Naturopathic Workforce: A Global Resource Toward the Declaration of Astana Goals-A Multimethods Study.

Introduction: The World Health Organization identified health to be the most important social goal and the 1978 Declaration of Alma Ata placed primary health care central to its attainment and the UN Sustainable Development Goals (SDGs) as the template. The Astana Declaration called on a change of focus in primary care, from treatment of specific diseases to the prevention and inclusion of both scientific and traditional knowledge. Such objectives require public-private partnerships in providing health care, including traditional and complementary medicine systems such as naturopathy that align. However, there is limited understanding of global regulatory frameworks and officially recognized training for naturopathy. Materials and Methods: This descriptive study employs an adapted mixed-methods explanatory framework to examine naturopathy regulation and education. Analysis merges data arising from a descriptive policy analysis of regulation from 36 countries and survey analysis from 65 naturopathic organizations from 29 countries. Results: Four types of workforce regulation were identified within 107 countries where naturopathy was practiced-statutory registration or occupational licensing, coregulation, negative licensing, and voluntary certification. No form of naturopathic regulation was most common. Higher graduate/postgraduate education and access to a broader range of practices were more frequently reported in countries where naturopathy is statutory regulated. Government audits were more frequently reported where naturopathy was statutory regulated or coregulated. Discussion: Naturopathic philosophy and practice align with primary health care goals outlined in the Declaration of Astana. The naturopathic workforce represents an untapped health care resource with a demonstrated track record of translating these aspirational goals into practice. However, naturopathy remains inconsistently regulated globally, serving as a significant barrier to partnering with other health system actors to attain the health-related SDGs. Workforce regulation for the naturopathic profession offers increased standards, reduced risks, integrative health workforce planning, and assistance to countries toward achieving the promise of the Declaration of Astana.

The Characteristics, Experiences and Perceptions of Registered Massage Therapists in New Zealand: Results from a National Survey of Practitioners.

BACKGROUND: Massage therapy is widely recognized as offering many health benefits, with a growing number of studies finding it has value in stress management, pain reduction, and overcoming physical limitations. However, there are few studies of massage therapists practices and perceptions in New Zealand and internationally. This paper reports the findings from the first national survey examining the characteristics, perceptions, and experiences of New Zealand-based massage therapists on a range of aspects related to their role and practices. PURPOSE: This study sought to ascertain the characteristics, experiences, and perceptions of massage therapists in New Zealand, particularly in the aspects of: integration of health care; attitudes and practices related to research; and evidence and attitudes to registration. SETTING: Massage practice in New Zealand (nationwide survey). PARTICIPANTS: Members of Massage New Zealand (a massage practitioners association). RESEARCH DESIGN: Massage practitioners were surveyed online, using a 65-part questionnaire, on a range of characteristics of their practices and their attitudes to research, integration, and registration. Statistical analysis was performed using STATA. Statistical significance was set at 0.05. MAIN OUTCOME MEASURES: Four hundred massage therapists (MTs) were invited to participate and 115 responded, providing a response rate of 29%. MTs valued research (95%) and perceived that it had an impact for their practices (88%). Significant correlations were found for research value and: mean case-load (p = .009) and level of academic qualification (p = .004). The majority of MTs (79%) supported integration with conventional practitioners, and 83% referred clients to general practitioners, with 75% receiving referrals from general practitioners. Ninety-three percent of MTs supported registration, with 67% of those supporting statutory registration. CONCLUSION: Massage practitioners perceive that they make a significant contribution to health care, but area of practice, such as research, and referral and integration into mainstream health care require more in-depth investigation.

The characteristics, experiences and perceptions of homeopaths in New Zealand: results from a national survey of practitioners.

