INTRODUCTION
Long long ago, the sages followed their intelligence, life and energy for the wellbeing
of the universe-the basis of whole existence. They developed a system of
medicine that still elude modern day scientists, a system that diagnose illness from the
throb of a pulse that heal with nature, one of the most effective system of medicine ever-
Ayurveda
Ayurveda is not just a dry description of facts giving freedom from diseases. It is
instead a philosophy; indeed a way of life. According to the modern science, Health is a
state of complete physical, mental and social well being and not merely an absence of
disease or infirmity. Health is a fundamental human right and it involves individual’s
state and international responsibility.
Positive health implies the notion of perfect functioning of the body and mind. It
conceptualizes health biologically, psychologically and socially. In this regard, health has
been described as a potentiality-the ability of an individual or a social group to modify
himself or itself continually, in the phase of changing condition of life. Positive health
depends not only on medicinal action, but on all the other economic cultural and social
factors operating in the community.
Health is multi-factorial. The factors, which influence health lie both within the
individual and in the society .The physical and mental traits of every human being are to
some extent determined by the hereditary factors. The environmental components
(physical, biological and psychological) are so inextricably linked with one another and
have a clear-cut relationship in the manifestation of diseases.
The life-style of an individual reflects the whole range of social values, attitude
and composed of cultural and behavioral patterns. Their level of socioeconomic
development, nutrition, employment, housing etc also determines health status of the
individuals and families. Health and family welfare services cover a wide spectrum of
personal and community services for the treatment of diseases, prevention of illness and
promotion of health.
PRIMARY HEALTH CARE - AN INTRODUCTION
The concept of primary health care came in to lime-light in 1978, following an
international conference in Alma-Atta, USSR.
DEFINITION
"Essential health care based on practical, scientifically sound and socially
acceptable methods and technology made universally accessible to individuals
and families in the community through their full participation and at a cost that
the community and the country can afford to maintain at every stage of their
development in the spirit of self-determination"
IMPORTANCE
Primary health care is a new approach to health care, which integrates at
the community level of all the factors required for improving the health status of the
population. While it integrates promotive, preventive and curative services. It is also
conceived as an integral part of the country’s plan for socio-economic development. It
involves de-professionalization of medicine.
DETERMINANT FACTORS OF HEALTH
Long and healthy life is essential to attain purushartha.
Ayurveda prescribes the ways to attain this target.
Agni
It is the factor responsible for all the transformations. The strength, health,
immunity etc. are dependent upon the power of digestion .So the capacity of an
individual to digest food properly must be preserved.
Bala
It helps to resist diseases and reduces the abnormal physiological and pathological
conditions.
Vihara
All good physical, mental and verbal activities give health to body and mind.
Wrong doings are always becoming the causes of ill-health.
Prakrithi
The biological constitution is determined by the five bhuthas. A perfect balance is
essential to combat the bodily variations .
Desa
Different geographic areas have many advantages and disadvantages .By
identifying the variations in the environment and the body, measures can be
adopted to avoid adverse reactions.
Mind
Control of mind is essential to abstain the sense organs from deleterious effects.
ROLE OF AYURVEDA IN HEALTH CARE
What makes this system of medicine unique from other medical system is its
philosophical touch and spiritual approach. It is evident from the ancient scriptures that
the main aim of Indian system of medicine is the well being of the entire universe -
‘sarve santhu niramaya.
Man is the one who rules over the earth and this human being is a part of the great
and boundless universe .He is the miniature form of universe itself, and the whole
universe is like a very big family-Vasudhaiva kudumbakam.
He can be compared to the taproot, from which evolves the branches and whole
tree itself. The branches symbolize the society and the tree, the universe. Only when the
taproot is strong the tree will be able to withstand. Keeping in mind the simple logic
Ayurveda stressed up on the health of an individual, which will lead to the health of the
society and the community, which will finally evolve as the health of the universe.
From this, we can see that it is clear that one of the main aims of Ayurveda is the
promotion of primary health care. In ancient India country was divided into
‘Janapadhas’ and the health management of each Janapadha was thoroughly
undertaken and the aims and objectives that can be employed to the long-term benefit of
a healthy being was also elaborately dealt with. This proves that Ayurveda can play a
significant role in the promotion of primary health .The presentation of Ayurveda is in
such a manner, as to make the people aware of the health and its importance, that is
possible only through health education.
