. To elicit community perception of any change in utilization of LHT Methods: The study was carried out in the urban slums and poor neighbourhoods of Aligarh city. One hundred households belonging to lower middle class, poor slum dwellers or homeless households purposively selected. Efforts were made to assess the attitude towards value of LHT in their day to day existence. Care was taken that no leading questions were asked. Results: More than 104 plants were named by respondents as being useful for treatment of different ailments. The use of home remedies for acute conditions was high (50% -98%). Home remedies were also extensively used for chronic diseases. A large number of household foods and herbs were used to improve lactation. Traditional home remedies were also used for care of newborn. Conclusion: The respondents were universally aware of the value of LHT and utilized it for both acute and chronic disease. There is change in practice over time of LHT. LHT should be viewed as complementary to other systems.

On the unraveling of \u2018revitalization of local health traditions\u2019 in India: an ethnographic inquiry

BackgroundIndia has recently renewed emphasis on non-allopathic systems of medicine as a means to address the health needs of its populace. Earlier in 2002, its national health policy had sought to ‘revitalize’ community-based health knowledge and practices – jointly christened ‘local health traditions’. Yet policy texts remain silent on the actual means by which ‘revitalization of local health traditions’ should take place. Our research sought to understand the policy lessons of and for revitalization of local health traditions in the three Southern Indian states through an ethnographic inquiry in 2014–2016.MethodsOur inquiry included a narrative synthesis of policy texts tracing the history of governance processes and mechanisms pertaining to traditional medicine, including local health traditions, linking this to the activities of non-governmental organizations (NGOs) and networks involved in “revitalization”. Through in-depth interviews, observations and case studies, we sought to understand the life worlds of local health tradition practitioners and what revitalization meant to them. Our method revealed that beyond a purely academic inquiry, we needed an (inter)action that would give greater voice to these perspectives and views leading to hosting an interactive dialogue among practitioners, NGO representatives, academics, and government officials.ResultsOur ethnographic inquiry unraveled the problematic of a litotic approach to local health traditions as those which are non- institutionalized, non-certified, non-documented; assuming the state to be the only source of power and legitimacy. Revitalization discussions were restricted (and often misled) by such an approach. Local health practitioners and others directed us to interesting possibilities of revitalization either through participatory modes of documentation of traditional health knowledge, strengthening existing collective forums for formal social recognition, and building pedagogical institutions that promote experiential learning.ConclusionWere we not enabled by ethnography as a method that changes its shape apace with emerging findings, we would have not been able to comprehensively answer our questions. This is critical because not only was this already a marginalized area of inquiry, but with any other method we risked reinforcing inequities by imposing epistemological and other hierarchies on our participants– whom we would argue were partners - in arriving at our conclusions.

The role of Garo tribes of Meghalaya (India) in the conservation and management of medicinal plants diversity used in treating livestock diseases

The Garo tribe of Meghalaya, India have rich local health traditions and large numbers of traditional healers have been practicing herbal medicines for many years. The present study aims at quantifying the plant species used for ethno-veterinary purposes and to identify their conservation status. Out of 90 informants 22 were traditional healers and 68 were farmers. A total of 75 ethnoveterinary medicinal plant species belonging to 71 genera and 49 families were documented and identified for treating 24 different livestock ailment. Most of the medicinal plants (83%) were collected from the wild and leaves were the most frequently used (58%) parts for formulation of drugs; oral application is most frequently employed (56%), followed by the dermal application which accounts for 31%. The medicinal plants collected are mostly trees (31%), followed by herbs (25%). The study indicates that some species are rare or endangered and their use is therefore unsustainable. The strategies for effective conservation of endangered medicinal plant are discussed here.

Ethnomedicine, Health Food and Nutraceuticals-Traditional Wisdom of Maternal and Child Health in India