BACKGROUND: The popularity of homeopathy is seemingly at odds with the scientific controversy over its effectiveness. Several studies have reported on effectiveness of clinical homeopathy, but few studies have been conducted on practices and perceptions of homeopaths, and none in New Zealand (NZ). To address this gap, this paper reports findings from the first national survey examining the characteristics, perceptions and experiences of NZ-based homeopaths regarding a wide range of issues relating to their role and practice. There were 176 homeopaths in NZ at the time of this survey, who were members of a voluntary register (The New Zealand Council of Homeopaths), homeopaths are not statutorily registered in NZ. METHODS: A 65 question, online survey was sent to homeopathic practitioners via their professional associations. A total of 176 homeopaths were invited to participate. Of these 176, 57 (32%) responded. RESULTS: The majority of homeopaths were female (93%). Twelve percent were under 45 years and 20% over 55 years. Most (85%) had qualification in homeopathy of diploma or certificate level and most (66%) were engaged in part-time practice. Mean year of experience was 12.6 and mean caseload per month was 25. 90% considered research useful to validate practice, while 88% considered that it impacted on practice, although only 48% had skills to interpret research papers. There was an association between skills to interpret research and its impact on practice (p = 0.038). The majority (87%) were in favour of registration, with a statistically significant association between attitudes to registration and age (p = 0.027), the older homeopaths being more in favour. Most (68%) were in favour of integration with conventional practitioners and many referred to conventional practitioners (mean referrals per annum to GPs = 57 and midwives = 30). Homeopaths assessed their contribution to New Zealand Ministry of Health objectives as significant, with 77% perceiving that they improved nutrition, 75% increasing physical activity and 63% reducing smoking. CONCLUSION: These findings enable greater understanding of the way in which homeopaths practice in New Zealand and how they perceive their role in health care. The findings potentially assist communication between homeopaths and other health professionals. There is a need to further investigate homeopaths' practices and perceptions in NZ.

The characteristics, experiences and perceptions of naturopathic and herbal medicine practitioners: results from a national survey in New Zealand.

BACKGROUND: Despite the popularity of naturopathic and herbal medicine in New Zealand there remains limited data on New Zealand-based naturopathic and herbal medicine practice. In response, this paper reports findings from the first national survey examining the characteristics, perceptions and experiences of New Zealand-based naturopaths and herbal medicine practitioners across multiple domains relating to their role and practice. METHODS: An online survey (covering 6 domains: demographics; practice characteristics; research; integrative practice; regulation and funding; contribution to national health objectives) was administered to naturopaths and herbal medicine practitioners. From a total of 338 naturopaths and herbal medicine practitioners, 107 responded providing a response rate of 32%. Data were statistically analysed using STATA. RESULTS: A majority of the naturopaths and herbal medicine practitioners surveyed were female (91%), and aged between 45 and 54 years. Most practiced part-time (64%), with practitioner caseloads averaging 8 new clients and over 20 follow-up clients per month. Our analysis shows that researched information impacts upon and is useful for naturopaths and herbal medicine practitioners to validate their practices. However, the sources of researched information utilised by New Zealand naturopaths and herbal medicine practitioners remain variable, with many sources beyond publications in peer-reviewed journals being utilised. Most naturopathic and herbal medicine practitioners (82%) supported registration, with statutory registration being favoured (75%). Integration with conventional care was considered desirable by the majority of naturopaths and herbal medicine practitioners surveyed (83%). Naturopaths and herbal medicine practitioners feel that they contribute to several key national health objectives, including: improved nutrition (93%); increased physical activity (85%); reducing incidence and impact of CVD (79%); reducing incidence and impact of cancer (68%). CONCLUSIONS: There is a need for greater understanding and communication between practitioners of conventional care and naturopathic and herbal medicine which could support informed, coordinated and effective health provision within the New Zealand health care system. There is a need for further in-depth research examining naturopaths and herbal medicine practitioners' perceptions and practices, to provide insights of benefit to all those practising and managing health services as well as those directing health policy in New Zealand.

Naturopathic management of rheumatoid arthritis.

Complementary and alternative medicines (CAM) are widely used by those with pain and/or musculoskeletal problems, and previous research has shown that high proportions of individuals with rheumatoid arthritis have used these therapies. One of the largest CAM modalities is that of naturopathy, which combines nutritional, herbal, and other complementary practices to treat such conditions. In this review, evidence is examined in relation to those factors which naturopaths believe are significant contributors to rheumatoid arthritis, and are hence the main focus of therapeutic management. These factors include food allergy, increased gut permeability, increased circulating immune complexes, excessive inflammatory processes, and increased oxidative stress. Naturopathic treatment attempts to alleviate symptoms by altering these factors through dietary modification, manipulation of dietary fats, and use of antioxidants and proteolytic enzymes. An understanding of the rationale for these treatments and evaluation of the evidence from their use in clinical settings will assist with the integration of complementary and conventional practices in the treatment of rheumatoid arthritis.