Dr. KRISHNAMURTHY JAYANNA is focused on the big picture: how do we ensure health and well-being for all? Here he writes about Sustainable Development Goal 3, the importance of Integrative Health, and the actions we will need to make to realize that goal.
The third UN Sustainable Development Goal (SDG) is about health and well-being. It aims at “ensuring healthy lives and promoting well-being for all at all ages.” Before this, the UN’s Millennium Development Goals focused on disease, and those conditions that contributed to the most illness-related deaths around the world. While that continues to be a priority, the current SDG also showcases the UN’s commitment to improving people’s well-being and quality of life. This is a huge, progressive leap in terms of how we envision the betterment of humanity and the world as a global community.
Is this realizable by 2030?
While it is good to be ambitious and aspirational when setting goals, unless our approach is backed by effective intervention and implementation processes that are contextually and culturally relevant, realizing the vision will be a challenge.
It is also important to be creative and innovative as we design ways to solve complex challenges, by bringing together the problems and the stakeholders. “Integrative approaches” appear to be promising, based on the evidence, and it is important that we review them critically for adoption within the public health ecosystem.
The National Center for Complementary and Integrative Health (NCCIH), the lead agency of the U.S. Government for scientific research in this space, describes Integrative Health as “an approach that brings together conventional and complementary healing processes in a coordinated way. It lays emphasis on multi-modal interventions for treating the whole person, rather than, for example, one organ system.”
The integrative approach focuses on the “person,” with various disciplines collaborating to achieve a common goal. The focus is also on the “whole person,” including feelings and emotions, not just the physical symptoms and physiological factors.
Research points to the gaps in well-being and quality of life due to the rise of chronic diseases. Treatment can be lifelong, with a greater demand for lifestyle management and treatment compliance, which can be stressful, hampering the quality of life. 40% of the U.S. population is engaged in complementary and alternative approaches (CAM) such as Tai chi, natural products, yoga, and meditation. The CAM approaches are perceived by clients as friendly and holistic, while providing more autonomy. Integrative approaches like Ayurveda recognize the unique nature of the human body-mind constitution, and offer personalized recommendations for treatment and lifestyle change. Yoga and meditation have been studied to understand their effects on physical and mental well-being, and are explored as complementary approaches to mainstream treatments.
In this context, the adoption of “Integrative approaches to Health and Well-being” within national health policies is a welcome change. In India, the AYUSH systems of Ayurveda, Yoga, Unani, Siddha, and Homeopathy are integrated within the primary health care systems. More recently, “Ayush man Bharat,” a flagship program of the Government of India, is giving renewed impetus to well-being by setting up 150,000 Health and Wellness Centers across the country. The Western nations have also demonstrated openness to researching the effects of integrative approaches in specific conditions.
Countries across the world
have to focus
on strengthening the
implementation of integrative
approaches through methodologies such
as
Implementation Science and Implementation Research.
While these developments are certainly encouraging, they are not enough from a public health perspective. Countries across the world have to focus on strengthening the implementation of integrative approaches through methodologies such as Implementation Science and Implementation Research. These methods focus not on a single intervention, but a package of interventions, and an intervention model as well as implementation processes that influence community health and well-being.
Research agendas and investments need to align in this direction. The small pilot studies, predominantly conducted in hospital settings, can expand into large-sample, community-based studies. Disease-centric studies can expand their focus to address the entire continuum of health – from disease prevention to treatment to rehabilitation.
Integrative health policies have been framed. The next step is to strengthen the science and research for a population-wide impact. Collaboration between implementation stakeholders and institutions is going to be critical, as we continue our march toward this vital SDG.
References
- Sustainable Development Goals [Internet]. https://sdgs.un.org/goals. UN [cited 2022 October 11]. Available from: https://sdgs.un.org.
- Complementary, Alternative, or Integrative Health: What’s in a Name? [Internet]. https://www.nccih.nih.gov. [cited 2021 Jul 19]. Available from: https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name.
- Clarke, T.C., L.I. Black, B.J. Stussman, P.M. Barnes, and R.L. Nahin, 2015. “Trends in the use of complementary health approaches among adults: United States, 2002-2012.” National Health Statistics Reports.10, 79:1-16.
- Lobb, R.and G.A. Colditz, 2013. “Implementation science and its application to population health.”Annual Review of Public Health.34:235-51.
- Roy, R, 2010. “Integrative medicine to tackle the problem of chronic diseases.” Journal of Ayurveda and Integrative Medicine.1, 1:18-21.
- Lahariya, C, 2018. “Ayushman Bharat” Program and Universal Health Coverage in India. Indian Pediatrics. 55, 6:495-506.
Krishnamurthy Jayanna
