Project Report

Towards Organisational effectiveness of

OPD service in Ayurvedic Dispensaries in

District Gautam Budh Nagar, Uttar Pradesh

Submitted by
Dr. Surendra Chaudhary
(PGC/ 3756/2010)

For
Certificate Course in Health and Family Welfare Management
2010-2011






National Institute of Health and Family Welfare-New Delhi

2


Acknowledgement
I am gracefully acknowledge, the immense support of my family members for
their constant motivation. I am personally thankful to my wife for her motivation and
allow me for sparing time for this project. My daughter, make this project error free
by her editing and my sons overseas calls always boost me for timely completion of the
project.
I am also graceful to all the faculty of distance learning cell, NIHFW New Delhi for
their guidance. All my fellow medical officers and paramedical staff of district
Ayurveda dispensaries support me warmly by providing the relevant data, answering
my survey questions and other information.
I personally thank Divisional Ayurvedic Officer Gautam Budh Nagar, Dr. Dhruv
Singh for proving the budget and other data required for this project.
Last but not the least; I thank all my friends for their pschycological support, and my
patients who missed me during my leaves for the contact programs.

I am very much thankful to Dr. Deoki Nandan , Director, NIHFW New Delhi for
inspiring me of joining this course during my earlier visits to the institute as U.P.
Government representative for trainings under NRHM.

-Surendra Chaudhary
3

Contents

S.N. Contents Page number

1. Introduction 5-6
About Ayurveda 6
2. Section I: Description of the selected Organization 7-15
Divisional Ayurvedic Office G.B.Nagar 7
Map Uttar Pradesh 8
Map Gautam Budha Nagar 9
District profile 10
Location of Ayurveda dispensaries on map 12
Organizational chart 13
Staffing pattern 14
Budget of the organization 15
3. Section-II: Situational analysis 17-23
Health status 17
Health facilities 17
Service program 18
Management analysis 19
Community participation, inter- sectoral coordination 22
SWOT analysis 22
Management problems and causes 23
Future development plan 23
4. Section-III: Selected health care programme 24-35
Objectives 24
Infrastructure 24
4

Staff position at field level 25
Basic qualification, experience and training- 26
Status of Medical Officers (experience) 27
Facilities at dispensaries 27
Performance, coverage and quality of the services 28
Patients growth 29
Other services 30
Target achieved 31
Observation 32
5. Section-IV: Managerial problems 36-37
Problems 36
Priorities of the problems 37
6. Section-V: suggested Interventions 39-41
7. Section VI: Action Plan 42-46

Appendix

Photos during field survey 47-49

List of medicine purchased by District officer 50
Questionnaire for medical officers- General Knowledge based 51
Questionnaire for medical officers- Hospital specific- 52

Essential drug list 54-75







5



Introduction
Ayurveda services are mainly availed by the poor population groups who are not served by
the popular medical care. For last few decades modern health care system develops very fast
resulting drastic decline in the services of Ayurvedic dispensaries. Most of the Ayurvedic
dispensary limited to serve the chronic or the common ailments only.
Ayurveda, even having an old medical delivery institute and such a tremendous community
involvement, OPD attendance is very thin in this district. The main propose of this project is
to find out the factors which affect the working of the system and how we can improve after
studying the public health management tools.
About Ayurveda
Ayurveda can be defined in terms of basics which include the Tridosha and
Panchmahbhoot theories. A brief introduction is given below-
Basics of Ayurveda
Life in Ayurveda is conceived as the union of body, senses, mind and soul. The
living man is a conglomeration of three humours (Vata, Pitta &Kapha), seven basic tissues
(Rasa, Rakta, Mansa, Meda, Asthi, Majja & Shukra) and the waste products of the body
such as faeces, urine and sweat. Thus the total body matrix comprises of the humours, the
tissues and the waste products of the body. The growth and decay of this body matrix and its
constituents revolve around food which gets processed into humours, tissues and wastes.
Theory of Panchamahabhutas
According to Ayurveda all objects in the universe including human body are
composed of five basic elements (Panchamahabhutas) namely, earth (Prithvi), water (Jal),
fire (Agni), air (Vayu) and vacuum (Akaash, ether). There is a balanced condensation of
these elements in different proportions to suit the needs and requirements of different
structures and functions of the body matrix and its parts. The tissues of the body are the
structural whereas humours are physiological entities, derived from different combinations
and permutations of panchmahbhoot
Health and Sickness
Health or sickness depends on the presence or absence of a balanced state of the total body
matrix including the balance between its different constituents. Both the intrinsic and
extrinsic factors can cause disturbance in the natural equilibrium giving rise to disease. This
loss of equilibrium can happen by dietary indiscrimination, undesirable habits and non-
observance of rules of healthy living. Seasonal abnormalities, improper exercise or erratic
application of sense organs and incompatible actions of the body and mind can also result in
creating disturbance of the existing normal balance. The treatment consists of restoring the
balance of disturbed body-mind matrix through regulating diet, correcting life-routine and
6

behaviour, administration of drugs and resorting to preventive Panchkarma and Rasayana
therapy

Preventive Treatment and the concepts of Aetio-Pathogenesis
Ayurveda has developed a very vivid analytical description of the stages and events
that take place since the causative factors commence to operate till the final manifestation of
disease. This gives this system an additional advantage of knowing that possible onset of
disease much before the latent symptoms become apparent. This very much enhances the
preventive role of this system of medicine by making it possible to take proper and effective
steps in advance, to arrest further progress in pathogenesis or to take suitable therapeutic
measures to curb the disease in its earliest stage.
Treatment
The basic therapeutic approach is, that alone is the right treatment which makes for
health and he alone is the best doctor who frees one from disease. This sums up the principal
objectives of Ayurveda, i.e. maintenance and promotion of health, prevention of disease and
cure of sickness.
Treatment of the disease consists in avoiding causative factors responsible for
disequilibrium of the body matrix or of any of its constituent parts through the use of
Panchkarma procedures, medicines, suitable diet, activity and regimen for restoring the
balance and strengthening the body mechanisms to prevent or minimize future occurrence of
the disease.
Diet and Ayurvedic Treatment
In Ayurveda, regulation of diet as therapy has great importance. This is because it considers
human body as the product of food. An individuals mental and spiritual development as
well as his temperament is influenced by the quality of food consumed by him. Food in
human body is transformed first into chyle or Rasa and then successive processes involve its
conversion into blood, muscle, fat, bone, bone-marrow, reproductive elements and ojas.
Thus, food is basic to all the metabolic transformations and life activities. Lack of nutrients
in food or improper transformation of food lead to a variety of disease conditions




----------------------------------------------------------------------



7

Section I: Description of the selected Organization
District Ayurvedic office Guatam Budha Nagar
Sponsoring agency - Government of Uttar Pradesh
The entire district Ayurveda service is governed by the Director Ayurveda services Uttar
Pradesh and comes under the ministry of Medical education headed by a cabinet minister
and supported by the minister of state (Ayurveda).
The department is headed by the director at state level and Regional Ayurvedic and Unani
Officer at district level.
We have 71 districts and 59 Divisional Ayurvedic officers.
Ayurveda department of this district is a new one and was created only on 15
th
Nov 2008.
Gautam Budha Nagar district was created in year 1997 from district Ghaziabad and Buland
shar. Department of Ayurveda was controlled by Divisional Ayurvedic Officer Ghaziabad
for 7 dispensaries and 5 dispensaries were governed by the Divisional Ayurvedic Officer
Bulandshahar.
Now all the administrative control is under Divisional Ayurvedic Office Gautam Budha
Nagar, located at Government Ayurvedic dispensary Dadri.
District Gautam Budha Nagar is one of the small districts of U.P. so is our department.
DEPARTMENT OF AYURVEDA is one of the oldest departments in U.P. providing health
care services through its dispensaries and hospitals throughout the state particularly in rural
areas.
We are not the partner of any National Health Programmes run by the Government of India
(GOI). We had an annual budget of Rs. 8000 (eight thousand only) per dispensary for
medicine supplied by the Government Ayurvedic Pharmacies situated at Lucknow and
Pilibhit. Budget allocation for district office includes contingencies, rent and very nominal
amount for maintenance of the building.
For last two years medicines worth Rs. 25 thousand for every dispensary are being supplied
by the department of AYUSH, GOI under the scheme strengthening of the existing AYUSH
dispensaries.
Most of the dispensaries of this district lack in proper maintenance of building, furniture,
equipments and all the other basic facilities.
8

District Gautam Budha Nagar
Uttar Pradesh showing district and state boundaries
(Source- http://censusindia.gov.in/2011-prov-results/prov_data_products_up.html - Provisional Population Totals Paper 1 of 2011 Series
10 - Uttar Pradesh)




9


10

Map G.B. Nagar (http://gbnagar.nic.in/)
District profile Gautam Budh Nagar
The District Gautam Buddh Nagar was formed on 6/9/97 with effect from Govt. order no
1249/97/82/97.District Gautam Buddh Nagar includes Dadri,Noida and Greater Noida from
gaziabad and Tehsil Sikandrabad and part of Khurja from Bulandshahar.The district has 4
development blocks,3 administrative tehsils and 16 police station.

