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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 5
| Issue : 1 | Page : 27-34 |
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Morbidity profile of the out patients in Swasthya Rakshan Programme of Siddha Central Research Institute, Chennai
Juliet Lawrence1, Samraj Karunanidhi2, Vinoth Nalupalil Purushothaman1, Parthiban Rajendran1, Thenmozhi Panneerselvam1, Sathiyarajeswaran Parameswaran1
1 Statistical and Survey Division, Department of Clinical Research, Siddha Central Research Institute, Central Council for Research in Siddha, Ministry of Ayush, Govt. of India, Chennai, India
2 Siddha Clinical Research Institute, Central Council for Research in Siddha, Ministry of Ayush, Govt. of India, Tirupati, Andhra Pradesh, India
| Date of Submission | 27-Oct-2022 |
| Date of Decision | 16-Jan-2023 |
| Date of Acceptance | 21-Jan-2023 |
| Date of Web Publication | 18-Apr-2023 |
Correspondence Address:
Dr. Juliet Lawrence
Statistical and Survey Division, Department of Clinical Research, Siddha Central Research Institute, Central Council for Research in Siddha, Ministry of Ayush, Govt. of India, Arumbakkam, Chennai - 600 106, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jrsm.jrsm_27_22
Introduction: Siddha medicine is an ancient system and it is based on holistic health principles with main aim on preventive health care. Goal of public health is to improve health outcomes by preventing disease, promoting behaviors that reduce the risk of communicable and non-communicable diseases, and ensure the public access to quality health services. Swasthya Rakshan Programme (SRP) is a nationwide program to propagate Ayush systems. The purpose of the program is to promote health and health education in villages. The objective of this study is to develop a morbidity profile of the patients attending the SRP for further research in the particular area.
Materials and Methods: A descriptive cross-sectional study has been done in the outreach outpatient department (OPD) and the data were collected from the old records maintained in the Statistical and Survey Division, Department of Clinical Research, Siddha Central Research Institute from April 2017 to March 2020. This record contains the demographic data, socioeconomic status, literacy, and diseases follow-up with diseases codes in the Ayapakkam, Mangadu, and Vanagaram villages in Tamil Nadu, India.
Results: Totally 5409 cases who were attending the SRP OPDs from April 2017 to March 2020 have been included in the study. These patients have been repeatedly visiting the Siddha OPD for various illnesses. The women were seeking the Siddha treatment more than the male with Female-1114 cases, Male-553 cases, Female children-42 cases, Male children-29 cases. The diseases have been classified as per the National Siddha Morbidity codes in National Ayush Morbidity standardized terminologies Electronic Portal (NAMASTE Portal). The topmost category of diseases is musculo skeletal diseases and osteo arthritis (41%). diabetes mellitus (10%), cough (8%), and eczema (8%) are the diseases which have a greater number of cases.
Conclusion: The success of a public health program depends on the public need. The more revisits of the patients show good response of the Siddha medicine. Hence this morbidity profile shows that there is a great need among the public toward the traditional medicines particularly Siddha medicine and it has been achieved to some extent through SRP program. Keywords: Morbidity profile, Siddha, Swasthiya Rakshan Programme
How to cite this article:
Lawrence J, Karunanidhi S, Purushothaman VN, Rajendran P, Panneerselvam T, Parameswaran S. Morbidity profile of the out patients in Swasthya Rakshan Programme of Siddha Central Research Institute, Chennai. J Res Siddha Med 2022;5:27-34 |
How to cite this URL:
Lawrence J, Karunanidhi S, Purushothaman VN, Rajendran P, Panneerselvam T, Parameswaran S. Morbidity profile of the out patients in Swasthya Rakshan Programme of Siddha Central Research Institute, Chennai. J Res Siddha Med [serial online] 2022 [cited 2023 Jun 3];5:27-34. Available from: http://www.jrsm.in/text.asp?2022/5/1/27/374337 |
| Introduction | |  |
Siddha is a comprehensive scientific medical system based on holistic health principles for catering to preventive, curative, and rehabilitative and rejuvenate health. The word Siddha is derived from the Tamil root word Siddhi (“Citti’) which means “attaining perfection,” heavenly bliss and accomplishment. The Siddha system has evolved on the basis of 96 principles which include physical, physiological, and psychological aspects of every human being. Holistic approach is the highlight of Siddha treatment, which concentrates on the health of body, mind, psyche, and genetics of the patients.
