Strategy followed for health delivery.system is different in different Asian countries. In this context, the Chinese experience is unique. Two important strategies followed in China are worth emulating for the rest of the Asian countries including India. (1) They have a successful bare-foot doctor, who can reach most of the population throughout China. These bare-foot doctors are diploma holders in medicine. In fact, they are selected from all walks of life and given 3 years integrated training in medicine covering the indigenous Chinese system of medicine with the allopathic system of medicine. China has an army of bare-foot doctors to cater to the needs of the population, (2) The second novelty of the Chinese health delivery system is called the family bed system. In China patients will be screened while visiting the hospitals and most of the patients will be sent back to their families after diagnosis and they are rendered service in their respective homes by the bare-foot doctors. Such service minimizes the need for more number of hospitals and in addition psychologically gives confidence to the patients which is a major prerequisite for curing the disease. These systems of service followed in China deserve replication and emulation in our country too. The strategy of using different systems of medicine is found to vary in different Asian countries. In this context, once again China is in the forefront. For instance, acupuncture is not only popular throughout China but is also being practiced in several developed countries. Similarly, utilization of indigenous herbs and bio- medicines, like Ginseng which is found to be effective for longevity are very popular in China and Korea. In fact the Chinese diet itself is very appropriate for healthy living because they consume only a cup of rice during lunch and dinner and the rest are supplemented by fish, meat and vegetables. In South Korea and Indonesia also peripheral indigenous workers are very popular and useful for health delivery system. They also use the indigenous system of medicine and services. In India we have ayurveda, homeopathic and unani systems of medicine along with the allopathic system. They are not suitably made use of in most states of India except in Kerala and Gujarat. In fact, several medicines of these systems are very effective for health promotion and they are cost-effective as well. Therefore should we neglect them and have prejudice against these indigenous systems of medicine? What should be done to improve their utilization in our country? When we improve the utilization of these systems of medicine throughout India we may also make a breakthrough in controlling certain diseases and epidemics like in China and South Korea.
Health Education : Health Education can be defined as the art of applying social and health sciences to facilitate the development of healthy life styles and behavior among people. Information, communication, motivation and media are essential and integral components of health education. It helps people become health conscious and develop a high value for health. It involves multi- disciplinary team work in planning educational strategies, in designing multi- media campaigns, in effective use of electronic and mass media and in folk communication activities. It is the art of working with people of various backgrounds to satisfy their needs by their own actions and resources and by mobilizing the resources of other sectors. Its main function is to create appropriate educational opportunities in varying environments for people to make their own enlightened decisions and act upon them. For this purpose, it uses home, market, and meeting place (community health education), school (school/student health education), work place (industrial health education), hospital (patient education), and employs methods and media suitable to the target groups and problems (Ramakrishna, 1992: 18).
Health promotion can he achieved largely through health education. It is a cost-effective, trouble free and appropriate service for the promotion of health. However, it is deferentially promoted in several Asian countries with varying success rates.
Although health policies of most of the Asian countries provide priority for health education in the policy document, at the implementation stage priority is shifted to curative services neglecting health education. It is largely due to the defective human resources development on the part of the clients. If health education is promoted seriously, morbidity and mortality can be effectively prevented. In fact, health education and its importance is not only increasing in the context of changing patterns of morbidity but also become necessary to prevent the dreadful diseases like AIDS and cancer.
Cultural practices may be beneficial or harmful in a society. Health education should identify such beneficial practices for introducing appropriate education for healthy living. In this context, life style is the most important aspect of the culture. In fact, life style forms the major determinant of cancer, AIDS, cardiovascular diseases and diabetes today. It is well known that smoking and chewing of tobacco cause oral cancer. Sexual hygiene has been linked to cervical cancer. Likewise oral hygiene is related to mouth cancer and the intake of fibrous food checks colon cancer. All these are culturally determined.
Similarly the type of sexual practices, hygiene involved and The use of condoms determine the occurrence of AIDS. Value attached to chastity is well known in several Asian countries. Of course, its degree varies from community to community. Such a value system is a positive cultural trait that prevents AIDS.
Another major disease like a cardiovascular problem is again caused largely by life style factors. For instance, excessive intake of fat, status syndrome associated with obesity, food habits, longing for more comforts and sedentary life are aspects of culture which promote cardiovascular diseases. On the other hand, the value attached to vegetarian food particularly among certain communities in India and Indian origin population in Asian countries acts as a benevolent cultural factor to minimize cardiovascular diseases.
Similarly, diabetes and communicable diseases can also be affected by certain cultural practices either adversely or favorably. Therefore, understanding of culture in human behavior forms a pre-requisite for the success of health education.
Promotion of personal hygiene and environmental sanitation are essential components of health education. Out of the seven Asian countries discussed here, Bangladesh and India are the most backward countries in personal hygiene and environmental sanitation. The level of hygiene and sanitation arc or a higher order in China, Korea, Indonesia and Thailand. The situation is also far better in Sri Lanka. The major reasons for such improvement of hygiene and sanitation in other Asian countries are partially conditioned by their cultural practices and promoted through education and modernization. Therefore, high priority must be given for hygiene and sanitation to prevent several communicable diseases in India and Bangladesh since they have been very much controlled in China, Indonesia, South Korea and Thailand, which are the major diseases caused by poor hygiene and sanitation. Important morbidity conditions in this context are the diseases mentioned above and all other communicable diseases particularly water-borne diseases like diarrhoea, dysentery, cholera, typhoid and jaundice and air-borne diseases like tuberculosis, polio, chickenpox, influenza, whooping cough.
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