District Gautam Budha Nagar is surrounded by Delhi NCR,Haryana, Bulandshar, Ghaziabad
and Aligarh district of U.P
(Map courtesy-http://gbnagar.nic.in/Map/map.jpg)
Population India Uttar Pradesh GB Nagar
Total 1,21,01,93,42 199,581,47 1,674,714
Male 62,37,24,24 104,596,41 904,505
Female 58,64,69,17 94,985,06 770,209
Population Density/sq.Km 382 828 1306
Sex ratio(per 1000 males) 940 908 852
Child 0-6 yrs Total 158,789,28 29,728,23 245,232
Child 0-6 yrs (Male ) 82,952,13 15,653,17 132925
112307 Child 0-6 yrs (Female ) 75,837,15 14,075,06
Literacy Rate 74.0 69.72 82.20
Literacy Rate-Male 82.1 79.24 90.23
Literacy Rate-Female 65.4 59.26 72.78

(Source- http://censusindia.gov.in/2011-prov-results/prov_data_products_up.html - Provisional Population Totals Paper 1 of 2011 Series
10 - Uttar Pradesh)
Description Figure Reference
Area 1442 Sqr KM


http://gbnagar.nic.in/
No. Of Tehsil 3
No. Of blocks 4
No. Of Lokshabha seats 1
No. Of Vidhan Sabha 3
Total village 373
Climate-Rainfall 303
Maximum temperature 44.4 http://www.uponline.in/Profile/districts/
Gautam.asp
Minimum temperature 2.2
11


Government Hospitals at Gautam Budh Nagar as on 2009-10
(As per development atlas of G.B. Nagar, dept of statics,Vikas Bhawan, SurajPur-G.B.nagar)
S.N. Nature of hospitals Numbers
1. Allopathic 4
2. Ayurvedic 12
3. Homeopathic 19
4. Unani 0
5. Community Health Centre 3
6. Primary Health Centre 18
7. Family and Mother-Infant Centre 43
8. Family and Mother-Infant Sub-Centre 327
9. Tuberculosis 1
10. Leprosy 1












12

Location of Ayurvedic dispensaries in District Gautam Budh Nagar- Block wise
distribution (http://gis.up.nic.in:8080/srishti/)

Geographical data of Ayurvedic dispensaries (http://gis.up.nic.in:8080/srishti/)
S.No. Village Tehsil Block Population*
As per 2001
census
Distance
from health
centre(KM)
1. Beel Dadri Dadri 1976 6-10
2. Bhaipur Jewar Jewar 2624 6-10
3. Parsaul Gb nagar Dankaur 4098 6-10
4. MandiShyamnagar GB Nagar Dankaur 4882 0
5. Dadri Dadri Dadri 57416 0
6. Surajpur GB Nagar Bisrakh 5569 6-10
7. Dujana Dadri Bisrakh 7901 0
8. Noida* Dadri Bisrakh 305058 0
9. Jahangirpur Jewar Jewar 7901 0
10. Sarfabad* Dadri Bisrakh 4291 6-10
11. Sidipur Dadri Dadri 1197 6-10
12. Bhunna Taga Jewar Jewar 1391 6-10
*Noida and Sharfabad dispensary are working at another place. Sharfabad is situated at
Chhijarsi and Noida, even being Urban dispensary is situated in villege Bajid Pur , Sec-63
Noida
13


Organization Chart #

*There are 71 districts in Uttar Pradesh and Divisional Ayurvedic Officers are working in
only 59 districts.
Minister
Medical Education
Director Ayurveda
Additional Director
Administeration
Deputy Director(3)
Administeration,
Planning ,Education
Divisinal Ayurvedic
Officer(59)*
Adittional Drug
Controller
Finance Controller
Director Education
(Pathyakarm
Mulyankan)
Principal Secretory
Medical Education
Special Secretory
Ayush-2
(Ayurveda)
Joint Secretory
Ayush-2
State Minister
(Ayurveda)
14

# Restructure of department of Ayush is in progress and post of Director General Ayush has
been created, but no further development has done at the time of preparing this project.
Resources-
a. Human-Staffing pattern-
S.
N.
Designation Sanctioned Positioned Vacant Remarks
A. At Divisional Ayurveda and Unani Office
1. Divisional Ayurvedic Officer 1 1 1* Officiating
2. L.D.C. 1 1
3. Chowkidar 1 1
4. Peon 1 1
B. At field level (Dispensary)
1. Medical Officer 13 11 2
2. Pharmacist 13 6 7
3. Staff Nurses 3 3
4. Bhritya 12 10 2
5. Chowkidar 1 1
6. Sweeper 2 3* 0ne surplus
7. Sweeper cum Chowkidar 7 6 1
8. Part time sweeper* 3 3 *Rs.25/month
*Dispensary having OPD facilities only, doesnt have sweeper,
Only three (25%) dispensaries have full staff against the sanctioned post, while 75% of
dispensaries are short of staff in the form of Pharmacist, M.Os and class IV employees.
There is one dispensary where post of Medical Officer and Pharmacist are lying vacant
and Medical Officer of another dispensary is on attachment there.
Availability of the field staff-
Description of dispensary Number
Dispensary having Medical officer along with pharmacist 5
Dispensary having Medical officer but without pharmacist 5
Dispensary Without Medical officer and Pharmacist 1
Dispensary having Pharmacist only 1
Dispensary having full staff as sanctioned 3



15



b. Financial-Budget allocation for the year 2009-10
B
u
d
g
e
t

H
e
a
d

B
u
d
g
e
t

Budget Items (Rs. Laks)
Salary TA/DA Raw Drugs
Aushadi
and
Rasayan*
Anurakshan
(Maintenan
ce)
Others

R
u
r
a
l

45.9
R E R E R E R E R E R E
30 30 6.0 6.0 1.50 1.50 3.50 3.50 1.50 1.50 2.40 2.40






U
r
b
a
n
26.65
20 20 4.0 4.0 0.20 0.20 0.70 0.70 0.15 0,00 1.60 1.60
T
o
t
a
l

72.55 50 50 10.0 10.0 1.70 1.70 4.20 4.20 1.65 1.50 4 4
Year end surrender amount Rs 15,000
Budget allocation for the year 2010-11
B
u
d
g
e
t

H
e
a
d

B
u
d
g
e
t

Budget Items(Rs. Laks)
Salary TA/DA Raw Drugs
Aushadi and
Rasayan
(Prepared
and dressing
materials)
Anuraksha
n
(Maintena
nce)
Others

R
u
r
a
l

85.70
R E R E R E R E R E R E
62 56 21 16.75 0.10 0.10 2.50 2.50 Nil Nil Nil N
il
U
r
b
a
n

37.13
24 24 8.5 5.30 0.10 0.10 0.30 0.30 Nil Nil 4* 4
Total 122.83
86 80 29.
5
22.05 0.20 0.20 2.80 2.80 Nil Nil 4 N
il

Year end surrender amount Rs 6, 33,000

16



Section-II: Situational analysis
1. Health status situation-
S.N. Rates and Ratio Value reference
1. Crude death rate 8.4 SRS 2008
2. Crude birth rate 29.1 SRS 2008
3. Infant mortality rate (IMR) 67 SERS 2008
4. Maternal mortality rate (MMR) 440 SRS 2008
5. Total fertility 3.8 SRS 2008
6. Sex Ratio/1000 male 852 Provisional
population report
census2011
7. Total literacy rate 90.23
8. Literacy rate female 72.78
9. Growth rate % 51.52

2. Health facilities- Health facilities in Gautam Budh Nagar are provided by the
government, private and corporate hospital. Government facilities are more rural
population centric while private and corporate health sector is available in urban
areas only.
Private health facilities-
Corporate multispecialty hospitals- 2
Private multispecialty hospital - 2
Private hospitals >100 beds 10
Private hospitals <100 beds >50
There is one medical college at Greater Noida having a 500 bed hospital



17






Government Hospitals at Gautam Budh Nagar as on 2009-10
(As per development atlas of G.B. Nagar, dept of statics,Vikas Bhawan, SurajPur-G.B.nagar)
S.N. Nature of hospitals Numbers
1. Allopathic 4
2. Ayurvedic 12
3. Homeopathic 19
4. Unani 0
5. Community Health Centre 3
6. Primary Health Centre 18
7. Family and Mother-Infant Centre 43
8. Family and Mother-Infant Sub-Centre 327
9. Tuberculosis 1
10. Leprosy 1
Two multispecialty hospitals are under construction, one each at Noida and Greater
Noida urban area.
Total number of dispensary-12
Dispensary running in
Rented 6
Government owned 2
Rent free/ Panchayat, Mandir, School , other 4
Having own land 2
Having only one room 4
Insufficient space 4
18



3. Service Program- All the National health programmes are run by the district health
and family welfare department. Department of Ayurveda is providing OPD services
as primary service with very limited IPD service, which is being utilized as day care
facility.
4. Management analysis of-
1) Policy, objectives, strategies and inputs-
There are no clear objectives and targets other than attending at least 20 new patients per
day. Strategies are framed at state level and forwarded to district level.
Inputs-
Human resources- Medical Officers are available in most of the dispensary but
pharmacist are short and affecting the function of the organization. There are some
dispensaries without medical officer and pharmacist. Pharmacist or medical officer
of another dispensary is attached, thus affecting both the dispensary.
Infrastructure Infrastructure is very poor in the entire district. Rent free buildings
are in bad shape and need a lot of money for repairing or maintenance.
Furniture and equipments- Most of the dispensaries do not have enough or good
quality furniture.
Equipments and instruments are neither adequate nor appropriate in nature.
Budget- Budget provision other than committed like salary, arrears etc is not
sufficient. Budget for maintenance or repairing is not provided every year. Medicinal
budget is sufficient as medicines are supplied as central assistance.
2) Organizational structure-
District organization is headed by Divisional Ayurvedic Officer supported by a junior clerk
and two class IV employees. There is no vehicle so management cant be up to the mark. At
dispensary level management is done by the medical officer and pharmacist (in case of un
availability of the M.O.)
3) Status of human resources management-
a) Staffing norms-
S.
N.
Designation Sanctioned Positioned Vacant
1. Divisional Ayurvedic Officer 1 1 1*
2. L.D.C. 1 1
3. Chowkidar 1 1
4. Peon 1 1
1. Medical Officer 13 11 2
2. Pharmacist 13 6 7
19

3. Staff Nurses 3 3
4. Bhritya 12 10 2
5. Chowkidar 1 1
6. Sweeper 2 3
7. Sweeper cum Chowkidar 7 6 1
8. Part time sweeper 3 3