Goal of public health is to improve health outcomes by preventing disease and the health consequences of environmental hazards and natural or man-made disasters as well as to promote behaviors that reduce the risk of communicable and non-communicable diseases and ensuring the public access to quality health services.[1] Characteristics of Public Health Programs are prophylaxis, treatment, and eradication.[2] The Holistic approach of Siddha system is achieved through prevention, prophylaxis, and management of chronic, non-communicable, and systemic diseases.[2] The very purpose of this public health initiative program, that is, Swasthya Rakshan Programme (SRP), is not only to establish sanitation facilities and awareness about good hygiene and health, but also to propagate the Ayush system for the welfare of the people). The objective of this study is to develop a morbidity profile of the patients attending the SRP, Siddha Central Research Institute (SCRI) for further research in the particular area.
SRP is a program launched in October 2015 by the Ministry of Ayush, Government of India, to promote health and health education in villages all over India.[3] The purpose of the program is to promote health and health education in villages. Sage Thiruvalluvar explained in Thirukural (a famous Tamil text) as “Noi naadi noi mudhal naadi, athu thanikum vai naadi vaipa cheyal.” He emphasized that, while treating diseases, we have to concentrate on the etiology like humoral changes and treat the diseases by managing the etiology. As per the Ministry of AYUSH recommendation, Siddha Central Research Institute under Central Council for Research in Siddha (CCRS) also implemented this program in three different rural and semi-urban areas in and around the Chennai, Tamil Nadu namely, Mangadu, Vanagaram, and Ayapakkam. Under this scheme SCRI and National Institute of Epidemiology (NIE) jointly opened a research clinic under this program in the premises of NIE, which started rendering its services successfully on every Thursday from January 12, 2017.
The objectives of the program are
➣ to organize Swasthya Rakshan outpatient departments (OPDs) (for treating diseases), Swasthya Parikshan Camps (For testing individual health), and hygiene awareness program
➣ to create awareness about cleanliness of domestic surroundings and environment
➣ to provide medical aid and incidental support in the adopted colonies and villages
➣ to document demographic information, food habits, hygiene conditions, seasons, lifestyle, and disease prevalence
➣ to assess health status and propagation of Siddha concept of pathiyam—abathiyam and extension of healthcare services through medical camps.
| Population profile | | |
The demographic details of the villages Mangadu, Vanagaram, and Ayappakkam are mentioned in the [Table 1] below as per the census survey done in the year 2011 (census, 2011).[4] The census survey 2011 defined worker as, “a person who does business, job, service, and cultivator and labor activity.”
According to the census 2011, in the village of Ayappakkam 12,150 people were engaged in work or business activity. Of this 9,101 were males while 3,049 were females. Of total 12,150 working population, 79.54% were engaged in main work (workers who had worked for the major part of the reference period, i.e., 6 months or more) while 20.46% of total workers were engaged in Marginal Work (those who had worked for less than 6 months or less than 183 days in a year). In Vanagaram, out of total population, 8,001 were engaged in work or business activity. Of this 5827 were male while 2174 were female. Of total 8001 working people, 80.73% were engaged in main work while 19.27% of total workers were engaged in Marginal Work. In Mangadu town panchayat out of total population, 14,567 were engaged in work or business activity. Of this 11,386 were males while 3,181 were females. Of total 14,567 working population, 87.13% were engaged in main work while 12.87% of total workers were engaged in marginal work.[4]
| Study Tools and Variables | | |
Information on sociodemographic variables such as age, gender, and clinical profile (diagnosis) were collected from records already maintained in the Siddha OPD. For the study purpose, diagnoses of the participants were recorded as reported in the Siddha clinic and morbidities were categorized as per the classification recommended by THERAN software (The Research Aplication Nexus-Hospital management software) which is followed in the SCRI OPD.
