Concepts of homeopathy among general population in Karachi, Pakistan.

OBJECTIVE: To explore the characteristics of patients and their gender influences concerning the use of homeopathic medicine, visiting both homeopathic and conventional medicine (allopathic) clinics. METHODS: This cross sectional study was carried out on 200 patients who attended private and public homeopathic and allopathic clinics or hospitals in Karachi using a pre-tested self-administered questionnaire. Data for demographic variables of frequencies and associations between variables were analyzed on SPSS version 12.0. Significance level was p < 0.05. RESULTS: Out of the total, 64.5% respondents, more among females than males (p < 0.01) believed in homeopathy. Although slightly more than a quarter preferred homeopathic treatment than allopathic treatment, 67.5% participants had had homeopathic consultation and treatment in the past. Amongst participants who had opted for homeopathy in any of their illnesses, the majority had it for chronic conditions which included skin lesions and problems of rheumatology. CONCLUSION: In this modern era, where people have the choice to decide newer and advanced forms of medical treatment and scientific methods, a large proportion of people still rely on alternative forms of treatment like homeopathy. More awareness regarding use of homeopathic treatment is needed among general population.

Providing quality abortion care: Findings from a study of six states in India.

OBJECTIVE: Although abortion has been legal in India since 1971, but very little research has been done so far on the issue of the quality of abortion services. To fill this gap, this paper examines whether the quality of abortion services provided in the country is in line with the WHO's recommendations. STUDY DESIGN: We analyse a cross-sectional health facilities survey conducted in six Indian states, representing different sociocultural and geographical regions, as part of a study done in 2015. MAIN OUTCOME MEASURES: Percentage of facilities offering different abortion methods, type of anaesthesia given, audio-visual privacy level, compliance with the law by obtaining woman's consent only, imposing the requirement of adopting a contraceptive method as a precondition to receive abortion. RESULTS: Except for the state of Madhya Pradesh, fewer than half of the facilities in the other states offer safe abortion services. Fewer than half of the facilities offer the WHO recommended manual vacuum aspiration method. Only 6-26% facilities across the states seek the woman's consent alone for providing abortion. About 8-26% facilities across the states also require that women adopt some method of contraception before receiving abortion. CONCLUSION: To provide comprehensive quality abortion care, India needs to expand the provider base by including doctors from the Ayurveda, Unani, Siddha, and Homeopathy streams as also nurses and auxiliary midwives after providing them necessary skills. Medical and nursing colleges and training institutions should expand their curriculum by offering an in-service short-term training on vacuum aspiration (VA) and medical methods of abortion.

The pathway followed by psychotic patients to a tertiary health center in a developing country: a comparison with patients with epilepsy.

The objective of this study was to describe and compare the pathways followed by Malay patients with psychoses (schizophrenia and schizophreniform disorder) and Malay patients with epilepsy to a tertiary health center in the northeastern area of peninsular Malaysia. There were 60 patients in each group. The most popular pathway for both groups was first contact with traditional or alternative healers. Consultation with Malay traditional healers (bomohs) and/or homeopathic practitioners (44.2%) was significantly higher for psychotic patients (61.7%) than for patients with epilepsy (26.7%) (chi(2)(2)=15.609, P<0.001). Direct access (24.2%) was the second most popular pathway and almost equally followed by both groups of patients. The third and last pathway was initial contact with private general practitioners and government doctors, respectively. Patients with epilepsy dominated the last two pathways. The treatment delay (TD) was significantly longer in epileptic than psychotic patients regardless of their visit to a bomoh and/or homeopathic practitioner (P<0001) or not (p<0.01). The socioeconomic status of psychotic patients also was significantly better than people with epilepsy (chi(2)=9.957, chi(2)(4), p=0.041).

Spread of Traditional Medicines in India: Results of National Sample Survey Organization's Perception Survey on Use of AYUSH.

