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National Ayush Mission NAM An over view Dr. Surendra Chaudhary [email protected]

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Once upon a time India's health care system was dominated by Ayurveda- the holistic health approach to keep persons disease free by adopting healthy life style. With so many attacks on Indian heritage Ayurveda was pushed back for centuries. Indian government never promote this health system as main health delivery tool. Now Prime Minister Shri Narendra Modi launches a much needed mission to make Ayush as one of main health delivery system in India. Here are salient features of National Ayush Mission

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Page 1: National Ayush Mission

National Ayush Mission

NAM

An over view

Dr. Surendra Chaudhary

[email protected]

Page 2: National Ayush Mission

The much needed step

Page 3: National Ayush Mission

• Every Ayurveda physician is eagerly waiting the details of National Ayush mission since the breaking news surfaced on 15th September 2014.

• In this presentation I try to put the main features of the framework for implementation of the mission vision and objectives.

• Those who are aware/familiar with some of the schemes run by department of Ayush, GOI may find it as “Old wine in a New bottle”

• Source-indianmedicine.nic.in

Surendra Chaudhary

Page 4: National Ayush Mission

Brief summary

The much needed government attention towards Ayush was fulfilled on 15th Sept 2014 whenunion cabinet approved the National Ayush Mission under the chairmanship of PrimeMinister.

National Ayush Mission(NAM) will set up a National Mission as well as correspondingMissions in States and Union territories. Much emphasis was given to the North easternstates where Ayush services are at minimal level and three hill states-J&K, Himachal andUttrakhand were treated with extra help.

Mission will provide financial help to achieve the desired goal for all the four core strategies tomake Ayush as main health care system of the country.

Most of the schemes were already in place under Centre sponsored schemes by thedepartment of Ayush. Some new components are included in all the streams- healthservices, educational institutions, drug standardization and medicinal plants.

Monitoring and evaluation may be more effective after establishment of NAM

There are some cosmetic changes like naming PIP(Program implementation Plan) toSAAP(State Annual Action Plan) with the same pattern.

Page 5: National Ayush Mission

Brief summary

• Two main intervention on the pattern of NRHM are being introduced by NAM are PMU(Program Management Unit) and HMIS(health Management Information System)

• Project Management Units will be set up at national and state level.

• All the recruitment will be on contractual pattern.

• Financial aid for Ayush services, education institutions and drug standardization will be in the following ratio-