HEALTH CARE THROUGH HEALTH EDUCATION
Health education is the process that informs, motivates and helps people to adopt
and maintain healthy life-style. It advocates behavioral, personal, social, economical and
environmental changes. Objectives of health education are to liberate man from
ignorance and to make himself reliant. Daily duties, seasonal conduct, proper food etc.
helps an individual to be in a balanced state of body, mind and spiritual elements. By
practicing these Ayurvedic health principles, the somo-psycho-spiritual well-being of the
community can be achieved .
SEASONAL CONDUCT AND HEALTH
There are six seasons in a year comprising of one season with two months.
Seasonal conduct is indicated to prevent diseases, which occur as a result of vitiation of
doshas in accordance with each ritu. The imbalances of doshas occur due to many factors,
of which ritu plays an important role.
In Hemantha ritu, the climate will start getting colder and as a result of it body of
an individual contract externally and closing the heat outlets in the skin, so that the
accumulated heat will increase the digestive power of the person. So one should take
sweet, sour and salty food in large quantities. Body should be massaged with oil. Food
consists of fat, meat preparations, wines etc .Hot water must be used for all purposes.
One should expose his body to bright sunshine. The same procedure can be followed in
Sisira.
As soon as Vasantha seasons starts, the sunshine will liquify the accumulated
kapha and start vitiating the digestive power of the person .The kapha should be removed
in the beginning by administering strong emetics and nasal medication .One should take
good food, satisfactory exercise and application of dry Udvarthana in order to remove fat
from the body. Day time sleeping is strictly prohibited. One should not take heavy, salty,
sour or sweet food in the season.
In Greeshma season, one should not take pungent, salty and sour things. Only
light exercises in the morning are welcomed. Food must be of sweet, sour and easily
digestible. Bathing should be undertaken with cold water. Wines must never be drunk.
In Varsha there is a chance of vitiation of tridosha . So, in the beginning of
Varsha season, persons must be given emetics, purgatives, enema etc. in order to clean
large intestine. Mudga also be given, as it is easily digestible. One should use shoes. The
food must be consisting of sour, salty and fatty substances
In Sharat, the accumulated pitta will get excited due to bright sun. In order to
alleviate it one should use ghee prepared with bitter tasting herbs.
One should avoid fat, oil, curds, day time sleep, alkalies etc. Purgatives must be
administered in time.
DAILY DUTIES AND HEALTH
• Daily duties play a major role in the regulation, not only of the body but
also of the mind.
• One should get up about three hours before sunrise and must evacuate
bladder and bowel.
• He should clean his teeth and tongue .
• Gargle the mouth with oil.
• One should apply Anjana every day to the eye. Nasal medication with
Anuthaila and medicated smoking should be done.
• Abhyanga with oil should be done especially on head ,ears and feet.
• Vyayama(exercise)should be conducted till he gets fatigue following oil
massage.
• Snana – after exercise one should have a bath .It increases the digestive
power. It keeps the mind in pleasant mood.
• Clean garments and ornaments should be worn
• Natural urges: Suppression of any natural urge causes certain diseases.
There are 13 urges, every one of which can be a factor of some diseases
and thus shortens the life span.
• Chastity (Brahmacharya: The semen, which holds prominence among
other fine elements has got extra potential powers in the body .It, should
be therefore used with control.
• Sleep: There is a disciplinary code of taking sleep. The ratio of the sleep
required for health differs in individuals. Sound sleep is useful for long
life.
FOOD AND HEALTH
Food is the cause of body strength appearance and energy. Beneficial food
is one, which keeps the person healthy and helps to maintain the normal functions of the
body.
Affection to wrong food habits lead to diseases. Selected food
preparations like Mandam, Peya, Vilepi etc., are beneficial in different health conditions.
Food for child:
Supplement dietary articles which are required for the formation of
healthy doshas.
Food for adult:
Supplement dietary articles in adequate quantity to maintain equilibrium
of doshas.
Food for old-age:
Supplement dietary articles which arrest degenerative changes and reestablish
homoeostasis.
HEALTH CARE OF MOTHER, CHILD AND OLDAGE PEOPLE
Ayurveda provides unique concepts about the formation and development
of embryo in the womb of the mother .It describes the methods to be adopted for
conceiving children of a desired sex, complexion and intellect. The food, drink and other
regimens of the mother during pregnancy and before conception, during the period of
fertility are described to determine the characteristic features-both psychic and physicalof
the offspring.
