Building Public Health Imagination in Controlling NCDs through Integrative Medicine - A Narrative Synthesis Scoping Review on its Challenges & Future in India
Abstract
Background: India is amidst an epidemiological transition with the country’s health system being tested to manage the dual burden of communicable and Non-Communicable Diseases (NCDs) and it is prudent that policy bearers should ensure stratification of data collected through large-scale surveys like NFHS & NSS for better understanding of NCDs in India and AYUSH users for NCDs. The subject scoping review focuses on the uptake of the AYUSH system of medicines in the backdrop of NCDs in India, systems approach to healthcare, the concept of integrative medicine and the challenges it faces in terms of scalability and mass adoption.
Design & Method: Through a comprehensive literature review exercise, and nationally representative NFHS data on health, the qualitative research work presents an analysis to comprehend the evident prevalence of NCDs in India and the usage of the AYUSH system of medicine to restrain these chronic conditions with mechanisms like integrative medicine.
Results: Out of the 1087 articles validated, 27 were finalised for a detailed review with respect to the identified thematic analysis. The selected articles assimilated through multiple themes and theories include the theory of the classical model of epidemiological and demographic transition and its inference in Indian settings with essential data on diseases (communicable and NCDs) in India, usage of Complementary and Alternative Medicines (CAM/ AYUSH) in global/ Indian context and its mainstreaming with biomedicine, systems approach to healthcare and global innovations in digital health.
How to cite this article:
Anthony KR. Building Public Health Imagination in Controlling NCDs through Integrative Medicine - A Narrative Synthesis Scoping Review on its Challenges & Future in India. Chettinad Health City Med J. 2022;11(4):61-78.
DOI: https://doi.org/10.24321/2278.2044.202242
References
Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. Milbank Mem Fund Q. 1971;49(4):509-38. [PubMed] [Google Scholar]
Goli S, Arokiasamy P. Demographic transition in India: an evolutionary interpretation of population and health trends using ‘change point analysis’. PLoS One. 2013;8(10):e76404. [PubMed] [Google Scholar]
India State-Level Disease Burden Initiative Collaborators. Nations within a nation: variations in epidemiolgical transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet. 2017;390:2437-60. [PubMed] [Google Scholar]
Martens P, Huynen M. A future without health? Health dimension in global scenario studies. Bull World Health Organ. 2003;81(12):896-901. [PubMed] [Google Scholar]
Department of Health & Family Welfare, Ministry of Health & Family Welfare, Government of India. 2020-2021 Annual Report: Section: National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). 2022. p. 175-8.
International Institute for Population Sciences (IIPS), ICF. National Family Health Survey (NFHS-5), 2019-21: India. Vol. 1. Mumbai: IIPS; 2022.
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta analysis: the PRISMA statement. BMJ. 2009;339:b2535. [PubMed]
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-88. [PubMed] [Google Scholar]
Yadav S, Arokiasamy P. Understanding epidemiological transition in India. Glob Health Action. 2014;7:23248. [PubMed] [Google Scholar]
Chesnais JC. Demographic transition patterns and their impact on the age structure. Popul Dev Rev. 1990;16:327-36. [Google Scholar]
Sinha R, Pati S. Addressing the escalating burden of chronic diseases in India: need for strengthening primary care. J Family Med Prim Care. 2017;6(4):701-8. [PubMed] [Google Scholar]
Rossler W, Lauber C, Angst J, Haker H, Gamma A, Eich D, Kessler RC, Ajdacic-Gross V. The use of complementary and alternative medicine in the general population: results from a longitudinal community study. Psychol Med. 2007;37(1):73-84. [PubMed] [Google Scholar]
Singer J, Adams J. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers. BMC Complement Altern Med. 2014;14:167. [PubMed] [Google Scholar]
Bhat S, Gupta N, Srikanth N, Padhi MM, Rana R, Singhal R, Dhiman KS. Approaches for integrating Ayurveda with the conventional system in a multispeciality hospital for management of osteoarthritis (knee). J Res Ayurvedic Sci. 2017;1(1):40-7.