• Center, state(other than NE&3Hill state- 75:25%-90:10% for medicinal plants

• NE&3Hill states- 90:10%- 100% for Medicinal Plants

Page 6: National Ayush Mission

Vision of NAM

A. Improving AYUSH services to provide cost effective

health care services

B. Effort to make Ayush system as the main healthcare

delivery system

C. Improving Ayush institutes to produce quality

graduates and post graduates

D. Availability of the raw material for standard and quality

AS&U medicine

Page 7: National Ayush Mission

NAM Objectives Providing cost effective Ayush services through upgrading

existing Ayush dispensaries and hospitals

Collocation of Ayush facilities at primary health centres,

community health centres and district hospitals

Institutional capacity building at state level by upgrading

state pharmacies,drug testing facilities etc

Supporting medicinal plants cultivation and adopting

GAP(Good Agriculture Practices) to provide good quality

raw material

Providing marketing and development instructions for

entrepreneurs and

Setting up of warehouses and promotion of cluster

cultivation

Page 8: National Ayush Mission

NAM Components

A. Mandatory component

B. Flexible component

Page 9: National Ayush Mission

A-Mandatory components

1. Ayush Health care services

2. Ayush educational services

3. Quality control of ASU&H drugs

4. Medicinal plants

Page 10: National Ayush Mission

B-Flexible component

1. Ayush wellness centres

2. Telemedicine

3. Sports medicine

4. Innovation in Ayush through PPP

5. Interest subsidies components to private Ayush educational institutions

6. Reimbursement of testing charges

7. IEC materials

8. R&D related to medicinal plants

9. Project based voluntary certification schemes

10.Market promotion, market Intelligence and buy back intervention

11.Crop insurance for medicinal plants

Page 11: National Ayush Mission

Mission mechanism

National level

1. Mission directorate - National governing body

2. Appraisal committeeState level

State Ayush mission society

1. Governing body

2. Executive body

Page 12: National Ayush Mission

National Mission DirectorateNational governing body

Page 13: National Ayush Mission

National Appraisal committee

Page 14: National Ayush Mission

State governing body

Page 15: National Ayush Mission

State Executive body

Page 16: National Ayush Mission

NAM Administrative Structure

Mission directorate

Appraisal committee

State Governing body

State Executive body

Approval of SAAP based on recommendations of

appraisal committee

Appraising the SAAP,submit to the governing

body

Ayush system overview,review of Ayush policies&programme

implementation,intersect oral coordination, approval is SAAP,exploration

of measures to promote Ayush

Review of expenditure & implementation of mission,preparation of state annual action plan(SAAP)

Submit SAAP to governing body,execution of approved SAAP,monitoring & evaluation

Page 17: National Ayush Mission

Resources

• Human resources- All Human resource will be on

contractual bases only

• Financial resources

Page 18: National Ayush Mission

Human ResourcesPMU

S.

N.

Post

Numbers

National State UT NE

1 Program Manager 4 1 1 1

2 Sr. Consultants 9 N/A N/A N/A

3 Jr.Consultants 4 N/A N/A N/A

4 Finance Manager 4 1 N/A N/A

5 Accounts manager 4 1 N/A N/A

6 HIMIS manager 3 1 N/A 1

7 Monitoring & Evaluation

consultants

2 N/A N/A N/A

8 Accountant 2 N/A N/A N/A

9 Data assistant 10 1 N/A N/A

10 Office assistant 2 N/A N/A N/A

11 Messenger / attendants 5

Consultants N/A 2 2 1

Page 19: National Ayush Mission

Component of NAM

• Core component- core or essential activities

• Flexible pool component- varieties of activities

Page 20: National Ayush Mission
Page 21: National Ayush Mission

Ayush ServicesCore or essential activities

1.Co-location of AYUSH facilities at PHCs, CHCs

and DHs

A. Establishment of AYUSH OPD Clinics in the Primary Health

Centres

B. Establishment of AYUSH IPDs in Community Health Centres

(CHCs)

C. Setting up of AYUSH Wings in District Hospitals

Page 22: National Ayush Mission

Ayush ServicesCore or essential activities

2. Supply of Essential Drugs to AYUSH Hospitals and Dispensaries

3. Up-gradation of exclusive/standalone Government AYUSH

hospitals (other than PHCs/ CHCs/ DHs)

4.Upgradation of Government/ Panchayat/ Government aided AYUSH

Dispensaries

5.Setting up of up to 50 Bedded Integrated AYUSH Hospitals

Page 23: National Ayush Mission

Ayush ServicesCore or essential activities

6.Public Health Outreach activity*

7.Behavior Change Communication (BCC)*

8.Mobility Support*

9.AYUSH Gram*

10.School Health Programme through AYUSH*

(*-Will discuss these issues later in this presentation)

Page 24: National Ayush Mission

Ayush ServicesActivities under Flexible Pool

1. AYUSH Wellness Centres including Yoga &

Naturopathy

2. Tele-medicine

3. Sports Medicine through AYUSH

4. Innovations on Mainstreaming of AYUSH

including PPP

Page 25: National Ayush Mission
Page 26: National Ayush Mission

Ayush Educational InstitutionsCORE ACTIVITIES

1. Infrastructural development of AYUSH Under-Graduate

Institutions

2. Infrastructural development of AYUSH Post-Graduate

Institutions/add on PG Pharmacy/Para-Medical Courses

3. Setting up of new AYUSH educational Institutions in the

States where it is not available in Government sector

Page 27: National Ayush Mission

Ayush Educational InstitutionsCORE ACTIVITIES

• Infrastructural developments includes the

construction of OPD/IPD, teaching departments,

library, laboratories, Hostel for girls and boys.

