Yoga in promotion of health: translating evidence into practice at primary healthcare level in India.

Sir,

Research in the field of yoga has shown its positive effect in promotion of health and prevention of certain diseases. The present demographic and epidemiological transition of diseases at global level with increase in trend of noncommunicable diseases necessitates the need for strengthening practice of yoga at community level in developing countries including India. The benefit of yoga differs in different settings because of difference in contribution of various known and unknown risk factors in causation of disease.

Various studies have shown its effects in stress-related disorders, respiratory allergies, anxiety neurosis, diabetes, coronary heart disease, and rehabilitation of disabled.[1] With respect to primordial and primary prevention of chronic diseases, its contribution is well documented,[2] while at secondary level of prevention also, its contribution to limiting the progression of chronic disease or reversing the trend of outcome has got its own value.[3] At tertiary level, once the complications develop, its effect varies with or without beneficial effect depending on the condition.[45] Also, studies have shown that yoga will help in improving the quality of well-being, disability limitation, and rehabilitation of the subjects with chronic diseases.[6]

So, it is imperative to initiate yoga as a health promotion measure at community level in India. District Yoga Wellness Center (DYWC) under Public Private Partnership (PPP) mode under which at least one nongovernmental organization (NGO) will be financially as well as technically assisted in each district of the country in phases during the 11th Five Year Plan is a welcome step in this regard.[7] Besides, as a component of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) under National Rural Health Mission (NRHM), yoga and naturopathy doctors were recruited in some states at primary healthcare level.[8] School yoga program should be initiated and strengthened as conducted in Nagaon of northeast India.[9] Accredited social health activists (ASHA) under NRHM should be involved in awareness generation of the importance of yoga in health and disease.

Concerted efforts from the community, local leaders, NGOs, adequate financing, capacity building, political commitment, and intersectoral coordination are the prerequisites to strengthen the awareness and practice of yoga in the community. At the same time, there is a need for conduct of descriptive studies to understand the magnitude of yoga practice and its associated factors at country level, multicentric cohort, and interventional studies to elucidate and quantify the role of yoga in health and disease.