MATERNAL HEALTH:
As the mother’s health determines the health of the future generation,
Ayurveda has considered this aspect in very detail. Maternal health care can be
classified into
(a) Antenatal care
(b) Natal care and
(c) Post-natal care
ANTENATAL CARE
During pregnancy the nutrition of the fetus is from the mother .So her
nutrition should be taken care of.
REGIMEN TO BE FOLLOWED IN ANTENATAL PERIOD
1st month - Madhuyashtyadi, sweets of ksheera kakoli add devadaru or powder of dry
black grapes ,white and red sandalwood
2nd month - Milk with kakoli group of drugs
3rd month -Drink milk with ghee and honey
4th month -Milk with butter
Rice with curd
5th month -Milk with good rice, leaves of dadima.
6th month - Diet of milk with ghee which is mixed with sweet groups of drugs, rice
mixed with ghee, bala, gokshura
7th month - Milk along with ghee which is mixed with kakoli group of drugs, drink
gokshura, musta , honey etc
8th month -Rice boiled with milk, or milk and ghee along with mutton soup
9th month -Rice boiled in milk along with honey and mutton soup
10th month -Rice boiled with milk along with ghee and mutton soup
The regimens, diet and monthly check up scheduled are all sorted out in to
a chart and it is made available at the Ayurvedic maternity home. This will definitely help
in the Ayurvedic maternal care.
NATAL CARE
Ayurveda has a major role in the natal care and the management of the
delivery complications etc. like application of thaila is done for three purposes.
(1) To accelerate the mechanism of labour by increasing the elasticity of the muscle
fibres
(2) To prevent further complications. Early complication is mainly bleeding and later
there may may be a prolapse
(3) To reduce muscle fatigue
There are various fermented preparations described in Ayurveda. This
include sura , asava etc. These are used to relieve pain. Both the Asthapana and
Anuvasana types of enema restore the vayu to its normal condition .The pregnant women
after the 9th month up to the time of delivery should take liquid food like gruel made of
ghee etc.
POST NATAL CARE
This is the most popular aspect of the Ayurvedic maternity care. During
this period all precautions should be taken in administration of diet drug and other
regimen so that the woman returns to the normal health. Immediately after delivery bala
thaila should be applied .A few drops of this oil should be given internally with a hot
decoction of drug that alleviate vatha .Oil massage should be given daily. A large piece
of cloth should be tied around her abdomen to avoid distension. Susrutha has suggested
the intake of ghee and pancakola for 2 to 3 days after delivery for correcting the
abnormality in any discharge. After normalcy, gruel of milk and unctuous substance
prepared with vidarigandhadi group of drugs should be taken for 3 more days, and
mamsarasa and yusha should also be given.
DIET DURING LACTATION:
First 2 or 3 days after delivery, rice gruel prepared with ghee and milk,
Panchakola with ghee or oil or meat soup, rice gruel prepared with vidarigandha,
decoction of sathavari ,yava, kola ,kuladha etc. can be given.
CHILD HEALTH
Children are the future of a country. Healthy children build a healthy
nation .He is also considered to be the saviour of his parents.
DIET FOR THE NEW BORN
Mothers milk is the main food. But for the first 3 to 4 days, this is not
available. Hence an alternative but useful food for the child is to be given.
1st day - The child should be fed 3 times. A handful (childs’s ownhand) of
ghee and honey mixed with the powder of the roots of anantha.
2nd &3 days - Ghee prepared with lakshmana root
4th day - Fed twice. A handful of honey and ghee.
This type of regimen is intented to
(a) Improve the immune status.
(b) Attain bala.
(c) Gain intelligence & memory.
DIET FOR THE YOUNG CHILDREN
As this is the growing age, children need a lot of energy and this can be
supplemented by providing them with a nutritious, energy rich balanced diet
Different types of preparations having good nutritive value like mudga,
yusha and gruel prepared with boiled rice now-a-days which are included under the midday
meal programmes at the schools has been explained in Ayurveda
FAMILY PLANNING
Ayurvedic sterilization and contraceptive prescriptions like flowers of
japa, pippalyadichoorna etc. mentioned in the early works are successfully used in the
villages of India even today. In the field of maternal and child healthcare Ayurveda has
tremendous scope
GERIATRICS
According to Ayurveda, old age begins from 70yrs onwvards. This is a
state of degeneration of body elements and mental faculties. They are prone to develop
diseases because of the poor immunity status produced as the result of dhatukshya .