* Presently, post is holding on officiating base.
b) Status of the vacant posts-
Name of the post Sanctioned Posting Vacant Vacant
%
1. Medical Officer 13 11 2 15
2. Pharmacist 13 6 7 54
3. Bhritya 12 10 2 17
4. Sweeper cum Chowkidar 7 6 1 14

c) Availability of the staff-Most vacant posts belong to pharmacists which are more
than 50% followed by class IV employees, while medical officers are posted in all
the dispensaries other than two.
Observations on availability of the staff-
In the absence of pharmacists medicines are distributed by the class IV employees, who are
not competent and technical. This increases the waiting time and medical officers always
fear about any lapse in distribution of the medicine.
90% of the field staff not staying at the headquarters. Reasons are-
No residential quarters- There is no provision for residence at the field units, so
staff is not staying there. Class IV employees are generally posted near their villages,
so they dont reside there. Medical officers reside in nearby towns.
Location of the field unit- These are situated in villages far from the city or town
having no facilities like education, entertainment and electricity etc, so medical
officers and pharmacist reside 10-20 km away from the headquarters.
d) Staff motivation- Staff motivation is at the lowest level. Entire staff is doing its
duties just till the withdrawal of their salary only. Salary, T.A, and other dues of the
staff are not paid in time because of lack of commitment of the district office.
Lack of motivation concerts the low turn up of the patients and cleanliness of the premises.
20

e) Training- Training was never planned. There is no provision of in-service training
for technical personnel.
There is no organizational policy for training.
Few of the medical officers take training for the financial management.
If there is any training program sponsored by the central government, employees are
not informed and never relieved for the training.
Technical skills of the medical and Para-medical staff are never evaluated and they
never feel the need of any training.
f) Leadership and supervisory practices- At district level no supervision or
monitoring is performed because of unavailability of the vehicle to inspect the
dispensaries. Medical officers are not trained in modern tools of management
including monitoring and supervision.
There is no supervisory plan for regular supervision.
There is no supervisory check-list.
No feedback is provided to the superiors.
Supervisors do not have adequate skill to supervise.
g) Team work-
There are some units where entire staff works as a team and achieves the desired targets.
Most of the units have some inter-personal conflicts, which require timely intervention of
solution.
h) Support system:
1. Financial support- Financial support is in the form of budgetary allocation from the
state government for the wages, medicine and equipments.
2. Materials support-
Medicines are supplied from the following sources-
1. State government- A total of Rs. 8,000 is earmarked for the medicine supplied
by the two state Ayurvedic pharmacies.
2. Local supply- Budget is provided for the local procurement of medicine and
other equipments. For local purchase three categories are defined,
I. Raw drugs- As per Ayurveda principle, certain medicines are available in
certain geographical areas which are very beneficial for the ailments which exist
21

in those areas, so government allocates certain budget to purchase these raw
drugs for individual dispensaries.
II. Aushad and Rasayan- This category has readymade medicines including
classical medicines. Dressing material is also procured under this category.
III. Third category consists of drugs from various sources including patent
Ayurvedic medicines.
Budget allocation for medicine (Last two years)
Year Raw drug Aushadi and Rasayan
2010-11 20,000 2,80,000
2009-10 1,70,000 4,20,000

3. Central government assistance-
Under the Ayush, GOI scheme for medicine @Rs. 25 thousand per dispensary is being
supplied for last two years. From year 2010-11 this amount has been increased to Rs.50,
000 per dispensary.
Procurement process-
For central assistance and state supply, directorate of Ayurveda services purchases
medicines on the recommendation of the purchase committee, while at district level
procurement is done on the bases of demand letter from the dispensaries. But this practice is
not followed and purchase is made at divisional Ayurvedic officers discretion only.
4) Community participation, inter- sectoral coordination and IEC-
Total aversion from community, there is no involvement. Medical officers are not
aware about the community need although Ayurveda has very good community
involvement in terms of knowledge.
No interaction between field unit staff and the community.
Most of the time community is not aware about the services we are providing,
resulting in loss of faith as well as patients.
NGOs never involve Ayurvedic dispensaries in their working environment.
There is no inter-sectoral coordination; involvement of main stream health service
department is limited to engage Ayurveda medical officer in immunization program
or using their facilities for setting up of the immunization booths during Pulse Polio
drive.
22

No IEC material ever supplied to the hospitals, neither staff is aware about any IEC
services.
Ayurvedic medical officers are not aware about the Village health societies and/or
Togi Kalian Samitis.
No Medical Officer is member of any Village health society or RKS.

Swot analysis
Strengths:
1. Strong community involvement in terms of Ayurveda knowledge.
2. Good acceptance among the people.
3. Experienced, committed medical and paramedical staff.
Weaknesses:
1. Poor infrastructure.
2. Poor record keeping.
3. No clear policies.
Opportunities:
1. Conducting of specialized clinic- kshar sutra, geriatric and rasayan therapy.
2. Propagation of lifestyle modification for prevention of disease.
3. Potent integration with the National Health Programs.
Threats:
1. Political patronage does not provide support to this system and political interference
is the biggest threat.
2. If involved in national health programs, department of health will misuse the
workforce and medical officers will be used for any work other than the treatment.
5) Decentralization-
No decentralization is done. There are two types of planning which are supposed to be done
at dispensary level-
23

Purchase of crude drugs- budget is allocated for purchasing local need based crude herbs to
provide the effective treatment, but this is not being followed. Divisional Ayurvedic officer
purchases raw drug on his own and supplies to the dispensaries.
User charges- 50% of user charges are supposed to be used exclusively for the betterment of
that particular unit in the form of purchase of most essential equipment, instrument or
furniture, but it is not performed at dispensary level.
6) Management problem and causes-
Most important management problems are supervision and monitoring. There is no
evaluation of the service at all. Vehicle is the main cause of the problem, without which
field movement is not possible. Dispensaries are situated far from the district headquarter
and public transport is not available every time.
Disbursement of wages and other arrears- most of the staff is facing this problem. Salary is
not disbursed in time and the cause is inter-personal conflict between LDC and the
Divisional Ayurvedic officer.
7) Future development plan of the organization- At district level every year provision of
certain new dispensaries is made in the district plan, but never succeeds in releasing the
state budget. This year also six new dispensaries are proposed in district plan.
24

Section-III: Selected health care programme
OPD services in Ayurveda dispensaries of Gautam Budh Nagar
III. i. Objective-
Main objective of Ayurveda services is to provide quality health care on two grounds-
Preventive- As Ayurveda theory explains that most of the diseases occur because of
unhealthy life style, we can prevent many diseases by adopting a healthy life style as per our
Prakriti as stated by Ayurveda.
This can be done by advising people to eat properly and act in accordance of nature.
Curative- If we are not following the regimen explained by the Ayurveda we can take
medicine to cure the diseases.
Main goal and objective is to attend at least 20 new patients per day i.e. a total of at least
7300 patients annually.
III. ii. Infrastructure, facilities and resources-
There are 12 dispensaries in the district covering mainly the rural population.
S.No. Dispensary at Tehsil Block Nature of
Dispensary
Bed
capacity
13. Beel Dadri Dadri Indoor 4
14. Bhaipur Jewar Jewar Indoor 4
15. Parsaul Gb nagar Dankaur Indoor 4
16. MandiShyamnagar GB Nagar Dankaur Out door 0
17. Dadri Dadri Dadri Indoor 15
18. Surajpur GB Nagar Bisrakh Out door 0
19. Dujana Dadri Bisrakh Out door 0
20. Noida* Dadri Bisrakh Indoor 4
21. Jahangirpur Jewar Jewar Out door 0
22. Sarfabad* Dadri Bisrakh Indoor 4
23. Sidipur Dadri Dadri Indoor 4
24. Bhunna Taga Jewar Jewar Indoor 4

Total bed capacity 43

*Noida and Sharfabad dispensary are working at another place. Sharfabad is situated at
Chhijarsi and Noida, even being Urban dispensary is situated in villege Bajid Pur , Sec-63
Noida


25

Rural -Urban classification-
Total dispensaries Urban Rural
12 2* 10

*Although classification of the dispensaries are as per budgetary provision in terms of Rural
or Urban, but due to fast urbanization of Noida and Greater Noida more and more Rural
dispensaries are serving urban population as well.
Building status of the dispensaries
Type No. %
Rented 6 50
Own 2 17
Rent free 4 33


Staff position at field level-
Name of the post Sanctioned Posting Vacant Posting %
1. Medical Officer 13 11 2 85

2. Pharmacist 13 6 7 46
3. Staff Nurses 3 3 X 100
4. Bhritya 12 10 2 83
5. Chowkidar 1 1 X 100
6. Sweeper 2 3* X 150
7. Sweeper cum Chowkidar 7 6 1 86
8. Part time sweeper* 3 3 X *Rs.25/month

Availability of the staff-
Description of dispensary Number %
Dispensary having Medical officer along with pharmacist 5 42
Dispensary having Medical officer but without pharmacist 5 42
Dispensary Without Medical officer and Pharmacist 1 8
Dispensary having Pharmacist only 1 8

26


Basic qualification, experience and training status of Medical Officers-
S.
N.
Name
Q
u
a
l
i
f
i
c
a
t
i
o
n


D
u
r
a
t
i
o
n

i
n

s
e
r
v
i
c
e

(
I
n

Y
e
a
r
s
)

D
u
r
a
t
i
o
n

o
f

p
r
e
s
e
n
t

p
o
s
t
i
n
g

(
I
n

Y
e
a
r
s
)

E
x
t
r
a

q
u
a
l
i
f
i
c
a
t
i
o
n

(
i
f

a
n
y
)


A
n
y

i
n

-
s
e
r
v
i
c
e

t
r
a
i
n
i
n
g


1. DR. Surendra Chaudhary B.A.M.
S.
28 5 Nil TOT in
NRHM from
NIHFW
2. Dr.Ashok Sharma -do- 22 13 Nil X
3. Dr. Anjali Sharma -do- 22 3 Nil DDO
Training
4. Dr. Sneh Lata -do- 23 6 Nil Ultra sound
training
5. Dr. Kavita Singh -do- <1 < 1 Nil X
6. Dr. Digvijay Pal Singh -do- 18 5 Nil X
7. Dr. Sukh Pal Singh -do- 24 3 Nil X
8. Dr. Dhruv Singh Rajawat -do- 31 3 Nil DDO
training
9. Dr.Dinesh Chandra
Salwani
-do- 2 2 Nil
X
10. Dr. Umesh Agarwal -do- 24 3 Nil X
11. Dr. Archna Singh -do- 10 days 10 days nil X







27


Experiences of Medical officer-
A. Length of service B. Posting at one place



Facilities at dispensaries
Total number of dispensary-12
Facilities Availability Non-availability
1. Appropriate location of dispensary Y=58% No=42%
2. Space as per facility 50% 50%
3. Signage and board 85% 15%
4. Drinking water- Hand pump 90% 10%
5. Toilet 50% 50%
6. Electricity* 67% 33%
7. Fan for patients* 50% 50%
8. Sufficient Sitting space for patients 100% 0
9. Separate sitting space for patients 70% 30%
10. Sitting furniture 100% 0
11. Public telephone 0 100%
12. Separate registration counter No No
13. Separate dressing room 0 100%
14. Sufficient Dressing material 80% 20%
15. Cleanness of the premises Yes 0
*There is no electricity in rural dispensaries during day time, even though dispensaries have
electricity connections.


