Utilization of alternative systems of medicine as health care services in India, study based on National Sample Survey

Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS

Authors : Shalini Rudra ,Aakshi Kalra , Abhishek Kumar ,William Joe

A study done by the Institute of Economic Growth, Delhi University, published in PLOS One journal in 2017, only 6.9% of all patients who had sought outpatient care used AYUSH services, 3.5% used Indian systems of medicine such as Unani and Siddha, and 3% used homeopathy. The study was based on a nationally representative health survey 2014 with the total sample size of 65,932 households (36,480 rural and 29,452 urban) comprising of 333,104 individuals (189,573 rural and 143,531 urban).

“This is consistent with the fact that use of allopathy treatment is more common and that there is hardly any differentials in use pattern across rural and urban India.

1. Also, allopathy care accounted for over 90% of outpatient care across key socioeconomic and demographic variables,” the study said.
2. “Overall AYUSH utilization in India (about 7% of outpatient care) appears to be on the lower side when compared to some of the previous estimates or general perceptions,” it further said.
3. The study found that use of AYUSH among middle-income households was lower when compared with poorer and richer households.
4. AYUSH care utilization was higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments, the study observed.
5. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal.
6. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication.
7. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments.
8. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care.
9. In rural and urban India, 93.4% and 93.5% patients (persons reporting illness) respectively, have received allopathy-based outpatient care in the last 15 days prior to the survey whereas during the same reference period AYUSH care was used by about 6.7% and 7.1% patients in rural and urban India, respectively.
10. The ISM is the key component of the AYUSH system with utilization over 3.4% rural and 3.7% urban patients.
11. Homeopathy also has a significant presence within the AYUSH system. Across age groups, use of ISM care is relatively high among elderly patients (4.1% and 4.8% in rural and urban India, respectively) while homeopathy care is relatively more among children (under-five years), particularly in urban areas (4.8%).
12. Compared to males, use of AYUSH care among females was relatively high in rural India whereas no such gender-differential was observed in urban areas.
13. Notably, use of AYUSH care was less observed among the middle MPCE quintile households whereas it was higher among those at the either end of the MPCE distribution.
14. Also, patients with chronic illness reported greater use of AYUSH care both across rural (8.8%) and urban India (8.1%). While the all-India figures  suggest that the AYUSH care was utilized by 6.9% of patients but there were considerable variations across states and union territories with nine of them having more than 10% patients utilizing AYUSH care.
15. Among major States, Chhattisgarh (15.4%), Kerala (13.7%), and West Bengal (11.6%) displayed the highest AYUSH utilization levels. While ISM system was more popular component of AYUSH in Chhattisgarh and Kerala, homeopathy had a dominant presence in West Bengal.

“The need of the hour is to streamline the AYUSH systems of medicine by standardization and quality control of Ayurveda, Siddha, Unani and Homeopathy drugs and improving the quality of education and healthcare services through AYUSH,” the parliamentary panel report said.

Cited from https://doi.org/10.1371/journal.pone.0176916