Food and medicine are indispensable companions of humans since the very beginning of his existence. The early man explored his surroundings to locate materials of natural origin for food and medicine. He continued his search in the plant and animal kingdoms to expand his food basket, to heal his ailments and discomforts. The desire to attain vitality and longevity also prompted the early man to experiment with whatever available in his immediate neighbourhood. By a process of trial and error, observation and empirical reasoning and inference the early man made conscious selections of a variety of biological materials to enhance his health, to alleviate pain or to treat other physical and mental ailments. The knowledge thus gathered was passed on to succeeding generations. Creative members of the succeeding generations incrementally improved and even added new knowledge to this body of traditional knowledge system. This traditional wisdom has come down to us from our ancestors and we now term it as traditional knowledge or ethnic knowledge. We find this knowledge system getting perpetuated through folklore, local health traditions, tribal knowledge system, family and community based knowledge systems etc. All ancient cultures and civilizations of the world had thus evolved their own traditional food, nutrition and medicine from their ambient biological wealth. The Ayurvedic Masters of ancient India had a clear understanding of the delicate cellular mechanism of the body and the deterioration of the functional capacity of human being. To arrest such deterioration of the functional efficiency and to revive and revitalize the body system, the Ayurvedic masters developed an elaborate rejuvenation therapy known as ‘Rasayana’ therapy. ‘Rasa’ in Sanskrit means the essence and ‘ayana’ means to circulate in the body without any obstruction. ‘Rasayana’ is one of the eight clinical specialities of Ayurveda that is aimed for the rejuvenation and geriatric care. Rasayana is not a drug therapy, but a specialized procedure practiced to cleanse the body from the toxic and other microbial substances. In Rasayana Therapy, with the help of special diet and nutritional agents comprising of highly powerful antioxidants, the body is rejuvenated by providing greater immunity, vitality, longevity and by improving all faculties to attain youthfulness of the whole body.

Local Health Traditions (LHTs)/Ethnomedical Practices (EMPs) for Sikkim

Aim: Sikkim state is endowed with rich plant biodiversity. Most of the tribal and rural populations following organic techniques for their livelihood depend on traditional systems for treatment of human ailments. The present work has been carried out to understand the local health traditions and use of common plants for treatment by rural populace of Sikkim. Materials and methods: The medico-ethno botanical survey was conducted by documenting the local health traditions by interviewing traditional healers of tribal and rural population and by collecting medicinal herb specimens and digital photography of herbs and healers for further process. Results: The medico-ethno botanical survey team documented a total of 20 folk claims with 18 medicinal plants used by traditional healers for ailments like wounds, cuts, bleeding, cough, fever, tonsils, sinusitis, migraine, pneumonia, breathing problems, jaundice, indigestion, burning sensation of stomach, constipation, piles, retention of urine, crack bone, dislocated bones, toothache, and ringworm. Conclusion: The tribal and rural population of Sikkim lives in remote rural areas with low income, and since it is difficult to afford modern medical treatment, local traditional healers use commonly available medicinal plants from nearby forests for the treatment of different ailments. It is high time to think and use common available medicinal plants in new formulations for treatment and to overcome the problem of substitutes and adulterations and also to conserve rare, threatened, and endangered medicinal plants.

Systematic Documentation and Validation of Local Health Traditions (LHTs) and Ethno-Medical Practices (EMPs) through a National Strategy for Centralized Coordinated Work

Systematic Documentation and Validation of Local Health Traditions (LHTs) and Ethno-Medical Practices (EMPs) through a National Strategy for Centralized Coordinated Work

Doktor Kot, Doktor Sla – book doctors, plant doctors and the segmentation of the medical market place in Meghalaya, northeast India

ABSTRACTDespite decades of research on India's plural health care market, the practices of many local health traditions outside the allopathic and codified traditions are under-studied. Drawing on interview and observational data, this paper explores the space in which indigenous traditional Khasi healers in Meghalaya state, northeast India, practice. Khasi indigenous healers describe themselves as doktor sla, plant doctors, to distinguish themselves from doktor kot, or book doctors. This distinction operates as a rhetorical resource, utilised to carve a distinct sphere of expertise in relation to the allopathic sector, and to mark claims for the specifically local appropriateness of traditional practices within a shifting market of state-sponsored provision. Khasi healers are a heterogeneous group who treat a wide variety of conditions, including physical ailments which have no obvious correlates in biomedical systems, and musculoskeletal disorders, with which they have recognised expertise. In addition to claiming these discrete strengths, healers also present themselves as accommodating deficiencies in biomedicine, including inherent generic weaknesses of allopathic care as well as specific local gaps in rural health care provision. Thus, the expertise niches of traditional healers have evolved through their interactions with, and the needs of, the community, but also through managing a shifting boundary with biomedical practitioners, who are explicitly sceptical of their efficacy, but tacitly accepting of the ways in which they manage the gaps in biomedical provision. While codified non-biomedical traditions in India have engaged in universalising professionalising projects, in this setting at least, non-codified practitioners have instead utilised discourses of localism.