3 or <3
yrs, 3
18 yrs,
1
20-30
yrs, 6
>30 yrs,
1
0 to 3
years, 6
3 to 5
years, 3
> 5
years ,
1
28


III. iii. Performance, coverage and quality of the services-
Outpatient services across the district are low as compared to the objective and target of the
department. Quality is not being provided because of poor infrastructure and low morale of
the staff. Medicines are adequate in terms of supply but are not as per the diseases
prevalence, resulting low turnout of the patients.
There are many drugs which are supplied in excess, while some drugs are not supplied in
sufficient quantity. There are some diseases for which no medicine is being supplied for the
last many years.
Total number of patients-


Dispensary wise distribution of the total patients for last three years
143368
138408
100598
0
20000
40000
60000
80000
100000
120000
140000
160000
2010-11 2009-10 2008-09
Total Patients
Total Patients
29


Patient growth- there is a remarkable growth in last two years as compared with the year 2008-09.
It was 38% in year 2009-10 and 43% in 2010-11. The main reason is supply of medicine from the
central government assistance and budgetary allocation for medicine at district level.
Patients growth in last two years-(Base 2008-09)







0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2010-11
2009-10
2008-09
43%
38%
2010-11
2009-10
35 36 37 38 39 40 41 42 43
Increment against 2008-09
30

Comparison with other Ayush Facility
Homeopathy is another component of Ayush providing health care services in the district with the
same number of dispensaries (12). The comparative yearly total for the 2010-11 is given below-


Other services Indoor patients (IPD)
Department has a bed capacity of 43 beds in 8 dispensaries including a 15 bed hospital.
Indoor facility is not being used by the department; only three dispensaries used indoor
facility and only 139 patients (old and new) were admitted as day care facility. Main reason
is unavailability of the facilities like diet, electricity, 24 hour staff and medical officer.
III. iv. Operational strategies-
Waiting time was more during peak hours of the OPD which was monitored and cut short by
adopting quick disbursement of the medicine. Cleanliness was taken care of on daily basis.
Facilities like drinking water, toilets and sitting space was being observed as a routine by the
medical officer.
III. v. Assessment of Performance -
Daily total of 20 new patients target was not achieved by most of the dispensaries. If we
compare target with base year of 2008-09 performance increases considerably, but was
below the target other than one dispensary. In year 2008-09 only one dispensary achieved
the target of attending a total of 7300 or more new patents in a year, only one dispensary
achieved 75-90% target, while 10 out of 12 dispensaries achieve less than 75% 0f the target.
143368
110073
0
20000
40000
60000
80000
100000
120000
140000
160000
Ayurveda Homeopathy
2010-11
31


It is clear from the table below that only one dispensary achieved the target in all the three
years. This is 15 beds hospital with a provision of two medical officers.
Annual patient target (%) achieved against a total of 7300 new patients.
Name 2010-11 2009-10 2008-09
Beel Akbar Pur 92 97 38
Bhunna Taga 90 67 21
Sheedi Pur 84 75 30
Mandi Shyam Nagar 97 89 28
Jahangir Pur 99 89 40
Noida 89 87 41
Dadri 114 122 102
Sharfabad 89 73 33
Parsaul 79 62 28
Bhai Pur 79 70 29
Dujana 80 59 22
Suraj Pur 87 90 77
Comparison between new and old patients-
As total numbers of the patients increases in good numbers, but a reverse trend was noticed
between new and old patients after 2008-09. In this year most of the dispensaries show more
old patients in comparison to new one, while in successive years it starts in other way of
more new patients.
There were 92%(11) having more older patients than new followed by 50%(6) in 209-10
and only 25%(3) dispensary attend more older patients in year 2010-11.

100% 90-99% 75-90% <75%
2010-11 1 4 7 0
2009-10 1 2 4 5
2008-09 1 0 1 10
0
2
4
6
8
10
12
N
u
m
b
e
r

o
f

D
i
s
p
e
n
s
r
i
e
s
Target Achieved
32

New and old patients daily average

2010-
11

2009-
10

2008-
09

Dispensary New Old New Old New Old
Beel Akbar Pur
18 6
19 8 8 13
Bhunna Taga
18 15
13 9 4 9
Sheedi Pur
17 11
15 12 6 11
Mandi Shyam Nagar
19 18
18 16 6 9
Jahangir Pur
20 20
18 22 8 16
Noida
18 22
17 27 8 17
Dadri
23 24
24 18 20 22
Sharfabad
18 34
15 30 7 29
Parsaul
18 14
12 14 6 16
Bhai Pur
16 14
14 9 6 10
Dujana
16 9
12 11 4 11
Suraj Pur
17 8
18 8 15 12
In this table bold and red are older patients more than the new.

Observation-
After interaction with medical officers and pharmacists of the respective dispensaries, it was
revealed that in the year 2008-09 there was no fix target for new patients, afterwards more
and more new patients were enrolled to achieve the target.
There are two dispensaries showing the static position in all the years in attending patients
having less number of old patients. These dispensaries witness patients for problems like
fever, vomiting, minor injuries, and diarrhoea having short duration of incubation.
To achieve the targeted goal medicines play an important role; medicines were not available
as per the disease demand resulting in inability of reaching the target.
If we look at the chart below (Total daily average), we will find that most of the dispensaries
failed to achieve the target even on total patients count which is less than the targeted figure
of 20 new patients. As I stated earlier, in year 2008-09 no target for new patient was laid by
the department, so most of the dispensaries daily average was in between 15-21 patients per
day.



33

Total daily average of patients-














24
33
28
37
40
40
38
52
25
25
25 25
27
22
27
33
40
45
42
44
27
23 23
26
21
16
17
15
24
25
42
36
21
16
15
27
0
10
20
30
40
50
60
2010-11 2009-10 2008-09
34

Daily average of new and old patients for last three years:














0
5
10
15
20
25
30
35
40
2010-11 New
2010-11 Old
2009-10 New
2009-10 Old
2008-09 New
2008-09 Old
35




Months of attending minimum monthly patients maximum monthly patients
Y
e
a
r

D
i
s
p
e
n
s
a
r
i
e
s

M
o
n
t
h
s


D
i
s
p
e
n
s
a
r
i
e
s

M
o
n
t
h
s

2010-11
25% Jun 17% February &
June
17% Oct 17% August
17% Dec 42% September
41% Other months 8% Other months
2009-10
50% April 17%each March &Oct
33% May 33% each July & Aug
17% Other months
2008-09
17% April 17% February
17% July 42% march
25% November 17% June
41% Other months 24% Other months

There is no definite pattern of attending minimum and/or maximum daily patients across the
district.





36

Section-IV: Managerial problems
i. Problems
There are many problems which affect the functioning of the OPD services. These are
categorized as follows-
A. Infrastructure-
1. Non-availability of toilets.
2. Signage and board are not clear.
3. Inadequate infrastructure.
B. Human resources-
1. Punctuality of the staff.
2. Indoor patients facility is zero percent.
3. Malpractice such as absenteeism, pilfering of drugs.
4. Lack of interest.
C. Managerial problems
1. Display of Citizen charter- what we are providing and responsibilities of patients.
2. Working hours.
3. No in-service training.
4. No inter-sectoral coordination.
5. Motivation of the employees.
6. Decentralization of raw drug purchase.
7. User charges are not being utilized by the M.O.
8. Dispensing table not organized.
9. Very poor record keeping.
10. No SOPs.
11. No specialized clinic.
12. Timely disbursement of the salary and other dues.
13. Monitoring and evaluation.
14. Divorced from community.
15. No assessment of communitys health need.
16. No clear policies.
17. No evaluation of the services.
18. No regular in service training.
19. No defined targets.
20. Isolation from district officials and other workers.
D. Medicine-
1. Decentralization of raw drug purchase.
2. Timely supply of the medicine.
3. Appropriate supply of the drug.
4. Shortage of essential drugs and equipments.
5. Unused and broken down equipments.
37

ii. Priorities of the problems:
P
r
o
b
l
e
m
s

A B C D
Low impact on
performance
Medium to
high impact
with low
severity
Require
attention, easy
to resolve
Remaining
problem need
more attention

1.Infrastructure

2.Inter-sectoral
Coordination

3.Poor record
Keeping

4.Toilet

5.Location

6.No specialized
clinic


1. Motivation

2.Timely supply
of the drugs

3.Adequate
drugs


1.Punctuality of
the staff

2.Opd strictly
follow 8 AM to
2 PM schedule

3.Cleanliness

4.Organised
dispensing
room

5.Waiting time

6.Availability of
the drug
7. supply of the
rational drugs
8..Timely
Disbursement
of the salary
and other dues