Vishnu N, Mini GK, Thankappan KR. Complementary and alternative medicine use by diabetes patients in Kerala, India. Glob Health Epidemiol Genom. 2017;2:e6. [PubMed] [Google Scholar]
Nailwal D, Venkatashiva RB, Gupta A. Patterns and predictors of complementary and alternative medicine use in people presenting with the non-communicable disease in an urban health facility, North India. J Public Health Res. 2021;10(1):2109. [PubMed] [Google Scholar]
Gopichandran V, Kumar SC. Mainstreaming AYUSH: an ethical analysis. Indian J Med Ethics. 2012;9(4):272-7. [PubMed] [Google Scholar]
Singhal S, Roy V. Awareness, practice and views about integrating AYUSH in allopathic curriculum of allopathic doctors and interns in a tertiary care teaching hospital in New Delhi, India. J Integr Med. 2018;16(2):113-9. [PubMed] [Google Scholar]
Rudra S, Kalra A, Kumar A, Joe W. Utilization of alternative systems of medicine as health care services in India: evidence on AYUSH care from NSS 2014. PLoS One. 2017;12(5):e0176916. [PubMed] [Google Scholar]
Chowdhury S, Kundu P. Alternate systems of medicine in India – how pervasive & why? J Health Manag. 2018;20(2):1-12. [Google Scholar]
Mohanty PC, Sharma K. Households’ responses on medical pluralism: dynamics and determinants of access to traditional medicines in India. Clin Epidemiol Glob Health. 2021;12:100880. [Google Scholar]
Gawde SR, Shetty YC, Pawar DB. Knowledge, attitude, and practices toward ayurvedic medicine use among allopathic resident doctors: a cross-sectional study at a tertiary care hospital in India. Perspect Clin Res. 2013;4(3):175-80. [PubMed] [Google Scholar]
Bolshete PM. Analysis of Ayurvedic clinical trials registered in Clinical Trials Registry of India: retrospective versus prospective registration. Anc Sci Life. 2018;37(1):9-15. [Google Scholar]
Devi MS, Sathiyarajeswaran P, Kanakavalli K, Vinod NP, Baskar V. Analysis of AYUSH studies registered in clinical trials registry of India from 2009 to 2020. J Ayurveda Integr Med. 2021;12(2):346-50. [PubMed] [Google Scholar]
Turner JR, Baker R. Just doing the do: a case study testing creativity and innovative processes as complex adaptive systems. New Hori Adult Educ Human Res Dev. 2020;32(2):40-61. [Google Scholar]
Patwardhan B. Bridging Ayurveda with evidence based scientific approaches in medicine. EPMA J. 2014;5(1):19. [PubMed] [Google Scholar]
Notarnicola I, Petrucci C, Barbosa MR, Giorgi F, Stievano A, Rocco G, Lancia L. Complex adaptive systems and their relevance for nursing: an evolutionary concept analysis. Int J Nurs Pract. 2017;23(3). [PubMed] [Google Scholar]
Rodgers BL. Concept analysis. An evolutionary view. In: Rodgers BL, Knafl KA, editors. Concept development in nursing: foundation techniques and applications. 2nd ed. Philadelphia: WB Saunders Company; 2000. p. 77-102. [Google Scholar]
Martin CM, Grady D, Deaconking S, McMahon C, Zarabzadeh A, O’Shea B. Complex adaptive chronic care – typologies of patient journey: a case study. J Eval Clin Pract. 2011;17(3):520-4. [PubMed] [Google Scholar]
Jiang F, Jiang Y, Zhi H, Dong Y, Li H, Ma S, Wang Y, Dong Q, Shen H, Wang Y. Artificial intelligence in healthcare: past, present & future. Stroke Vasc Neurol. 2017;2(4):230-43. [PubMed] [Google Scholar]