For the first time, we have a comprehensive database on usage of AYUSH (acronym for Ayurveda, naturopathy and Yoga, Unani, Siddha, and Homeopathy) in India at the household level. This article aims at exploring the spread of the traditional medical systems in India and the perceptions of people on the access and effectiveness of these medical systems using this database. The article uses the unit level data purchased from the National Sample Survey Organization, New Delhi. Household is the basic unit of survey and the data are the collective opinion of the household. This survey shows that less than 30% of Indian households use the traditional medical systems. There is also a regional pattern in the usage of particular type of traditional medicine, reflecting the regional aspects of the development of such medical systems. The strong faith in AYUSH is the main reason for its usage; lack of need for AYUSH and lack of awareness about AYUSH are the main reasons for not using it. With regard to source of medicines in the traditional medical systems, home is the main source in the Indian medical system and private sector is the main source in Homeopathy. This shows that there is need for creating awareness and improving access to traditional medical systems in India. By and large, the users of AYUSH are also convinced about the effectiveness of these traditional medicines.

Utilization of indigenous systems of medicine & homoeopathy in India.

BACKGROUND & OBJECTIVE: Very little information is available on the utilization of Indian systems of medicine and homoeopathy (ISM&H) in India. A study was undertaken on the usage and acceptability of indigenous systems of medicine to provide estimate of utilization of different indigenous systems of medicine in the country along with the reasons for preferences as well as the cost of treatment. METHODS: The study covered 35 districts spreading over 19 States of the country. From 16 major States, two districts each were selected randomly one from the list of districts with high utilization level and another with low level of utilization. From other 3 States, one district each was selected randomly. From each selected district, 1000 households with at least one sick person were covered. This was achieved by selecting 50 Urban Frame Surveys (UFS)/villages and 20 sick persons each per village/UFS. Allocation of 50 First Stage Units (FSUs) among rural and urban sectors was made in proportion to rural-urban population of the district. From selected FSUs, 20 households with at least one sick person was selected randomly. The data were collected on the health seeking behaviour of persons who were sick (with common or serious ailments) in the last three months before survey including at the time of survey. RESULTS: About 45,000 sick persons from 33,666 households from 35 districts of the country were covered. The preference of ISM&H for common ailment was about 33 per cent while only 18 per cent preferred to use these systems in case of serious ailments in the country. The sick persons actually availing ISM&H treatment were about 14 per cent. Of those who preferred ISM&H, the reasons were mainly "no side effect" and low cost of treatment. Slow progress was the main reason for not preferring the indigenous systems. INTERPRETATION & CONCLUSION: The findings of this study showed that about 14 per cent sick persons utilizing indigenous system of medicine. Slow progress and non availability of practitioners were the main reasons for not preferring the ISM & H treatment.

Acute lower respiratory infections in rural Bangladeshi children: patterns of treatment and identification of barriers.

A study conducted in rural Bangladesh examined the patterns of health seeking behavior, mothers' recognition of symptoms, the perceived causes and barriers to timely treatment of acute lower respiratory infections (ALRI). A total of 194 children under 5 years of age suffering from ALRI in an intensive maternal child health and family planning area was prospectively followed. About 62% of the mothers sought allopathic treatment for their children within 24 hours of case detection. No treatment of any kind was sought in 45 (23.2%) cases. Most of the mothers could recognize the different symptoms of ALRI. Cold was reported as the most common cause of ALRI. No significant difference was observed in the reported symptoms or perceived cause of the disease between those who sought no treatment and those who sought allopathic, homeopathic, spiritual or combined treatments. Failure to recognize severity followed by work loss were the most common reasons identified for not seeking any medical care. Whether or not a mother sought allopathic treatment was not associated with the child's age, sex, mother's age, mother's education, duration of illness, birth order, housing type or distance from the health center. The study indicates the potential value of giving parents clear guidelines on recognition of severity of symptoms of ALRI and motivating them to seek treatment quickly when these symptoms present. Health service providers should be aware of the heavy work loads which rural women have and the severe time constraints which deter them from seeking timely treatment from the appropriate sources.

Access to and utilization of the health services among the patients in a government homeopathic hospital in West Bengal, India: a cross-sectional study.