1.Infrastructure-
repairing,
construction of
new building

2.Monitoring

3.Decentralizatio
n of raw drugs

4.Training

5.Rational supply
of the drugs and
equipments

6.Specialized
clinic

7.Inter-sectoral
coordination

8.SOPs

May be ignored Low priority Right now take
action
Prepare an action
plan





38

Section-V: suggested Interventions
After finding the problem I would suggest the following intervention to resolve and solve
the problem-
Problem Gap Solution
Motivation Not getting salary and
other dues in time
Timely disbursement of
all the dues and wages
Punctuality 8AM to 2PM timing are
not being followed
Motivation of the staff
about the fact of being in
time, regular supervision
and inspection
Waiting time at OPD Longer during peak hours Early distribution of the
medicine
Fan and light at waiting
area
No fan available Solar fans and lights can
be obtained through non
conventional energy
department at a very
nominal price.
Toilets Not available With coordination of PRI
toilets can be prepared
without problem.
Toilets Not clean Sufficient water storage in
the toilets can resolve the
problem.
Dispensing In very bad shape Medicine racks be well
organized having label at
all the containers.
Dispensing time Maximum time As Ayurveda prescription
have multi ingredient
formulation, some
common formulation can
be prepared by mixing the
ingredients in advance.
Dressing room No separate room If separate room is not
available, a corner of the
room can be used as
39

dressing table which can
be separated by curtains.
Quantity of medicine In Sufficient As most of the essential
medicines are in short
supply, donation is the
best way of maintaining
required amount of
medicine.
Irrational supply Some medicines are in
large quantity while some
few.
Medicine purchase must
strictly be demand based.
Boards and signage Boards are not placed Boards should be host in a
manner that it is visible
from distance
Records keeping Very poor OPD registered has name,
age, sex, provisional
diagnosis and name of the
medicine. There must be
provision for records like
main complaints, finding
and symptoms with local
address and phone number
(if any). Prescription is not
clear and quantity of
medicine should be
mention clearly.
Progressive chart Not up to date Progressive report chart
about monthly patients
must have the number of
male, female, child, and
disease wise classification.
SOPs Not available SOPs be prepared for
OPDs as well as dressing
and certain diseases.
Community involvement Divorced from the
community
Community involvement
can be done by hosting
health melas or clinic in
40

temple or community
centres. Dhanwantari
jyanti or Ayurveda day
can be celebrated with the
community.
Damaged and unusable
equipments and furniture
No C&D Condemnation and destroy
can be done periodically
Monitoring and evaluation Not performed Be done regularly at field
unit level.
Decentralization Not done Decentralization of drug
procurement be done at
dispensary level. Raw
drugs should be purchased
by the medical officer as
per his requirement. Other
medicine should be
procure as per the demand
from the medical officer
Inter-sectoral coordination No coordination at all Irrigation, ICDS, women
welfare, health and family
welfare, education, PRI
and forest departments are
the integral part of health
delivery system. Ayurveda
awareness can be spread
very fast through
coordination with these
departments.
IEC Not available IEC material can be
obtained from department
of ayush ,GOI regarding
prevention of certain
disease through diet,
general information about
plants and herbs which
may grown in kitchen
gardens.
Specialized clinic Not conducted Specialized clinic in the
field of geriatric care and
41

use of Rasayan as
rejuvenate therapy can be
started with a little
training.
Training Not provided Several training schedule
are being offered by the
central government in the
form of campaign for
Amla, Kshar Sutra and
MCH.
National campaign Not aware Our medical can start
different national
campaign on Ayurveda,
which increase the
credibility and popularity.
National health programs Not involved Most of the national health
programs can easily be
performed by the medical
officer who again creates
awareness among the
people.
Citizens charter Not available There must a display of
services provided by us,
facilities available and
duties and responsibilities
of the patients be
displayed at an
appropriate place.

42

Section VI: Action Plan
For the proper functioning of OPD services main problem is very poor infrastructure in the
form of building. There are 4 out of 12 dispensaries which are located in a single room and 4
others do not have sufficient space as per services provided by those dispensaries.
For the proper functioning of OPD services main problem is very poor infrastructure in the
form of building. There are 4 out of 12 dispensaries which are located in a single room and 4
other do not have sufficient space as per services provided by those dispensaries.
Analysis of the steps

S.N
.
Activities to be
performed
Where Time
(Month
s)
Resources
input
required
Who does Monitorin
g to done
by
1. Adverisement Local news
papers
1-3 Budget Director D.A.O.
2. Constitution of
the Bhawan
Samiti
District 1 Medical
officer
D.A.O. D.A.O
3. Scrutinizing of
the request
applications
District 2 days Human
resource
committee D.A.O
4. Selection of the
owner
District 2 days committee D.A.O.
5. Inspection of
the building
District 1 day Human
resource
committee D.A.O.
6. Recommendati
on of the rent
District 1 day Human
resource
committee D.A.O.
7. D.Ms Approval District 1 District
magistrate
M.O/
D.A.O.
8. Forwarding the
recommendatio
ns
District 1 day Informatio
n
D.A.O. D.A.O.
9. Follow up Directorate 2

D.A.O D.A.O.
10. Sanctioning of
rent
Directorate 6 Director D.A.O.
11. Provision of the
budget
directorate 3 Informatio
n
Finance
controller/Dir
ector
D.A.O.
12. Payment of the
rent
District Any
time
budget D.A.O. D.A.O.



43

My action plan as follows-
Time it will take at least one year in case of rented buildings and 1 to 5 years for the
organizations owned or rent free premises.
A) For rented buildings-
Rented and rent free/ department owned has the equal ratio, 50:50.
Main sufferings
No maintenance of the building,
No electricity supply
No provision of toilet
Not allowing using drinking water facility
Not allowing sign board on their wall other than the rented portion
Not ready to provide any help to the employee
Sometimes spread negative remarks to get their promises vacated
Reason for these-
Rent not paid in time
Rent was not revised even after the contract period
Fear of not vacating their property- being government organization
With inflammation rent, increased many fold and land lord will get more rent
once vacated by the department.
Lack of fund in case of rent free/ department owned
Consequences-
Tense working environment
Low turnout of the patients
Facilities for the patients in waiting area are not adequate
Who are involved?
Landlord
Medical officer and other staff
44


It comes from
Internal weakness and lethargic attitude of the organization
Inability to feel the need of landlord
Lack of knowledge about procedure and steps of rent related problems
External factors like inflation in rental value of the property.
To be solved by
Land lord
Medical officer
Divisional Ayurvedic Officer
Director, Ayurvedic services
Strategic choices-
There may two strategic choices
Increase the rent- the process takes less time for disposal and the land lord
feels that department is taking interest in solving his genuine problem. The
day process starts his attitude and behaviour changes a lot. It involves all the
parties from landlord to director.
There is a procedure for this which requires an application from the landlord
for requesting increase in the rent. A three members committee constituted at
district headquarter having the concerned medical officer as one of its
member. Committee recommends the need of increment in rent and new rate
also defined. These recommendations are sent to district magistrate for
approval and he has sent back the signed certificate after getting required
information about the rates and need of increasing rent. Now divisional
officer will send these recommendations along with his own remarks to the
director for final sanctions.
Shifting the hospital in new building- takes a longer time and procedure. It
should be published in local news papers and acceptance letters are invited
with rent quotations. The committee constituted for this purpose evaluate the
proposals and after physical inspection of the building gives its
recommendations and approval. Further process is the same as for increasing
the rent.
45

Try for rent free space- It is the best option with many hurdles. Gram sabha
can provide the required space in panchayat ghar, primary school,
dharamshala, if there is any space available.
My strategy- new building on rent
Change in the system- as old building does not have enough space as per the
services available, and landlord never provides the extra space, I will choose
the new building at more appropriate location with all the requirements, like
electricity, toilet and drinking water available.
Inputs- required input is the money for advertisement which in this case is
done by the publicity department of the state. Man power in terms of
monitoring the whole process and finally the budget approval above and over
the sanctioned money.
Role and Responsibility Medical officers role is very important. As being
the local officer he can search better space with the help of local community
involvement. District officers responsibility will make the whole process
easy and sanctioning of the rent can be speedy.
Obstacles- there are certain obstacles in this process. Foremost is negative
remarks by the present landlord and another is political pressure, where gram
pradhan or members of the gram panchayat pressurize about the location of
the building should be in their area.
Process-
Publication in the news papers, analysis of the request applications by the Bhavan
Samiti and choosing the best one on the bases of location, space specification and
facilities provided. Choosing the best one will initiate the further process like
submission of the application by the owner in the prescribed form supported by the
blue print of the premises and signing of the government agreement.
Committee recommends the quoted rent and its recommendations are send to district
magistrate for approval and he send back the signed certificate after getting required
information about the rates and justification. Now divisional officer will send these
recommendations along with his own remarks to the director for final sanctions.
2) For rent free or government owned-
As these are the rent free or government owned spaces, the only way is to improve
the facilities by constructing new building where land is available (in this case two
dispensaries have land and one has building).

46


Process-
Only input is finance which can be try from
MLA fund
MP fund
Donations
Departmental budget allocation for the same
Evaluation and follow up of implementation of action plan-
Follow of the plan is very important for its implementations. In this plan I will
review and evaluate following-
What to review-
Request applications in response to advertisement
Following the status of district magistrates recommendation letter and
review it if some problem arises.
At directors office for any legal lacunae
How to review-
If the request application are as per the government guidelines
Committees recommendations are as per Performa
Personal contact with the concerned officer in other departments to get the
D.Ms letter
At directors office requesting her for speedy approval







47

No proper signage-

Properly place sign board-

48

Indoor- un organised-

Indoor- organised

49

Organised dispensing desk-

Un-organised dispensing desk-

50

List of medicine purchased by the divisional Ayurvedic Officer year 2010-11





51

Questions regarding medical officers awareness assessment-
:1 i<<i >rii><i i<i+i c<ii fa (i i<i+ii i aii+i1
z1 fii +i <i ( (Infant Mortality Rate-IMR) i Qi >i+iSia <if( i ai
<i ( c<ii ?
s1 Maternal Mortality Ratio i Qi >i+iSia <if( i ai <i ( c<ii ?
4. NRHM c<ii ?
5. JSS iaiai >i8ii <iiiaii c<ii ?
6. ASHA c<ii ?
7. Mainstreaming of Ayurveda-c<ii Qiai S>i >iaii ? <if( i ai <i c<ii

8. National campaign of Ayurveda f>i f>i frii<i -i~i i ?
9. c<ii >i f>i >i a <fai=i +i Qiai >ii=i f~i<ii 1<if( i ai
i Qi f>i a ?
:c1 Qai f-if>ii~i<i i Qi Qfi >i8i+i iaiiai f~i<i fai (i
Q>iirii Qirii Q>ifriiiQi i >ii+iaii aii o i 1S>i f(ii +i
Qi -iaii+i >iSiiri1