Page 28: National Ayush Mission

Ayush Educational InstitutionsFLEXIBLE ACTIVITIES

Interest subsidy for Development of Private AYUSH Educational

Institutions

Private non-profitable educational institutions duly permitted by the Central

Government for last five years under Indian Medicine Central Council (IMCC)

Act 1970 and Homoeopathy Central Council Act, 1973 are eligible. Assistance

will be given on a Detailed Project Report for up-gradation of the UG/PG

Institution.

Page 29: National Ayush Mission
Page 30: National Ayush Mission

ASU&H Drugs

Objectives

To strengthen State Govt. ASU&H Pharmacies and

Drug Testing Laboratories

Strengthening of ASU&H regulatory framework.

To improve the Quality of ASU&H Drugs to enable

their export in International Markets.

Page 31: National Ayush Mission

ASU&H Drugs

Core Component

1. Grant in aid to State/Govt. ASU&H Pharmacies/ State Govt. ASU&HCooperatives, State Govt. ASU&H PSU’s.

2. Grant in aid to State Drug Testing Laboratories of Ayurveda, Siddha, Unani and Homoeopathy (ASU&H) Drugs.

3. Grant-in-aid for strengthening of ASU&H Drug Control Framework.

4. Grant in aid to State Licensing Authority of ASU&H Drugs for documentation publication and dissemination of quality control material for States.

Page 32: National Ayush Mission

ASU&H Drugs

Core Component

• It is for strengthening of existing manufacturing

units in the form of grant for upgrading of

equipments, reagents & chemicals and building,

drug testing facilities including man power

• Setting up of new manufacturing units in state

and cooperative sectors

Page 33: National Ayush Mission

ASU&H Drugs

Flexible Component

• IEC materials

Page 34: National Ayush Mission
Page 35: National Ayush Mission

Medicinal Plants

• Medicinal Plant Board

• Development and cultivation of medicinal plants under the

CentrallySponsored Scheme of National AYUSH Mission

• Good Agriculture Practices (GAP), Good Collection Practices

(GCP), and Good Storage Practices (GSP).

• Support Cultivation of Medicinal Plants

• Establishment of Seed / germ plasm Centers and nurseries for

Supply of Quality Planting Material

• Model Nurseries, Small Nurseries

Page 36: National Ayush Mission

Medicinal Plants

• Support for Medicinal Plant Processing and Post Harvest Management including Marketing-

• Drying yards, Storage godowns, Processing unit ,Quality testing of raw material

• Marketing-

• Market Promotion, Market Intelligence, Buy – back Interventions:-

Page 37: National Ayush Mission

Medicinal Plants

• Quality testing, certification and insurance

• Quality Testing

• Certification

• Crop Insurance

Page 38: National Ayush Mission

MEDICINAL PLANT PROCESSING CLUSTERS

Each of the cluster development projects including collection cluster

implemented by a Special Purpose Vehicle (SPV) for medicinal

plants processing units in a cluster shall be eligible for funding

under the scheme upto 60% of cost of the core interventions, 25%

of the cost of add on interventions, within overall ambit of 60% of

the project cost subject to maximum of Rs. 10.00 crore per cluster.

The assistance is further subject to the following:

1.Assistance for engagement of CDEs and other management

support of SPV shall not exceed 5% of the overall project cost.

2.Assistance for engaging engineers / architects / construction

management / other experts for execution of civil works shall not

exceed 5% of the overall project cost.

Continued………

Page 39: National Ayush Mission

MEDICINAL PLANT PROCESSING CLUSTERS

2.Assistance for engaging engineers / architects / construction management / other experts for execution of civil works shall not exceed 5% of the overall project cost.

a) Project cost for the purpose of the scheme shall mean the total cost of proposed interventions.

b)The scheme would be modular in nature with a provision to add interventions o the approved project DPR while implementation is on. The addition however, hould be in conformity to the overall project and the scheme objectives and subject to approval by Standing Finance Committee (SFC)

c) SPVs may dovetail funds from other sources as well for the project, provided there is no duplication of funding for the same component / intervention. However, in cases of such dovetailing, it shall be ensured that the contribution of the participating units of SPV is at least 10% of the overall project cost.

Page 40: National Ayush Mission

Salient new features of Ayush

health care services under

National Ayush Mission

Page 41: National Ayush Mission

Public Health Outreach activity

1. To reduce the incidence of the disease burden ofcommunicable or non-communicable or both as the case maybe in selected geographical area during specific period of time.

