Medical pluralism among indigenous peoples in northeast India ‐ implications for health policy

Objectives 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. Method 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. Conclusion 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. Objectifs Le gouvernement de l'Inde fait la promotion et augmente l'investissement dans les systèmes de médecine traditionnelle: Ayurveda, Yoga, Unani, Siddha et Homéopathie (AYUSH), dans la région du nord‐est de l'Inde. Mais il y a peu de données empiriques qui appuient cette décision politique. Cette étude évalue la connaissance et l'utilisation des différents systèmes médicaux en zone rurale à Meghalaya, un Etat du nord‐est de l'Inde avec une population majoritairement ethnique tribale. Méthode Enquête transversale multi‐étape sur un échantillon aléatoire des ménages en zone rurale à Meghalaya. Pour permettre des estimations appropriées pour l'ensemble de la zone rurale de Meghalaya, les données ont été pondérées pour permettre la probabilité de sélectionner des ménages à chaque étape du processus d’échantillonnage. Résultats La médecine tribale locale et la biomédecine étaient largement acceptées et utilisées, mais la majorité (68,