52

Questionnaire about hospital premises and OPD facilities.
aii+i f-if>ii~i<i
1. +i-ii >i+ifaia -
c>ic aii+i / ( fi8ii fri>ii=i +i
i >i
ria+iiai >iiai
i >i
Qa<i
: f-if>iifii
z i+iif>i><
z1 f-if>ii~i<i >i+ifaia
:1 f-if>ii~i<i i i if=i i<<ii <ica
z1 >iriai ii<i fi<i i faii~1 fii~i a>iai ai1
s1 f-if>ii~i<i i iio ~i=ii <ii ai
.1 f>fifa c<ii f-if>ii~i<i 3f-ia >iiai Qrif>ia Qirii ai1 <if(
ai ai i iaii -iif<i1
a1 c<ii f-if>ii~i<i >iriai 3~ii >ifriiiQi Qai <iia <if( ai
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53

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:1 c<ii Qi =iiri +i i=i ~<iii >i+ifa i =ioai <if( i ai c<ii
Qi 3>i >i(><i

54

Essential Ayurvedic Drugs For Dispensaries & Hospitals
(This list is a compilation work based on main streaming of Ayush undewr NRHM,
published by dept. Of Ayush ministry of health and family welfare, Government of
India)

Ayurvedic system of medicine holds numerous single and multi-ingredient formulations
made up of herbal, mineral and herbo-mineral combinations. Their use by the Ayurvedic
practitioners varies to a large extent. While some formulations being so frequently
prescribed in one part of the country may not find place in the prescription of the other
part. Region-wise traditions of Ayurvedic practice is also one of the important causes of
popularity of certain medicines in one particular region. Interestingly, the uses of Ayurvedic
formulations are also so diverse that sometimes not only the patients but doctors too, get
confused in situations where a medicine not indicated in a specific disease condition is
prescribed by the Ayurveda physician solely because of his own experience of treating that
particular disease condition with that very medicine. Though, it is rightly claimed that the
medicines have certain limit of actions yet the physician with his judicious approach can
use one particular medicine for various clinically diverse diseases or symptoms provided he
is well versed with underlying pathogenesis of the ailment and simultaneously has the
understanding of complete range of action and scope of the drug. Such guidelines for
varied uses of medicines are already described in the classical texts of Ayurveda.
List of ASU medicines procured in various States differ so much and some of the
departments and institutions have restricted its number to too little to cover the variety of
disease-condition.
In view of this and the administrative problems being faced for selection the Adyurvedic
drugs for a dispensary or a hospital, the need was felt to create a standard list of optimally
required medicines likely to be acceptable to the practitioners all over the country, who
would be able to prescribe the enlisted medicines in a judicious way.
The Department of Indian Systems of Medicine & Homoeopathy, took initiative in this
direction and the concerted efforts of various experts of Ayurveda and departmental
technical staff members have resulted in bringing out this document "Essential Ayurveda
Drugs for Dispensaries and Hospitals". It is worthwhile to mention that Essential Ayurvedic
Drugs List is notably different from Essential Drugs List of Allopathic System of Medicine.
The former includes only those medicines which are essentially required in any Ayurvedic
dispensary or hospital whereas the latter one is the list of essential drugs for the treatment
of various clinical states of the patients.
The bid to formulate Essential Ayurveda Drugs List got through with great deal of
interaction with various eminent Ayurvedic Physicians in Government and private sectors in
different parts of the country. Due care was undertaken to include experts from all fronts of
Ayurveda, like institutionally & non-institutionally qualified Ayurveda experts, old & new
Ayurvedic doctors, dispensary and hospital doctors, college and pharmacy attached
doctors, graduates and postgraduates. The response from these experts was compiled,
analysed and put in a systematic format. Then a core group comprising technical officers of
55

the department and a renowned Ayurvedic expert as a private sector representative
discussed in details for final selection of essential drugs for Ayurvedic dispensaries and
hospitals, on the basis of availability, reliability, cost-efficacy and therapeutic efficacy of the
medicines. Due scrutiny was done for short-listing. Ample care was taken to cover
maximum disease conditions treatable with Ayurvedic medicines. Classical Ayurvedic texts,
formulary of Ayurvedic drugs published by Govt. of India and personal experience of the
Vaidyas were considered for finalising the list.

The present publication aims at providing ready reference for selection or procurement of
Ayurvedic drugs for dispensaries and hospitals of various levels. Its utility is much higher
for the learners and practitioners of Ayurveda as it will provide a window to peep into the
wide range of Ayurvedic medicines required for setting up their professional
establishments. The single drug preparations in the end of the list are incorporated to fill
the gaps left in the original list for different kinds of uses of simple remedies in a cost
effective manner.

56


A- List of essential Drugs for various ailments.
Sl. NO Name of the Drug Dose
(1) JWARA (FEVER)
1:1 Navajwara (Acute fever)
1. Tribhuvan Kiriti Ras 125 to 250 mg.
2. Sanjivani Vati 125 to 250 mg.
3. Godanti Mishrana 125 to 250 mg.
1:2 Visamajwara (Malarial fever)
4. Ayush 64 500 mg. To 1 gm.
5. Saptaparna ghana Vati 250mg. To 500 mg.
6. Sudarshana Churna 3 to 6 gm.
1:3 Vat shaishmak Jwar (Viral Fever)
7. Laksmi Vilas Ras 125 to 250 mg.
8. Samsamani Vati 500mg. to 1 gm.
1:4 Jirna jwara (Chronic fever)
9. Pratap Lankeshvar Ras 125 to 250 mg.
10. Mahasudarsana Churna 3 to 6 gm.
11. Amritarishta 20 to 30 ml.
1:5 Sannipatika jwara (Typhoid fever)
12. Nardiya luxmi Vilas Ras 250 to 500 mg.
13. Bhunimbadi Kwath 10 to 20 ml.
(2) DISORDERS OF RESPIRATORY SYSTEM
2:1 Kas (Cough)
14. Gojihvadi Kvath 20 to 40 ml.
15. Sitopaladi Churna 5 to 10 gm.
57

16. Kantakaryavaleha 5 to 10 ml.
2:2 Kapha nissarana (Expectorant)
17. Tankana Bhasma 500 mg. to 1 gm.
18. Talisadi Churna 3 to 5 gm.
19. Vasavaleha 5 to 10 gm.
2:3 Svasanika Soth (Bronchitis)
20. Laghu malini Vasanta 125 to 250 mg.
21. Lavangadi Churna 3 to 5 gm.
22. Chounsath prahari pipal 500 mg. to 2gm.
2:4 Rajyakshma (Tuberculosis)
23. Raj Mrigank Rasa 125 to 250 mg.
24. Svarna Basant Malati Ras 125 to 250 mg.
25. Abhrak Bhasma Shatputi 0.75 to 125 mg.
26. Mukta Panchamrit 125 to 250 mg.
27. Shilajatwadi louha 250 to 500 mg.
2:5 Pratisyaya (Common cold)
28. Hinguleshwar Rasa 125 to 250 mg.
29. Panchakola Churna 2 to 5 gm.
2:6 Peenas (Sinusitis)
30. Shadbindu Tel 2 to 5 drops in nose
31. Dashmula Rasayanam 5 to 15 gm.
2:7 Tundikeri sotha (Tonsilitis)
32. Ksara Madhu Throat paint Local application
33. Khadiradi Vati Chewable
34. Vyoshadi Vati 2 to 4 tab.
2:8 Shvasa (Asthma)
58

35. Dhanvantar Gutika 1 to 2 pills
36. Pushkarmula Churna 5 to 15 gm.
37. Shringyadi Churna 5 to 15 gm.
38. Kanakasava 10 to 30 ml.
39. Vasarishta 10 to 30 ml.
(3) DISORDERS OF CARDIO-VASCULA RSYSTEM
3:1 Hrid-Daurabalya (Cardiac weakness)
40. Nagarjunabhra Rasa 250 to 500 mg.
41. Muktapisti 125 to 250 mg.
42. Jwahar Mohra 125 to 250 mg.
43. Arjunarishta 10 to 30 ml.
3:2 Rakta Chap (Hypertension)
44. Yogendra Rasa 50 to 125 mg.
45. Sarpagandha Mishran 2-4 Pills
3:3 Raktabhar Alpta (Hypotension)
46. Makaradhvaja gutika 50 to 125 mg.
47. Kasturi bhairav Ras 50 to 125 mg.
3:4 Hritshoola (Angina)
48. Sringa Bhasma 125 to 250 mg.
49. Mahavat Raj Ras 75 to 125 mg.
(4) BLOOD DISORDERS
4:1 Pandu (Anemia )
50. Punarnavadi Mandura to 1 gm.
51. Lohasava 10 to 30 ml.
4:2 Raktpitta/Raktsrav (Haemorrhagic Tendency and Bleeding Disorders)
52. Trin Kantmani Pisti 250 to 500 mg.
59

53. Lakshadi Churna 5 to 10 gm.
54. Usheerasava 15 to 30 ml.
4.3 Rakta Dushti (Blood impurity)
55. Nimbadi Kvatha 20 TO 40 ml.
56. Panchanimba Churna 5 to 10 gm.
57. Manjisthadi Churna 5 to 15 gm.
58. Sarivadyasava 15 to 30 ml.
59. Khadirarishta 15 to 30 ml.
(5) DISORDERS OF DIGESTIVE SYSTEM
5.1 Atisara (Diarrhoea)
60. Karpoora Rasa 50 to 125 mg
61. Jatiphaladya Churna 5 to 10 gm.
62. Karpoorasava 10 to 20 drops
63. Babbularishta 15 to 30 ml.
5:2 Pravahika (Dysentery)
64. Panchamrit Parpati 250 to 500 mg.
65. Bilwadi Churna 5 to 10 gm.
66. Bilwadi Kwath 20 to 40 ml.
67. Kutajarishta 15 to 30 ml.
5:3 Amlapitta (Hyperacidity)
68. Kamdudha Ras 125 to 250 mg.
69. Dhatri Rasayana 5 to 15 gm.
70. Madhuyastyadi Churna 5 to 10 gm.
71. Avipattikara Churna 5 to 10 gm.
5:4 Samgrahani (Colitis/Ulcerative Colitis)
72. Samkhodar Ras 75 to 150 mg.
60