2. To have public awareness about the importance of hygiene,dietary habits, prevention, promotion etc. through AYUSHsystems of medicine in the area.

3. To establish a Community Based Surveillance System(CBSS) for early identification of the outbreak.

4. To increase the accessibility of AYUSH treatment of thepopulation residing in the particular geographical region.

Page 42: National Ayush Mission

Public Health Outreach activity

Formulation of specific module for the activities at that

geographical region. The unit size of the

implementation will be 2 blocks.

1. Formulation and training of Health Education team

2. Medical camps

3. Peripheral OPDs

Page 43: National Ayush Mission

Public Health Outreach activity

Formulation and training of Health Education team

Health team comprising of health professionals,

teachers, public health activists etc

Community intervention through behavioral change

communication techniques, regular health education

classes,

Page 44: National Ayush Mission

BCC & Mobility support

1. The disease burden of the country is shifting towards communicable

diseases to non- communicable diseases. Early prevention and case

detection is the most important strategy of all non-communicable diseases

which are generally emerged due to life style deviations and ill-healthy diet.

AYUSH systems of medicines are thrived in the country with well-founded

principles of disease prevention, promotion of health and specific

intervention considering patient and environmental and dietary factors.

2. Mass media communication strategy incorporating AYUSH strengths in early

prevention of diseases through promotion of healthy diet and life style to be

adopted by the community will be advocated by the states for which

adequate financial support is proposed to be provided under AYUSH

flexipool.

• Mobility support-Successful generation of outcome envisaged under the

mission can only be resulted by regular and systematic monitoring. Therefore,

provision has been made for financial assistance for limited mobility support to

the State and District functionaries for conducting essential monitoring

activities.

Page 45: National Ayush Mission

Ayush Gram

AYUSH Gram is a concept wherein one village per block will be selected for adoption of method and practice of AYUSH way of life and interventions of health care. In AYUSH village AYUSH based lifestyles are promoted through behavioural change communication, training of village health workers towards identification and use of local medicinal herbs and provision of AYUSH health services. The elected village representatives are sensitized towards the concept so that there is also active participation from the community.

Objectives:

To spread awareness within community for practice of those dietary habits and life styles as described in AYUSH Systems of Medicine which help in preventing disease and promoting health. To advice people for preservation and cultivation of those herbs which are found in their surroundings by explaining them their medicinal values. To advice people about common ailments and its cure thorough use of herbs found in their localities. To raise campaign against communicable diseases like Malaria, T.B., Diarrhea etc. and measures for their prevention and treatment.

Page 46: National Ayush Mission

Ayush Gram

The AYUSH Medical Officers under the programme implement the health plans and train the health workers in identification of medicinal plants and utilization of home remedies. The health workers keep the record of health status and health register of village and provide information regarding health related issues of the wards in village.

He/She will also identify the medicinal herbs in the area to ensure its utilization, and protection. The members from Medicinal Plants Board will motivate the farmers to cultivate medicinal herbs and provide necessary information and assistance for cultivation of medicinal plants. The Self Help Groups involved in the programme will manufacture herbal preparations as home-remedies and with the help of health worker motivate villagers to utilize it for different health problems. Traditional healers of the village may also be involved in identification of medicinal plants and their use as home-remedies.

Organizing Yoga camps and participating in National Health Programs, medical camps, anti-natal check ups.

Page 47: National Ayush Mission

School Health Programme through

AYUSH

AYUSH Health and Nutrition education

Education on home remedies and locally available medicinal plants and importance of growing medicinal plants in home gardens.

Practice of Yoga, Education on sexual and reproductive health issues

Health screening:- Early detection and management of common problems e.g;- visual and hearing problems, physical disabilities, common skin problems, learning disabilities etc.

Nutrition, anaemia, worm infestation management, Development and dissemination, Referral linkages with health services and local remedial action.

Referral linkages with AYUSH Medical colleges or AYUSH Hospitals for remedial and preventive measures may also b e undertaken. Nodal teachers for AYUSH School Health programme should be identified

Page 48: National Ayush Mission

[email protected]

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