Accessibility to and utilization of the hospital health services is a complex and multifaceted issue. This study aimed to assess the knowledge of the patients of health services, current level of access to and utilization of services and to identify barriers and socioeconomic disparities in an Indian homeopathic hospital. A cross-sectional survey was conducted in December 2013 on systematically sampled 377 patients. Responses were analyzed using descriptive statistics and univariate logistic regression. Mean knowledge score and perceived mean difficulties in access to and utilization of services were 68.4% and 78.5%, respectively. Knowledge of the services was influenced by age, residence, education, speaking and reading of Bengali language, and income status (P < .05). Difficulty in access to and utilization of the health services were influenced by residence, understanding of Bengali language, and monthly household income (P < .05). Overall, health service access and utilization appeared promising, but needs improvement.

A systematic literature review of complementary and alternative medicine prevalence in EU.

BACKGROUND: Studies suggest that complementary and alternative medicine (CAM) is widely used in the European Union (EU). We systematically reviewed data, reporting research quality and the prevalence of CAM use by citizens in Europe; what it is used for, and why. METHODS: We searched for general population surveys of CAM use by using Ovid MEDLINE (1948 to September 2010), Cochrane Library (1989 to September 2010), CINAHL (1989 to September 2010), EMBASE (1980 to September 2010), PsychINFO including PsychARTICLES (1989 to September 2010), Web of Science (1989 to September 2010), AMED (1985 to September 2010), and CISCOM (1989 to September 2010). Additional studies were identified through experts and grey literature. Cross-sectional, population-based or cohort studies reporting CAM use in any EU language were included. Data were extracted and reviewed by 2 authors using a pre-designed extraction protocol with quality assessment instrument. RESULTS: 87 studies were included. Inter-rater reliability was good (kappa = 0.8). Study methodology and quality of reporting were poor. The prevalence of CAM use varied widely within and across EU countries (0.3-86%). Prevalence data demonstrated substantial heterogeneity unrelated to report quality; therefore, we were unable to pool data for meta-analysis; our report is narrative and based on descriptive statistics. Herbal medicine was most commonly reported. CAM users were mainly women. The most common reason for use was dissatisfaction with conventional care; CAM was widely used for musculoskeletal problems. CONCLUSION: CAM prevalence across the EU is problematic to estimate because studies are generally poor and heterogeneous. A consistent definition of CAM, a core set of CAMs with country-specific variations and a standardised reporting strategy to enhance the accuracy of data pooling would improve reporting quality.

Complementary and alternative medicine provision in Europe--first results approaching reality in an unclear field of practices.

BACKGROUND: The demand for complementary and alternative medicine (CAM) treatment in the European Union (EU) has led to an increase in the various CAM interventions available to the public. Our aim was to describe the CAM services available from both registered medical practitioners and registered non-medical practitioners. METHODS: Our literature search comprised a PubMed search of any scientific publications, secondary references and so-called grey literature, a search of government websites and websites of CAM organisations to collect data in a systematic manner, and personal communications, e.g., via e-mail contact. Due to the different reliability of data sources, a classification was developed and implemented. This weighted database was condensed into tables and maps to display the provision of CAM disciplines by country, showing the distribution of CAM providers across countries. RESULTS: Approximately 305,000 registered CAM providers can be identified in the EU (~160,000 non-medical and ~145,000 medical practitioners). Acupuncture (n = 96,380) is the most available therapeutic method for both medical (80,000) and non-medical (16,380) practitioners, followed by homeopathy (45,000 medical and 5,800 non-medical practitioners). Herbal medicine (29,000 practitioners) and reflexology (24,600 practitioners) are mainly provided by non-medical practitioners. Naturopathy (22,300) is dominated by 15,000 (mostly German) doctors. Anthroposophic medicine (4,500) and neural therapy (1,500) are practised by doctors only. CONCLUSION: CAM provision in the EU is maintained by approximately 305,000 registered medical doctors and non-medical practitioners, with a huge variability in its national regulatory management, which makes any direct comparison across the EU almost impossible. Harmonisation of legal status, teaching and certification of expertise for therapists would be of enormous value and should be developed.

[Complementary and alternative medicine in primary care in Switzerland]. / Komplementarmedizin in Schweizer praxen der grundversorgung.

