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Dr. Mukta Sraj: Note on Mandate of HWCs & Ayurveda

Response from Dr. Mukta Sraj on mandate of HWCs and ability of Ayurveda Practitioners

1. The purpose of Health and Wellness Centers, as envisaged by Govt. of India is envisaged to deliver a comprehensive range of services which will address the primary health care needs of the entire population within the jurisdiction of each HWC, while expanding access, universality and equity within the community being served.

2. There is a pronounced emphasis on health promotion and prevention, designed to retain the focus on keeping people healthy by engaging and empowering individuals and communities to be responsible for choosing health seeking life style and regulated daily regimen which will together minimise exposure to the risk of developing chronic diseases and other morbidities.

3. A. Within this scheme of things, GoI envisages that primary health care needs include:
• meeting people’s health needs throughout their lives;
• addressing the broader determinants of health, such as clean drinking water and say, sanitation through multisectoral policy and action; and
• empowering individuals, families and communities to take responsibility for their
own health.

3. B. Primary and secondary prevention:
• Vaccination and post-exposure prophylaxis of children, adults and the elderly;
• Provision of complete information on the medical and health risks typically associated with behavioural and lifestyle management and what measures would be relevant and appropriate to reduce risks at the individual and population levels;
• Inclusion of disease prevention programmes at primary and specialized health care levels, with access to preventive services (ex. counselling);
• Nutritional and food supplementation; and
• Dental hygiene education and oral health services.
• Population-based screening programmes for early detection of diseases;
• Provision of maternal and child health programmes, including screening and prevention of congenital malformations; and
• Provision of chemo-prophylactic agents to control risk factors (e.g., hypertension)

3. C. Health promotion
• Policies and interventions to address intake of tobacco and alcohol, the dangers of physical inactivity, and the benefits of regular, healthy diet (e.g., FCTC , DPAS, alcohol strategy and NCD best-buys)
• Dietary and nutritional intervention would also appropriately tackle malnutrition, defined as a condition that arises from eating a diet in which certain nutrients are lacking, or are in excess (too high an intake), or in the wrong proportions
• Intersectoral policies and health services interventions to address mental health and substance abuse
• Strategies to promote sexual and reproductive health, including through health education and increased access to sexual and reproductive health, and family planning services, while cautioning about risky behaviour
• Strategies to tackle domestic violence, including public awareness campaigns; treatment and protection of victims; and linkage with law enforcement and social services. The MoHFW also states that – the principle being “time to care” to be no more than 30 minutes.

3. D. Expanded services includes

1. Care in pregnancy and child-birth.

2. Neonatal and infant health care services

3. Childhood and adolescent health care services.

4. Family planning, Contraceptive services and other Reproductive Health Care services

5. Management of Communicable diseases including National Health Programmes

6. Management of Common Communicable Diseases and Outpatient care for acute simple illnesses and minor ailments.

7. Screening, Prevention, Control and Management of Non-Communicable diseases

8. Care for Common Ophthalmic and ENT problems

9. Basic Oral health care

10. Elderly and Palliative health care services

11. Emergency Medical Services

12. Screening and Basic management of Mental health ailments

INPUTS from DR. MUKTA SRAJ (Ayurveda)
1. An AYUSH practitioner can take care of, and handle all the tasks and activities at the HWC except for the Emergency Care, which encompasses roughly 5-10% mortality in rural areas.
2. AYUSH practitioners can run a HWC single handedly tbecause their primary focus is expected to remain as health care promotion and prevention provided that they are also trained in basic life saving skills, so that they can contribute towards minimizing the mortality.
3. AYUSH practitioners could be trained in the diagnosis and treatment of the emergency care. Methods and medicines do exist BUT the major drawback is

1. No research on emergency Ayurvedic medicines
2. No research on Ayurvedic methods of Emergency handling

4. I have spoken to a few doctors both Ayurvedic private doctors and Allopathic doctors
working as MO –

1. Many BAMS students have commenced working in private hospitals and have begun to handle emergencies as soon as they complete their internship. Today there are a fair number of young Ayurvedic students with knowledge of equipments and methods used in emergencies
2. Many MO’s placed in the field, across rural India, shared with me that they have barely encountered any emergency healthcare that that cannot be sent to CHC

5. The maximum part of the HWC include the Preventive and promotive health , and that is the USP of AYUSH.

Role for Ministry of AYUSH
1. To help the teachers and practicing doctors to test the emergency methods they have
2. Then proceed further: these knowledgeable emergency care, AYUSH practitioners can train the students during their Graduate level education AS PART OF THE CURRICULUM.
3. Since this will benefit the next generation, for now, AYUSH practitioners in HWCs would need training in basic life saving skills before appointment.