Study population
Patients attended the Siddha OPD in the Siddha Healthcare Facility under the SRP at Ayapakkam, Mangadu, and Vanagaram from April 2017 to March 2020 were included. Both new and old cases (patients) attending the OPD were included.
| Results | | |
Number of patients seeking Siddha medicines, no. of new and old patients on repeated visits, gender distribution and their morbidities were summarized from the OPD register from April 2017 to March 2020.
[Table 2] reveals the new and repetition of patients visits to the medical camps. The new comers are mentioned as new cases and the old cases are denoted as the repetition of patients.
The details about the total number of patients visits to the camps, regularity, and the diseases treated in the camps are clearly explained in the following tables and graphs with respect to the places Ayappakkam, Mangadu, and Vanagaram [Figure 1] and [Figure 2]. | Figure 1: Consolidated month-wise number of patients treated in the camps
Click here to view |
From [Figure 3] and [Figure 4], it was clear that 43% of the total patients visit was in the year 2017–18, 34% were in the year 2018–19 and 23% of the patients visited the SRP camps in 2019–20. The above graphs show a decreasing trend in the overall patient visits. The reason behind the trend is that, Until March’20, SCRI has successfully conducted 48 medical camps at Ayappakkam and 11 medical camps at Mangadu. The medical camps at Vanagaram have been stopped temporarily because of man power deficit from April 2019 and at Mangadu from October 2019. [Figure 5][Figure 6][Figure 7] shows the total number of patients in Ayapakam, Mangadu, and Vanagaram.
Ten most common diseases of outpatients attending Siddha outreach SRP camps in Chennai.
The repetition of patients to the SRP camps indicates the efficacy of the Siddha medical system and their continuous interest on Siddha after getting good prognosis from this health system.
| Discussion | | |
Siddha system of medicine is becoming a boon to the health of the society and the quality of life of Siddha seeking people has been improved, and also reduced the diseases burden. We used National Siddha Morbidity Code from the National Ayush Morbidity standardized terminologies Electronic Portal[5] developed by Ministry of Ayush, for categorizing the diseases.
In this present study, musculoskeletal diseases which are under vatham diseases in Siddha shows high number of patients 44% and occupies the first and skin diseases next with 15% among the patients attended the SRP OPD. The diagnosis of patients has been categorized as systematic diseases and the total number of patients in each category was listed below in [Table 3] and in [Figure 8]. According to the quote, Vathamalathu meni kedathu, the vitiated vatham is the main to cause for the skin problems and musculoskeletal diseases, also the vitiated vatham logged in the joints cause pain and swelling. Hence the vitiated vatham can be neutralized by giving viresanam (purgative), since Siddha quote says that Viresanathal vatham thaazhum and we prescribed Agathiyar kuzhambu, a known purgative as a first line of treatment to reduce the vitiated vatham. Respiratory diseases which can be categorized under Kapam diseases comes next and it affects about 13% of the total patients attended. Diseases of gastrointestinal disorders come with next having 7% of cases. Among the top 10 diseases reported, Azhal keel vayu (osteoarthritis) is the first common disease that patients are seeking Siddha medicine. Age, obesity, sport injury, inflammation, and genetic predisposition[6] may be the cause for the increased number of osteoarthritis. Diabetes and cough are the next diseases in the top 1 diseases list. [Table 4] shows ten most common diseases of outpatients attending Siddha outreach SRP camps in Chennai. Hence common life style modifications, yoga, and diet have been taught to the patients visiting the Siddha OPD.