OBJECTIVE: This study investigated the current supply of complementary and alternative medicine (CAM) in Swiss primary care. Information was collected on physicians' qualifications in CAM, frequency of patients' demand for CAM, physicians' supply and temporal resources for CAM as well as physicians' referrals to CAM. MATERIAL AND METHODS: 750 (500 German-speaking and 250 French-speaking) randomly selected Swiss female and male primary care physicians were asked to complete a questionnaire (response rate 50.4%). Sociodemographic data on professional training, place of residence, and sex were used to calculate a weighting factor to correct the responders' data in the analysis accordingly. RESULTS: 14.2% of the physicians were qualified in at least one CAM discipline. Around 30% (95% confidence interval 25.4-34.6%) of the physicians were asked for CAM by their patients more than once a week. Homeopathy and phytotherapy were the most frequently offered therapies, followed by traditional Chinese medicine (TCM)/acupuncture. 62.5% (57.6-67.4%) of the physicians refer their patients to CAM. Most patients were referred to TCM/acupuncture. Of the 37.2% (32.6-42.4%) of the physicians who do not refer their patients to CAM, around 40% (35.1-44.9%) offer it themselves. CONCLUSION: About three quarters of the physicians offer CAM themselves or refer their patients to CAM treatments. CAM is very important in primary medical care in Switzerland. Clear regulations for CAM are required in order to ensure a high quality in care.

Percepções dos usuários da clínica pública ou privada sobre a homeopatia e acesso aos medicamentos homeopáticos / Perception of public and private clinics users about homeopathy and access to the homeopathic medicines

Esta dissertação teve como objetivo principal analisar as percepções de usuários sobre a clínica homeopática no município de Florianópolis, Santa Catarina, bem como levantar os medicamentos homeopáticos aviados em Farmácias Homeopáticas dos municípios de Florianópolis e de Itajaí, Santa Catarina. Trata-se de uma pesquisa exploratória e descritiva, com abordagens qualitativa e quantitativa, que, inicialmente, foi desenvolvida junto a quatro farmácias homeopáticas instaladas em Florianópolis e uma em Itajaí, e, num segundo momento, junto a 23 usuários de homeopatia, de clínica pública e privada, de Florianópolis. Os resultados apontam que os medicamentos policrestos são os mais prescritos tanto nas receitas aviadas no Sistema Único de Saúde (SUS) como nas advindas da clínica privada, reforçando a importância de manter esse grupo de medicamentos em estoque na Farmácia. A forma farmacêutica gotas, em doses repetidas foram as mais prescritas assim como a quantidade de 30 e 50 em volume ou massa nos dois municípios. Porém quando se analisa apenas receitas SUS, Florianópolis avia mais formulações complexas. Este estudo ressalta a importância da acessibilidade e do acesso ao medicamento homeopático no município de Florianópolis. Na percepção dos usuários, a maioria mulheres, idade média de 45,4 anos, se diferenciando apenas no grau de escolaridade, não houve diferenças entre os atendimentos da clínica pública ou privada. Os pacientes se sentiram acolhidos e confiantes com os prescritores, pois buscavam a clínica principalmente por desencanto com a alopatia e por um tratamento integral, bem como consideraram o medicamento eficaz.(AU)

This dissertation has as main objective - to analyze the perception of user about the homeopathic clinic in Florianópolis, Santa Catarina, Brazil, as well as find out which are the dispensed homeopathic medicines in Homeopathical Pharmacies in Florianópolis and Itajaí, Santa Catarina, Brazil. This is an exploratory and descriptive research, with quantitative and qualitative approaches, that, at first, was developed with four Homeopathically pharmacies installed in Florianópolis and in Itajaí, and, in a second moment, with 23 homeopathy users of public and private clinics of Florianópolis, Santa Catarina, Brazil. The outcomes point out that the polychrests drugs are the most prescribed in the dispensed SUS prescription and also in the private prescription, reinforcing the need of keeping this medicine group stored on the pharmacy. The pharmaceutical form drops, in repeated doses were the most prescribed as it was the quantity of 30 and 50 in volume or mass in both towns, but when it is evaluate only SUS prescriptions, Florianópolis dispenses more complex formulations. In the users perceptions, most women, with average age group of 45,4 years, only different in education degree. There were no difference between the public and private clinics treatment, all the patients felt welcomed and confident with prescribers, that is, because they seek the clinic, mainly for dissatisfaction with allopathic medicine, for lhe wish of a holistic treatment and also, because they consider this medicine effective.(AU)