Tribal Health Care Research Program

Introduction: Tribal Health Care Research Program (THCRP) was initiated by the Central Council for Research in Ayurvedic Sciences (CCRAS) in 1982. The core objective of the program is to study the living conditions of tribal people, which includes health-related demography, documentation of folk claims, local health traditions (LHTs), use of common medicinal plants and their availability, propagation of knowledge about personnel hygiene, and prevention of diseases besides extending medical aid at their doorsteps. The program has been implemented in Madhya Pradesh, Maharashtra, Bihar, Assam, Arunachal Pradesh, and Andaman and Nicobar at different years from 1982 to 2016. During this period, five independent Tribal Health Care Research units have been relocated through reorganization, which came into force in the year 2000. Further, during the year 2014 to 2015 and 2016 to 2017 the program has been extended in 10 more states, viz., Rajasthan, Jammu and Kashmir, Himachal Pradesh, Karnataka, Tamil Nadu, West Bengal, Odisha, Andhra Pradesh, Sikkim, and Telangana. Currently, the THCRP is being executed in 14 states through 15 peripheral institutes of CCRAS under tribal subplan (TSP). Materials and methods: The gross physical achievements including the beneficiaries of health care services, details of villages, tribal pockets covered, documentation of disease prevalence, and LHTs during the period 1982 to 2016 were compiled, summarized, and presented based on the information available in the published monographs, technical reports, and annual reports. Conclusion: A critical appraisal of THCRP revealed that from 1982 up to March 2016, CCRAS has extended health care services at 1,358 villages/tribal pockets that represent around 50 tribes across 14 states covering a population of 947,587. Apart from propagation of knowledge about hygiene and prevention of diseases, medical aid was provided to 336,015 seekers. In addition to this, through this program about 734 folklore claims, LHTs, use of common medicinal plants and their availability were documented and also the prevalence of different diseases in the tribal pockets was recorded.

Suggested Format for Documentation of Demographic Data, Living Conditions, and Health Status for Research-oriented Health Care Programs

ABSTRACT Central Council for Research in Ayurvedic Sciences (CCRAS) has initiated various research-oriented health care programs, such as Tribal Health Care Research Program (THCRP) under Tribal Subplan, Ayurveda Mobile Health Care Program (AMHCP) under Scheduled Caste Subplan, and Swasthya Rakshan Program (SRP) linked with Swachh Bharat. The aim of these programs is to study the living condition of people, to make them aware about the importance of good health, knowledge about hygiene, awareness about cleanliness of domestic surrounding and environment, documentation of folk medicine and local health traditions, availability and use of common medicinal plants in that area, and to extend medical aid at their doorstep. Through peripheral institutes of CCRAS, THCRP is being executed in 14 states, AMHCP in 18 states, and SRP in 19 states. As an effective information generation tool for research-oriented health care programs, CCRAS has developed a comprehensive format for documentation of demographic data, living conditions and health status, etc. of population, which can be well utilized as a tool for uniform documentation of information by students, scientists, and researchers of various organizations involved in such type of research activities. How to cite this article Maheswar T, Singh S, Singh R, Khanduri S, Ota S, Srikanth N. Suggested Format for Documentation of Demographic Data, Living Conditions, and Health Status for Research-oriented Health Care Programs. J Drug Res Ayurvedic Sci 2017;2(3):241-246.

Methodical Documentation of Local Health Traditions and Folklore Claims

Quest for healthy and long life is perhaps as old as human existence and efforts are unremitting to address the challenges and triumph over the bottlenecks across this journey. Natural products of botanical, animal or mineral sources have initiated the scientific expedition of drugs since antiquity. Still, more interesting leads are emerging for drug discovery from documented traditional knowledge and certain oral undocumented Local Health Traditions (LHTs). The LHTs encompass the integral component medical heritage of the any country. Systematic documentation of such knowledge is pivotal to preserve the medical heritage of the country besides scientific validation of its attributes and principles. Central Council for Research in Ayurvedic Sciences (CCRAS) has developed a comprehensive format for documentation of Local Health Traditions (LHTs), Folklore Claims etc. This format could be well utilized as a tool for uniform recording of information by scientists and scholars engaged in ethno medicinal, ethno pharmacology and traditional medicine research

A Review on Mainstreaming of AYUSH and Revitalization of Local Health Traditions under NRHM

A Review on Mainstreaming of AYUSH and Revitalization of Local Health Traditions under NRHM