Muthappan S, Elumalai R, Shanmugasundaram N, Johnraja N, Prasath H, Ambigadoss P, Kandhasamy A, Kathiravan D, Ponnaiah M. AYUSH digital initiatives: harnessing the power of digital technology for India’s traditional medical systems. J Ayurveda Integr Med. 2021;13(2):100498. [PubMed] [Google Scholar]
Cohen AB, Dorsey ER, Mathews SC, Bates DW, Safavi K. A digital health industry cohort across the health continuum. NPJ Digit Med. 2020;3:68. [PubMed] [Google Scholar]
Maddula R, MacLeod J, Painter S, McLeish T, Steward A, Rossman A, Hamid A, Ashwath M, Martinez HR, Guha A, Patel B, Addison D, Blaes A, Choudhuri I, Brown SA. Connected Health Innovation Research Program (C.H.I.R.P.): a bridge for digital health and wellness in cardiology and oncology. Am Heart J Plus. 2022;20:100192. [Google Scholar]
Health Systems Governance and Financing UHL, World Health Organisation, The World Health Report; Health Systems: improving performance. 2000; A53/4; ISBN: 924156198X
Buckley W. Society as a Complex Adaptive System. In: Systems research for the behavioral science. Aldine Publishing Company; 1968. [Google Scholar]
Maslow AH. A theory of human motivation. Psychol Rev. 1943;50:370-96.
Ridder DD, Stockl T, Langguth B, Vanneste S. Noninvasive transcranial magnetic and electrical stimulation: working mechanisms. In: Evans JR, Turner RP, editors. Rhythmic stimulation procedures in neuromodulation. Academic Press; 2017. [Google Scholar]
Notarnicola I, Stievano A, Pulimeno A, Rocco G. Systems thinking, complex adaptive systems and health: an overview on new perspectives for nursing education. Springer Nature, Switzerland AG 2019, AISC; 2019;804. p. 1-8. [Google Scholar]
Turner JR, Baker RM, Romine K. Complex Adaptive Team Systems (CATS): scaling of a team leadership development model. In: Franco M, editor. Digital leadership: a new leadership style for the 21st century. London, UK: IntechOpen; 2020. [Google Scholar]
Botelho R. Reverse the epidemic tides of unhealthy habits: personal, professional and leadership challenges. In: Sturmberg J, Martin CM, editors. Handbook of systems & complexities in health. New York: Springer; 2013. p. 727-54. [Google Scholar]
Nagel T. Reductionism and antireductionism. In: Bock GR, Goode JA, editors. The limits of reductionism in biology. Wiley, Chichester (Novartis Foundation Symposium 213); 2007. p. 3-14. [Google Scholar]
Maizes V, Schneider C, Bell I, Weil A. Integrative medical education: development and implementation of a comprehensive curriculum at the University of Arizona. Acad Med. 2002;77(9):851-60. [PubMed] [Google Scholar]
Fekih RB, Lahami M. Application of blockchain technology in healthcare: a comprehensive study. In: Jmaiel M, Mokhtari M, Abdulrazak B, Aloulou H, Kallel S, editors. The impact of digital technologies on public health in developed and developing countries. ICOST 2020. Lecture Notes in Computer Science. Vol 12157. Springer, Cham; 2020. p. 268-76. [Google Scholar]
Brown SA, Beavers C, Martinez HR, Marshall CH, Olaye IM, Guha A, Cho D, Bailey A, Bergom C, Bansal N, Bauer B, Cheng RK. Bridging the gap to advance the care of individuals with cancer: collaboration and partnership in the Cardiology Oncology Innovation Network (COIN). Cardiooncology. 2022;8(1):2. [PubMed] [Google Scholar]
Caufield BM, Donnelly SC. What is connected health and why will it change your practice? QJM. 2013;106(8):703-7. [PubMed] [Google Scholar]