Physical activities are also decreased. "Rasayana cannot be done because it should be
preceded by Sodhana therapy which is contra indicated in old age." They need support
and care from the society .So we can help them by providing supportive therapy.
PREVENTION AND CONTROL OF COMMUNICABLE DISEASES
Man is the part of nature. So the changes in nature reflect in human
beings. Acharya Charaka has described the causes of epidemic and endemic diseases –
vitiation of Desa, Kala, Jala, Vata etc. in Janapadodhwamsaniya chapter
SOIL POLLUTION
It can be corrected with
• Tree plantation-this will cover the soil and retain water in the soil.
AIR POLLUTION
• Selective tree plantation is the right method .In Ayurveda the plantation of
Ocimum sanctum is advised
• Azadiracta indica-powerful action against insect growth.
• Camphor tree –gives aromatic smell.
• The HOMA or burning of cow ghee and rice is the most scientific method to
purify home atmosphere
WATER POLUTION
According to Susrutha, water can be purified in two ways.
(a) Marjana - water is boiled or made warm by sunlight.
(b) Prasadana – By adding Strychnus potatorum.
SHORT TERM PREVENTION
It includes the eliminating therapies.
LONG TERM PREVENTION
It includes Rasayana, Vajeekarana etc.
CONCEPT OF ESSENTIAL HERBAL DRUGS
The term drug derived from the French word "drogue" (a dry herb) is
defined as "any substance or product used to modify or explore physiological systems or
pathological states for the benefit of the recipient". The base of the concept of drug in
Ayurveda lies in medicinal plants.
• ESSENTIAL DRUGS AVAILABLE FROM THE LOCALITY
Universal coverage by primary health care cannot be achieved without the
involvement of the local community. So we should be able to find out the essential drugs
from the local community itself. As the rural folk have a very vast knowledge about
traditional medicines, educating them about the tremendous possibilities of the locally
available plants will help to make Ayurveda a part of their life
• PROTECTION OF MEDICINAL PLANTS
We should evolve a sound system of conservation of forests and for
rational exploitation of medicinal herbs. Modern techniques like tissue culture should
be employed to reproduce the endangered species.
• STANDARDISATION OF RAW DRUGS
Now a days study are mainly on standardization of prepared drugs,
forgetting the fact that without standards in herbal sources of raw drugs, there can not
be any standard in prepared drugs. So the first and foremost need of the hour is to
have a uniform pattern in the selection of various herbal sources of drugs.
• CULTIVATION OF MEDICINAL PLANTS
In each house there should be some medicinal plants. It can be distributed
with the help of voluntary agencies. Providing financial assistance such as bank loans
etc can encourage cultivation of medicinal plants.
• INFORMATION ABOUT THE SINGLE DRUGS AVAILABLE
Plant exhibition helps in creating awareness about different types of easily
available rare drugs. Single drug therapy can be4 encouraged by giving information
regarding this matter with the help of primary health centres.
• MAINTENANCE OF QUALITY WITH FINANCIAL ADVANTAGE
Raw drugs should be collected in appropriate time and preserved in
PHC’s. There will be of great importance during epidemics. Powdered drugs, tablets
decisions etc. can be made at a cost without any financial burden. Collection,
preservation, and other processing of drugs should be done with the full cooperation of
the community so as to create a sense of involvement, personal acceptance and decoction.
Judicious use of such herbs, flowers and other palliative purposes in primary health care
can make a major contribution towards reducing a developing countries drug bill.
Availability of herbal medicines for the treatment of diseases is easily available in India
having a very rich flora and fauna. With very successful community participation all sorts
of medicines can be made available for effective treatment.
CONCLUSION
In this topic the values of human life and the aims and objectives of
Ayurveda are discussed briefly to establish the role of Ayurveda in primary health care.
Primary health care is intended to extend the available health care facilities to all
populations. The measures advised by Acharyas are so valuable in bringing the
community health to a very high level. Like modern health care systems Ayurveda also
gives higher status to health educations. The Acharyas wished well being of the universe.
The measures for the health care discussed here are easily practicable and can be
implemented with out any burden to the community. These can be extended to the deep
root level, and the advantage of this is that the requirement in the form of man, money
and material is minimum. Taking in to consideration of all these factors, the role of
Ayurveda in PRIMARY HEALTH CARE IS INEVITABLE.
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