73. Sutsekhar Ras 125 to 250 mg.
74. Bilwadi Avaleha 5 to 10 gm.
75. Mocharas Churna 3 to 5 gm.
5:5 Yakrit roga (Liver disorders)
76. Arogya Vardhini 500 mg. To 1 gm.
77. Navayas Louha 250 to 500 mg.
78. Phalatrikadi kwatha 15 to 30 ml.
79. Sarbat phalasa 30 to 50 ml.
80. Daruharidra phala churna 5 to 10 gm.
81. Rohitakarishta 15 to 30 ml.
5:6 Shoola (Abdominal colic)
82. Shankha bhasma 250 to 500 mg.
83. Shankha Vati 2 to 4 tab.
84. Lasunadi Vati 2 to 4 tab.
85. Hingu vachadi Churna 3 gm. to 5 gm.
86. Narikel lavana 250 to 500 mg.
5:7 Adhman (Flatulence)
87. Kankayan Vati 500 mg. to 1 gm.
88. Hingvastaka Churna 5 to 10 gm.
89. Ark Ajmod 5 to 15 ml.
90. Lavana Bhaskar Churna 5 to 10 gm.
5:8 Chhardi (Vomiting)
91. Mayur pichha bhasma 50 to 125 mg.
92. Bilvadi leham 1 to 3 gm. 2 hrly
93. Eladi Churna 2 to 5 gm.
5:9 Ajirna (Indigestion)
61

94. Yavani Sandhav Churna 5 to 10 gm.
95. Shivakshara pachana churna 3 to 5 gm.
96. Chitrakadi Vati 2 to 4 tab.
5:10 Agnimandya (Anorexia)
97. Agnitundi Vati 250 to 500 mg.
98. Vaishvanara Churna 3 to 5 gm.
99. Panchakola Churna 3 to 5 gm.
5:11 Vibandh (Constipation)
100. Ichhabhedi Ras 125 to 250 mg.
101. Panchasakara Churna 5 to 10 gm.
102. Svadista Virechana Churna 5 to 10 gm.
103. Abhayarishta 15 to 30 ml.
104. Isabgol Husk 10 to 20 gm.
105. Haritaki Churna 10 to 15 gm.
5:12 Arsha-Bhagander (Piles and Fistula-in-ano)
106. Shigru guggul 500 mg. to 1 gm..
107. Bol baddha ras 125 to 250 gm.
108. Pranada Vati 2 to 4 tab.
109. Rasanjana Vati to 1 gm.
110. Kasisadi tel 2 to 5 ml.
111. Jaya Vati 250 to 500 mg.
112. Kshar Sutra & Kshar Varti Q.S. for Kriya
5:13 Krimi Rog (Helminthiasis)
113. Vidangadi louha to 1 gm.
114. Palash beej churna 3 to 6 gm.
115. Kampillaka yog 2 to 4 gm.
62

(6) DISEASES OF CENTRAL NERVOUS SYSTEM
6:1 Medhya (Brain Tonics for concentration, memory, sleep disturbances)
116. Brahmi Vati 2 to 4 tab.
117. Tagaradi Churna 3 to 5 gm.
118. Brahmi Rasayana 5 to 10 gm.
119. Saraswatarishta 15 to 30 ml.
120. Brahami Ghrita 5 to 10 gm.
6:2 Nadi Dourbalya (Nervine Weakness)
121. Krishna Chaturmukh Ras 125 to 250 mg.
122. Dhanvantara tel Q.S. for body Application
123. Mahanarayana tel Q.S. for body Application
124. Eranda pak 5 to 15 gm.
125. Balarishta 10 to 30 ml.
6:3 Kampavat ( Parkinsonism)
126. Chaturbhuj Ras 125 to 250 mg.
127. Kaunch Churna 2 to 5 gm.
6:4 Sirasula (Migrain)
128. Sirah shooladi Vajra Ras 250 mg. to 1 gm.
129. Chandrakant Ras 125 to 250 mg.
130. Godanti praval yog 500 mg. to 1 gm.
131. Pathyadi kwath 10 to 20 ml.
6.5 Pakshaghat (Hemiplegia)
132. Yogendra Ras 125 mg
133. Ksheer Bala Tail 5-10ml Internal/external
134. Ksheer Bala Tail (Aavarti) Nasal- 5-10 drops
(7) PHYCHIATRIC PROBLEMS
63

7:1 Anidra (Insomnia)
135. Nidrodaya Ras 125 to 500 mg.
136. Jatamansi kwath 10 to 20 ml
137. Madananand Modak 5 to 15 gm.
138. Aswagandha Churna 5 to 10 gm.
139. Him sagar Tel Q.S. for Head
7:2 Akshepa (Convulsive Disorders)
140. Svarna bhasma 15 to 30 mg.
141. Panchagavya ghrita 5 to 15 ml.
142. Aptantrakari Vati 125 to 250 mg.
7:3 Unmad (Psychosis)
143. Unmad gajkesari Ras 125 to 250 mg.
144. Maha paishachik ghrita 5 to 15 gm.
145. Maha chaitasa ghrita 5 to 15 gm.
146. Manas mitra vatak 125 to 250 mg.
7:4 Vishad (Depression)
147. Jyotismati Tel 10-20 drops
148. Smriti Sagar Ras 125-250 mg
149. Vacha Churna (shudh) 75-125 mg
(8) JOINT DISORDERS
8:1 Amavata (Rheumatic/Rheumatoid Arthritis)
150. Amavatari Ras 125 to 250 mg.
151. Trayodashang guggulu to 1 gm.
152. Kottamchukadi Tel Q.S. for application on body
8:2 Vat Rakta (Gout)
153. Kaishore guggulu to 1 gm.
64

154. Maharasnadi kwath 5 to 15 ml.
155. Pinda Tel Q.S. for application on body
8:3 Sandhi Vat (Osteoarthritis)
156. Simhnad guggulu to 1 gm.
157. Yograj guggulu to 1 gm.
158. Panchaguna Tel Q.S. for application on joints
8:4 Sandhigat Vat (Arthralgia)
159. Vatari guggulu to 1 gm.
160. Sameergaj keshari Ras 125 to 250 mg.
161. Maha vishgarbh Tel Q.S. for topical use
(9) DISEASES OF URINARY SYSTEM
9:1 Alpa Mutrajanana (Oliguria/Anuria)
162. Punarnavastaka kwath 20 to 40 ml.
163. Panavirladi bhasma 5 to 20 gm.
164. Punarnavasava
9:2 Ashmari (Urolithiasis)
165. Pasan Bhedadi Kwath 20 to 40 ml.
166. Hajaral yahood bhasma 250 to 500 mg.
167. Kulathadi ghrita 10 to 20 ml.
9:3 Mutrastheela (prostatic hypertrophy)
168. Varunadi guggulu to 1 gm.
169. Shilajtwadi Vati to 1 gm.
170. Punarnavadi Guggulu to 1 gm.
9:4 Mutravishmayata (Uraemia)
171. Sarbato Bhadra Ras 50 to 250 mg.
172. Veeratarvadi kwath 20 to 40 ml.
65

173. Trina panchmula kwath 20 to 40 ml.
174. Kanmad bhasma 500 mg. to 1.5 gm.
175. Vastyamayantaka ghrita 5 to 15 gm.
9:5 Mutra krichra (Dysurea)
176. Svarna Bang 125 to 250 mg.
177. Chandrakala Ras 250 to 500 mg.
178. Traikantakadi kwath 20 to 40 ml.
(10) DERMATOLOGICAL DISORDERS
10:1 Twak Roga (Skin Disorder),Kushtha (Dermatoses)
179. Ras Manikya 125 to 150 mg.
180. Gandhaka Rasayana 250 mg. to 500 mg.
181. Eladi Tel Q.S. for topical use
182. Kustha Rakshasa Tel Q.S. for topical use
10:2 Twak-Karshnya (Hyperpigmentation)
183. Kumkumadi Tel Q.S. for topical use
184. Dashanga Lepa Q.S. for topical use
10:3 Kandu (Pruritus)
185. Haridra Khand 5 to 15 gm.
186. Bilwadi gutika 1 to 2 pills for topical use
187. Nalpamaradi Tel Q.S. for topical use
188. Maha Marichyadi Tel Q.S. for topical use
10:4 Twak Vaivarnya (Skin Discolouration)
189. Chalmongra Tel Q.S. for topical use
190. Sidhmahara Lepa Q.S. for topical use
191. Markava Rasayanan 10 to 20 gm.
10:5 Keshya (Hair Tonic for Poor Hair Growth)
66

192. Bhringaraja Tel Q.S. for head & hair
10:6 Khalitya (Premature Hair fall)
193. Dhasturpatra Ker Tel Q.S. for head & hair
194. Durvadi Ker Tel Q.S. for head & hair
195. Kayyonyadi Ker Tal Q.S. for head & hair
10:7 Palitya (Premature greying of hair)
196. Neeli Bhringyadi Ker Tel Q.S. for head & hair
197. Kuntal Kanti Tel Q.S. for head & hair
10:8 Svitra (Vitiligo)
198. Kakodumbarikadi Kwath 10 to 40 ml.
199. Markava Rasayana 5 to 15 gm.
200. Avalgujadi Lepa Q.S. for topical use
201. Gomutrarishta 10 to 20 ml.
(11) FEMALE DISEASES
11:1 Asrigdara Menorrhagia-Metrorrhagia)
202. Pradarantak Ras 250 to 500 mg.
203. Patrangasav 10 to 30 ml.
204. Lodhrasava 10 to 30 ml.
205. Ashokarishta 10 to 30 ml.
11:2 Svet Pradara (Leucorrhoea)
206. Kukkutand Twak Bhasma 1 to 3 gm.
207. Pusyanug Churna 5 to 10 gm.
208. Supari Pak 5 to 15 gm.
209. Satavari gud 5 to 15 gm.
210. Panchavalkala kwath 10 to 30 for douche
11:3 Rajah Krichra (Dysmenorrhoea)
67

