title: Medical pluralism among indigenous peoples in northeast India - implications for health policy.
abstract: OBJECTIVE
  The government of India is promoting and increasing investment in the traditional medicine systems of Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) in the northeast region of India. But there are few empirical data that support this policy decision. This study estimates the awareness and use of the different medical systems in rural Meghalaya, a state in north-east India with a predominantly ethnic tribal population.
  
  
  METHODS
  We conducted a cross-sectional multistage random sample household survey across all districts of Meghalaya. To enable appropriate estimates for the whole of rural Meghalaya, the data were weighted to allow for the probability of selection of households at each stage of the sampling process.
  
  
  RESULTS
  Both local tribal medicine and biomedicine were widely accepted and used, but the majority (68.7%, 95% CI: 51.9-81.7) had not heard of AYUSH and even fewer had used it. Tribal medicine was used (79.1%, 95% CI 66.3-88.0), thought to be effective (87.5%, 95% CI: 74.2-94.1) and given in a variety of disorders, including both minor and major diseases. In the 3 months prior to the survey, 46.2% (95% CI: 30.5-62.8) had used tribal medicine. Only 10.5% (95% CI: 6.1-17.6) reported ever using any of the AYUSH systems.
  
  
  CONCLUSIONS
  Our comparative estimates of the awareness and use of tribal medicine, different systems of AYUSH and of biomedicine among indigenous populations of India question the basis on which AYUSH is promoted in the northeast region of India and in the state of Meghalaya in particular.
authors.affiliation: Indian Institute of Public Health, Shillong, India.|Public Health Foundation of India, New Delhi, India.
authors.forename: Sandra
authors.initials: S
authors.lastname: Albert
authors.affiliation: Martin Luther Christian University, Shillong, India.
authors.forename: Melari
authors.initials: M
authors.lastname: Nongrum
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Webb
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: John D H
authors.initials: JD
authors.lastname: Porter
authors.affiliation: Martin Luther Christian University, Shillong, India.
authors.forename: Glenn C
authors.initials: GC
authors.lastname: Kharkongor
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001364:Awareness; D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection; D005006:Ethnicity; D005191:Family Characteristics; D005260:Female; D006291:Health Policy; D006705:Homeopathy / Q000706:statistics & numerical data*; D006801:Humans; D007194:India; D008297:Male; D008515:Medicine, Ayurvedic; D008519:Medicine, Traditional / Q000706:statistics & numerical data; D012424:Rural Population; D015013:Yoga
keywords: Khasi tribe; Sistema sanitario; health policy; health system; indigenous peoples; medical pluralism; nord-est de l'Inde; nordeste de la India; northeast India; peuples autochtones; pluralisme médical; pluralismo médico; población indígena; politique de santé; política sanitaria; système de santé; tribu Khasi