Generation of Basic Information on Claims pertaining to Local Health Traditions, Oral Health Traditions, and Ethnomedical Practices for Validation: An Elective Pro Forma for Documentation by Individuals

Generation of Basic Information on Claims pertaining to Local Health Traditions, Oral Health Traditions, and Ethnomedical Practices for Validation: An Elective Pro Forma for Documentation by Individuals

How healthy are we? Narratives of experiential health from a village of Western Nepal

It has become a custom citing development reports, which show remarkable progress in some of the health indicators, to signify the higher quality of life achieved over the years. The human development datasets, for instance, present impressive progress in terms of decreased mortality, increased life expectancy, higher literacy and falling poverty which is synonymous to a higher standard of living. With the amazing success in medical science, advancement in therapy and surgery, and prevention and control over some of the dangerous diseases, we are bound to believe that we have achieved much, and there is no question whether the overall health condition has been worsened in the last few decades. The real life experience of local people, however, challenges this fact and compels us to reflect on “are we really healthy than before?” Drawing from a qualitative study conducted in a district of mid-western Nepal, this paper presents people’s narratives to deepen our understanding of how people in an urbanizing village experience health. The paper recognizes the deteriorating health experience of the people which has primarily resulted from a loss of local health traditions exacerbated by the current change and development.

Dissociated reality vis-a-vis integrative planning of AYUSH in Maternal Health Program: A situational analysis in Jaleswar block of Balasore district of Odisha, India

Mainstreaming of AYUSH and revitalization of local health traditions is one of the innovative components of the National Rural Health Mission (NRHM) in the state of Odisha, India. In this study, an attempt was made to assess the potential of collocating AYUSH to improve maternal health services in tribal dominated Jaleswar block of the Balasore district. In addition, the study aimed at unearthing the underlying challenges and constraints in mainstreaming AYUSH and linking it with the Maternal Health Program.Review of the policy documents and guidelines, both central and state government, was made to assess the implementation of AYUSH in Odisha. Primary data were collected through interviews with AYUSH doctors, district and block level health administrators, and tribal women.The study revealed the inadequacy of basic amenities, infrastructure, drugs, and consumables in the health centers for integrating AYUSH in the delivery of maternal health services. Analysis of the job chart and work pattern of AYUSH doctors showed underutilization of their specialized knowledge to treat patients. Lack of continued medical education, standard operating procedures for treatment and spatial marginalization made suboptimal utilization of AYUSH services. This is unfortunate given the fact that such regions are economically underdeveloped and already have a distinct orientation toward indigenous health systems. AYUSH, on account of its holistic approach and proven cost-effectiveness, could be a viable option for improving maternal health in the region.The study concluded that although there is huge scope for integrating AYUSH in Maternal Health Program under the ongoing NRHM, the full potential is yet to be exploited.

Assessment of traditional ecological knowledge and beliefs in the utilisation of important plant species: The case of Buhanga sacred forest, Rwanda

Traditional ecological knowledge is an integrated part of the African people and indeed the Rwandese for cultural purpose. Buhanga sacred forest is a relict forest of tremendous ecological importance to Rwandan society located in Musanze District. The aim of this study was to assess the traditional ecological knowledge and belief in the utilisation of some important plant species for the conservation of Buhanga sacred forest. Ecological information about ethnomedicinal and traditional practices were collected following structured questionnaire through interview involving eight traditional healers and three focus group discussions. Data were collected from the natural habitats, home gardens, farmlands and roadsides of Buhanga sacred forest. A total of 45 botanical taxa belonging to 28 families were reported to be used by the local community. Species such as Brillantaisia cicatricosa and Senna septemtrionalis were the popular species cited by traditional healers to treat human and animal diseases and ailments, respectively. The results of the study indicated that because of the cultural norms and values associated with the sacred forest, this has led to non-exploitation. The study presents key sites and plant species in which their use and belief can lead to their conservation. However, not only is it imperative to conserve traditional local knowledge for biocultural conservation motives but there is also need to train traditional healers on how to domesticate indigenous species as conservation measure because some species have become susceptible to extinction.Conservation implications: Highlighting indigenous species investigated in this research will provide a powerful tool for ensuring biodiversity conservation through community participation in a country of high population density in Africa. Some plant species that provided satisfactory Local Health Traditions among communities surrounding Buhanga can contribute as good material for further research in Rwanda.

Standardization of Unani Antidiabetic Tablet - Qurse Tabasheer.