211. Rajah Pravartini Vati 250 to 500 mg.
212. Kumarika Vati 250 to 500 mg.
213. Kumaryasava 10 to 30 ml.
11:4 Yoni Vyapat (Vaginal Disorders)
214. Subhakari Vati to 1 gm.
215. Somanath Ras 125 to 250 mg.
216. Soubhagya Vardhana Tel 5 to 10 drops for Tampon
11:5 Rajah Purva Tanav (Premenstrual Tension)
217. Yavakshara Yog 500 mg. To 1.5 gm.
218. Saptasaram Kasayam 10 to 20 ml.
11:6 Garbhapat (Habitual Abortion)
219. Garbhapal Ras 250 to 500 mg.
220. Garbh Raksini Gutika 2 to 4 tab.
11:7 Raktla Yoni (Dynfunctional Uterire Bleeding D.U.B.)
221. Kaharuva Pisti 250 to 500 mg.
222. Ashok Ghrita 5 to 15 gm.
223. Lakshmana Louha 500 mg. To 1 gm.
11:8 Stanya alpata (Hypo lactation)
224. Stanya janana kashaya 10 to 20 ml.
225. Shatavaryadi Churna 5 to 10 gm.
11:9 Sutika Roga (Postpartal Disorders)
226. Soubhagya Sunthi 5 TO 10 gm.
227. Dashmularishta 15 TO 30 ml.
11:10 Bandhyatva (Primary Sterlity)
228. Phala Kalyan Ghrita 5 to 15 gm.
229. Palash puspasava 15 to 30 ml.
68

230. Lakshmanarishta 15to 30 ml.
11:11 Stri Beej Pranali Dushti (Hypo-ovarianism/Poor ovarian funcion)
231. Puspa Dhanva Ras 250 to 500 mg.
11:12 Beej Kosh Puti (Ovarian Cyst)
232. Siggru Gugglu to 1 gm.
233. Sobhanjanarishta 10 to 30 ml.
234. Punarnava Mandur 250 to 500 mg.
(12) VAJEEKARANA (SEXUAL WEAKNESS/LOSS OF LIBIDO)
235. Manmath Rasa 125 to 250 mg.
236. Akarkarbhadi Gutika 1 to 2 tab
237. Asvagandhadi Leha 5 to 15 gm.
238. Sukrastambhana Rasayana 5 to 15 gm.
239. Srigopal Tel For topical use
240. Kamini Vidravana Ras 250 to 500 mg.
(13) RASAYANA (GERENTOLOGICAL CONDITIONS)
241. Brahm Rasayana 5 to 15 gm.
242. Chyavan Prasha Avaleha 5 to 15 gm.
243. Brinhani Gutika 1 to 2 tab.
(14) VRANA ROPANA (WOUND HEALING)
244. Jatyadi Tel For topical use
245. Marma Gutika 250 to 500 mg.
246. Triphala Guggulu 250 to 500 mg.
247. Lakshadi Guggulu 250 to 500 mg.
248. Yashad Malhar Q.S. For topical use
249. Manjishtadi Tel Q.S. For topical use
(15) DISEASES OF EYE AND ENT
69

15:1 Netra Roga (Opthalmic Disorders)
250. Saptamrit Louha 2 to 4 tab.
251. Maha triphala Ghrita 5 to 15 gm.
252. Chandrodaya Varti Q.S. For topical use
253. Elaneer kuzhampu 2 to 5 drops topical use
254. Shatpatryark (Gulab Arka) 2 to 5 drops topical use
15:2 Nasa Roga (Nasal Diseases)
255. Anu tel 2 to 5 drops as nassal drop
256. Nasika Churna to 1 gm. topical use
257. Chitrak haritaki 5 to 15 gm.
258. Katphal Churna to 1 gm. topical use
15:4 Galganda (Goitre)
259. Kanchanara Guggulu 500 mg. To 1 gm.
15:5 Mukh Rog (Oral Disorders)
260. Pitaka Churna Q.S. for gargle
261. Sudh Soubhagya Q.S. for paint
262. Irimedadi Tel Q.S. for paint
263. Brihatyadi Kwath Q.S. for gargle
15:6 Dant Roga (Dental Problems)
264. Dasana Samskar Churna Q.S. for local rubbing in tooth &
gum
(16) PRAJANAN SAMSTHAN DUSTHTI (REPRODUCTORY PROBLEMS)
16:1 Purush Prajanan Akshamta (Male sterility)
265. Jund Vadastar Vati 2 to 3 pill
266. Puspadhanva Ras 125 to 250 mg.
16:2 Stri Prajanan Akshamta (Female sterility)
70

267. Jiyapota Churna 5 to 15 gm.
268. Sivalingi Beej 3 seed daily for 28 days
16:3 Parivar Niyojana (Contraception)
269. Pipplyadi Yog 2 to 4 gm.
270. Neem Tel 2 to 5 ml.
(17) DAURBALYA (General weakness/Asthenia/Loss of strength)
271. Drakshasava 5 to 30 ml.
272. Sudh Shilajit 250 to 500 mg.
273. Phalasava 10 to 30 ml.
274. Tapyadi Louha 250 to 500 mg.
(18) METABOLIC DISORDERS)
18:1 Madhumeha (Diabetes mellitus)
275. Trivanga Bhasma 125 to 250 mg.
276. Vasant Kusumakar Ras 125 to 250 mg.
277. Nisha Katakadi Kwath 10 to 30 ml.
278. Nyagrodhadi Churna 5 to 15 gm.
279. Jambavadyarishta 10 to 30 ml.
280. Ayaskriti 10 to 30 ml.
18:2 Visama Meda (Dyslipidaemia)
281. Medohara Churna 5 to 15 gm.
282. Medohar Vidangadi Louha 1 to 2 gm.
18:3 Sthaulya (Obesity)
283. Navak Guggulu 2 to 4 tab.
284. Triphala Churna 5 to 15 gm.
18:4 Shotha (Oedema/inflammation)
285. Rasna-erandadi Kwath 10 to 20 ml.
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286. Shigru Varun Kwath 10 to 20 ml.
287. Gomutrarka 5 to 10 ml.
288. Kansa Haritaki 5 to 10 gm.
289. Shoth Kalanal Ras 125 to 250 mg.
290. Grihdhoomadi Lepa For topical use as poste
291. Kokilakshak kashaya 10 to 20 ml.
18:5 Sleepada (Filariasis)
292. Nityanand Ras 250 to 500 mg.
293. Shakhotak Kwath 20 To 40 ml.
294. Sapta parna ghan Vati 500 mg. to 1gm.
18:6 Krimi-upsarg (Infective/Septic conditions)
295. Rasanjana Vati to 1 gm.
296. Shudh Gandhak 250 to 500 mg.
297. Nimbadi Tel For topical use
298. Nimbadi Vati 500 mg. to 1 gm.
299. Jaya Vati 250 to 500 mg.

(19) BAL-ROG (PAEDIATRIC PROBLEMS)
300. Dantodbheda gadantaka Ras 125 to 250 mg.
301. Balark Ras 62.5 to 125 mg.
302. Kumar Kalyan Ras 62.5 to 125 mg.
303. Bal Chaturbhadra Churna 250 mg. 1 gm.
304. Ras Pipari 250 mg. 500 gm.
305. Gopi Chandanadi Gutika 250 to 500 mg.
306. Tambula Leha 2 to 5 gm.
307. Sankhpuspi Tel For head
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308. Arvindasava 5 to 15 ml.
309. Kamal beej gatta churna 1 to 3 gm.
310. Sudha vacha 125 to 250 mg.
311. Jatiphal Churna to gm.
312. Lakshadi Tel For massage
313. Blal Rasayana 1 to 3 gm.
314. Ayush Ghutti to 1 gm.
315. Ark Pudina 3 to 5 ml.
316. Ark Ajwayan 1-2 ml
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(B) MULTI PURPOSE-BHASMA


S.No. Name Eng.Name Properties
1. Svarn Makshik Bhasm Copper pyrites Anaemia, urticaria, hyperacidity,
tonic
2. Sphatika Suddh Alum Haemorrhage, cough, fever,
antiseptic
3. Tankan Bhasm Borax Cough, tonsillitis, fever
4. Shankh Bhasm Conche Gastrointestinal disorders
5. Kapardika Bhasm Covries Earache, wound healing,
intestinal colic
6. Mandoor Bhasm Pig iron bhasma Anaemia, jaundice, oedema
7. Lauh Bhasma (30 puti) Iron bhasma Anaemia, general debitity,
pregrancey
8. Mayur puchha bhasm Pea cock feather
bhasma
Hic cough, irritating couth,
vomiting
9. Godanti bhasma Gypsum bhasma Cough, cold, fever bodyoche
10. Sringa bhasma Stag horn
bhasma
Fever, sinusitis, bronchitis,
preumonia
11. Abhrak bhasma Mica (Biotite) Hyperacidity, anaemia,
respiratory disorder


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(C) EMERGENCY AYURVEDIC DRUGS

S.No. Name of the Drugs Uses
1. Karpoor Ras For acute diarrhoea
2. Vedanantak Ras For severe pain of musculo-skeletal or visceral
origin
3. Siddha-makardhwaj For peripheral circulatory failure.
4. Jwaharmohra For palpitation, syncope, cardiac tonic
5. Mutka pisti For acute tachycardia, palpitation, cardiac
problems
6. MaHavatraj ras For neurogenic shock, angina
7. Sameer gajkesari ras Neurological shock, angina, neuro-muscular pains
8. Shvaskaschinlamani ras For severe dyspnoea of pulmonary origin
9. Suvarn sameer pannag ras For acute dyspnoea, arthralgia
10. Mritsanjivani sura For high grade fever, with delirium, shock
11. Dhanwantar gutika For acute respiratory distress
12. Manasmitra vatak For mental disorders, insomnia
13. Marma gutika For pain and inflammation in vital parts
14. Gorochanadi vati For cardio respiratory problems, fever
15. Murivenna oil Local application for traumatic pain and
inflammation etc.


75