In any public health program, program evaluation and research contribute a vital role in effective management of the program in a successful way. Specific questions evaluation periodically may pave a way for an in-depth assessment of the successful moving of the program. Many public health programs like SRP may succeed if they satisfy the six categories as below. (a) Innovation-like new ideas—like new public health measures or awareness program and obtaining some important issues like Knowledge Attitude Practice studies, Health assessment studies to quantify how they are aware of some implications or their health after the implementation of the program. (b) Technical package—well organized research plans to execute, (c) effective management—implementations of beneficial ideas like medical camps and its effective management for the welfare of the patients like regular supply of medicines etc., (d) good relationship with public and other Government institutes/Non Government organizations, etc.) effective and timely communication with public—for example, Encouraging public usage of Nilavembu kudineer during dengue seasons and Kaba sura kudineer during COVID times, (f) local political support—like the Panchayat Welfare associations.[7]
| Importance of Programme Research | | |
Researches in programs should be in such a way to monitor the progress, to prepare and determine the components for the progress, to compare the group of people, to give proper justification for the desirable funds, to think vigorously for new opportunities and to ensure that the resources were not wasted. These things will certainly give a promising quality improvement.
This study is the first study on morbidities profile of the patients attending SRP outreach camps and we used a standard classification of diseases as followed in Theran software especially used in OPD of SCRI and CCRS. Although SCRI has selected 10 places in Chennai surrounding for conducting camps, we used the data of three places running successfully in Ayapakkam, Mangadu, and Vanagaram.
This study has few recommendations (a) to establish many SRP camps in various parts so that various communities from public will be benefitted, (b) start with COHORT studies which can be implemented in that adopted villages with the help of Public health researchers, (c) conducting many awareness programs and pamphlets can be distributed to the public, (d) major need of the public can be identified, and (e) various methods to implement the program, can be adopted according to their socioeconomic and health profile.[8]
This knowledge of morbidity profile of the patients seeking Siddha in the SRP outreach camps may give the understanding of focused areas/diseases among public and will lead to plan many training modules, awareness booklets, and pamphlets which include Siddha basic principles and theories and to build a healthier nation through Siddha interventions. It will give an idea for the procurement of drugs and need of effective implementation strategies for the success of the program.
| Conclusion | | |
Female patients constitute more than three fourth of outpatients seeking care from Siddha SRP camps. Degenerative diseases such as arthritis and non-communicable diseases were the common morbidities in this group. Various educational programs regarding changes in life style including increase of sun exposure (suttigai), ennai kuliyal (oil bath), healthy diet as mentioned in Siddha especially different diet for different body constitution, as well as proper cleansing methods such as vamanam, viresanam, and nasiyam, regular movements and physical work to every joint, intake of healthy drinks, can be framed in future. Extension and expansion of Siddha outreach camps under SRP may be very useful to develop healthy body, mind, and soul in the public.
Financial support and sponsorship
Not applicable.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | US Department of Health and Human Services. Public Health in America. Washington DC: US Department of Health and Human Services; 1994.  |
| 2. | Patil SB, Patil MS, Chittam KP, Wagh RD. A review on Ayurveda and Siddha: Indian systems of medicine. Pharma Sci Monit 2014;5:40-9. |
| 3. | |
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| 5. | National AYUSH Morbidity and Standardized Terminologies Electronic Portal. namstp.ayush.gov.in/#/index. |
| 6. | Chen D, Shen J, Zhao W, Wang T, Han L, Hamilton JL, Im HJ. Osteoarthritis: Toward a comprehensive understanding of pathological mechanism. Bone Res 2017;5:16044. |
| 7. | Frieden TR. Six components necessary for effective public health program implementation. Am J Public Health 2014;104: 17-22. |
| 8. | Centers for Disease Control and Prevention. Framework for program evaluation in public health. MMWR 1999;48. Available from http://www.cdc.gov › guide › cdcevalmanual. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8]
[Table 1], [Table 2], [Table 3], [Table 4]
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