Background:Quality control of Unani polyherbal formulations is the need of the day for better acceptance of Unani medicine. Qurse Tabasheer (QT) is a Unani polyherbal formulation containing six ingredients, Tabasheer (Siliceous concretions) (Bambosa arundinaceae Retz.), Gule Surkh (Rosa damascena Mill. flower), Gulnar (Punica granatum Linn. flower), Tukhme kahu (Lactuca sativa Linn. seed), Tukhme khurfa (Portulaca oleraceae Linn. seed), and Gile Armani (bole) widely used in treatment of diabetes. The present study was taken up to scientifically evaluate the various physicochemical parameters to standardize the formulation.Objective:To evaluate various physicochemical parameters including ash values, moisture content, extractive values, thin layer chromatography (TLC) and high-performance TLC (HPTLC), friability, disintegration, uniformity, and weight variation for standardization of QT.Materials and Methods:Ingredients were identified by the experts. The method mentioned in national formulary of Unani Medicine with modification was followed for preparation of the tablets. Physicochemical standards were established for ideal batch of tablets on the basis of set parameters regarding friability, hardness, and disintegration. Various parameters such as organoleptic characters, extractive values for the extract and HPTLC fingerprinting postcompression were carried out for evaluation of QT.Results:Parameters for loss of weight on drying, pH, ash values, extractive values documented. Qualitative chemical tests indicated the presence of alkaloid, glycoside, tannins, and steroids. TLC and HPTLC fingerprinting studies showing the presence of major peaks were documented. Friability, hardness, and disintegration time of ideal batch was 0.09 ± 0.0057, 4.03 ± 0.087, and 25.57 ± 0.4860 min, respectively, and it was found to be within the set limit. Weight variation was <5%. Total fungal and bacterial counts were found to be within the limit.Conclusion:Standards were established for poly herbal formulation QT, which may be used as reference for preparation and standardization of QT.SUMMARY In this work Standardization of anti-diabetic tablet Qurse Tabasheer with diverse ingredients including herbal and mineral origin drugs has been attempted with identification of its ingredients, formulation, physicochemical evaluation and HPTLC finger printing, which may help in preparing consistent and better efficacious formulations. Abbreviations Used: QT: Qurse Tabasheer TLC: thin layer chromatography HPTLC: high-performance thin layer chromatography WHO: World health organization FRLHT: Foundation for Revitalization of Local Health Traditions Fe2O3: Iron oxide Sio2: Silica CaCo3: Calcium carbonate, Tio2: Titanium Oxide NIUM: National Institute of Unani Medicine #: Mesh size LOD: Loss of weight on drying USP: United state Pharmacopeia UV: Ultra Violet λ: Lambda θ: theta CFU: Colony-forming unit

Is 'mainstreaming AYUSH' the right policy for Meghalaya, northeast India?

BackgroundNational policy on medical pluralism in India encourages the mainstreaming of AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) systems and the revitalization of local health traditions (LHT). In Meghalaya state in the northeast, the main LHT is its indigenous tribal traditional medicine. This paper presents the perceptions of tribal medicine and of AYUSH systems among various policy actors and locates the tribal medicine of Meghalaya within the policy on medical pluralism currently being implemented in the state, a region that is ethnically and culturally different and predominantly inhabited by indigenous peoples.MethodsA stakeholder mapping exercise identified appropriate policy actors and 46 in-depth interviews were conducted with policy makers, doctors, academics, members of healer associations and elders of the community. A further 44 interviews were conducted with 24 Khasi and 20 Garo traditional healers. Interview data were supplemented with document analysis and observations. Qualitative data were analyzed using thematic content analysis that incorporated elements of grounded theory.ResultsIn Meghalaya there is high awareness and utilization of tribal medicine, but no visible efforts by the public sector to support or engage with healers. The AYUSH systems in contrast had little local acceptance but promotion of these systems has led to a substantial increase in AYUSH doctors, particularly homeopaths, in rural areas. Policy actors outside the health department saw an important role for tribal medicine due to its popularity, local belief in its efficacy and its cultural resonance. The need to engage with healers to enhance referral, training, documentation and research of tribal medicine was made.ConclusionsThe wide acceptance of tribal medicine suggests that tribal medicine needs to be supported. The results of the study question the process of the implementation of the ‘mainstreaming AYUSH’ policy for Meghalaya and highlight the importance of contextualizing health policy within the local culture. A potential role for Health Policy and Systems Research (HPSR) at sub-national levels is also highlighted.