Protocol-Assessment about Knowledge of Panchakarma in Asha Workers and their Sensitization with Panchakarma Module in Wardha Taluka

Background: A village level community health worker " Accredited Social Health Activist " (ASHA)’acts as a bridge between community & health care facilities. The ASHA workers act as catalysts in promoting various programmes of the foundation and encourage people to avail the available benefits. Aim and objectives: To study the assessment about Knowledge of Panchakarma in ASHA Workers & Sensitization to them with Panchakarma module in Wardha taluka Objectives are 1.To design Panchakarma questionnaire module and then to assess the existing knowledge and awareness in ASHA Workers of Wardha Taluka. 2.To sensitize ASHA Workers about Panchakarma procedures with the help of demonstration videos and lectures ,then post test and compare pre & post assessment score about Knowledge and awareness about Panchakarma. Study Protocol Chaple and Sawarkar; JPRI, 33(30B): 1-6, 2021; Article no.JPRI.68577 2 Methodology: The study will be Interventional study. Permission will be taken from the institutional ethical committee. Data will be collected in Wardha taluka by Pre and Post test interview of ASHA. All the subjects will be personally interviewed on the basis of questionnaire .Questionnaires administered by an interviewer are used to survey socio demographic factors, Knowledge, awareness and attitudes regarding Ayurveda (AYUSH Programme) . Before taking the Pre test the verbal consent of the subject will be taken. Results: ASHA will be as a facilitator for promoting awareness in the community about Panchakarma. Conclusion: Conclusion will be on the basis of observation and analyzed data.


Background
At present, the Government of India is providing comprehensive integrated healt hcare to the rural population under the umbrella of National Rural Health Mission (NRHM).
Village level community health worker serves as a bridge between "recognized social health worker" (ASHA) community and health care facilities.
ASHA works as a catalyst to promote various programs of the Workers Foundation and encourages people to reap the benefits available. This is currently a growing phase and further harmonization is required with the participation of ASHA workers [1,2]. Panchakarma (Pentabiopurificatory and Karma-procedures or therapies) mentioned in Ayurveda is act as therapeutic and preventive therapy that involve a five procedures i.e. Vamana karma (Therapeutic Emesis), Virechanakarma (Therapeutic Purgation), Basti karma (Therapeutic Enema), Nasya karma (Nasal Medication) and Raktamokshana (Blood Letting) for internal purification. It restores and maintains good health, strengthens the immune system, protects the body from diseases by removing toxins and rejuvenating the internal systems of the body. By adopting Bio purification therapy the doshas get eliminated from its root, if once eliminated from the physique it won't reoccur, that is known as Apunarbhava chikitsa (radical treatment) [3,4].
ASHA is the important component of health care system which acts as a bridge between society & health care facilities [5]. The aim of this study is to assess the Knowledge about Panchkarma among ASHA Workers in Wardha taluka. The training modules of ASHA include general introduction and advantages of Panchakarma which is considered to be effective in preventing the onset and management of common ailments for diseases.
So, we can first trained to ASHA Workers, We will be giving the training lectures for awareness and knowledge about Panchakarma . Therefore present study will conduct to access the knowledge about Panchakarma in ASHA workers based on specific designed Panchakarama module

Aim
Assessment about Knowledge of Panchakarma in ASHA Workers & Sensitization to them with Panchakarma module in Wardha taluka.

Secondary Objectives
1) To enhance the knowledge of Ayurveda amongst the masses 2) To recognize the contribution and involvement of Ayurveda i.e. treatment modalities in healthcare services.

Place of Work
Wardha Taluka.

Study Type
Interventional study.

Methodology
Data will be collected in Wardha taluka by Pre and Post test Interview or questionnaire .All the subjects will be personally interviewed on the basis of questionnaire .Questionnaires administered by an interviewer will be used to survey socio demographic factors, Knowledge, awareness and attitudes regarding Panchakarma. For sensitization workshop, the tools will be used demonstrations videos and lectures will be arranged to impart the knowledge and increase awareness regarding Panchakarma. Before recruitment, the verbal consent & Pre test regarding Knowledge of Panchakarma of the subject will be taken followed by the Panchakarma awareness special training programme in the form of lectures for the sensitization purpose for consecutive 7 days. Following topic should be covered in the sensitization programme .
 Introduction of Panchakarma Therapy  Advantages of Panchakarma Therapy After successful completion of the these training programme i.e. after 7 days, post test of each recruited ASHA Workers will be completed.
Total Duration of Study 6 month.

Inclusion Criteria
All ASHA in two villages of Wardha Taluka.

Exclusion Criteria
ASHA those will not ready for study.

Assessment Criteria
Pre & Post test questioner based .

RESULTS
For promoting knowledge about Panchakarma to ASHA workers.By taking Pre and Post test analysis the result will be calculated and know the how many ASHA will be sensitized and also Whether sensitization brings about designed impact in ASHA workers.The result will be analysed statistically on the basis of study. Lastly ALG( Average Learning Gain) will be calculated.

DISCUSSION
Considering the current scenario, less awareness of Panchakarma in rural population that may be related to lack of specific training and Panchakarma services to ASHA workers. it is highly imperative to adopt these Panchkarma procedures not only for management of diseases but also for improving immunity i.e. for prevention of the disease. Many people especially in Rural population are unaware about its importance & utility. In addition to these, there are many misconceptions regarding its utility as well as Do's & Don't pre & post procedures. It results into the poor compliance rate of patient for accepting such therapies & ultimately they may get deprived of their miraculous benefits. In spite of all above things, there are certain hurdles which may restricts the wide utility of these procedures. Unawareness about the utility& precautions regarding panchakarma procedures in health care providers as well as society is the important aspect among them. This concept can percolate to the community easily through ASHA Workers and large numbers of people can be benefited with Panchakarma. In this context the grass root workers like ASHA who mobilize the community and facilitate them in health and health related services may be effectively utilized for creating awareness of Panchakarma .After the sensitization about Panchakarma ,the ASHA will give the referral to the patient at Health and wellness centre and Mahatma Gandhi Ayurved College Hospital & Research Centre Salod [H.], Wardha for further procedures according to its disease condition. This module will help ASHA to guide people who desire to undergo treatment as per their preference for a particular way of life through Ayurved Panchakarma. She will guide the community to simple technique of Panchakarma like snehan and swedan procedure at home . All above guidelines about Panchakarma ASHA can easily guide the community in simple manner. These measures are recommended for boost an individual's immunity against infections. Hence this Panchakarama module is helpful to ASHA workers for giving health facility to community.
Moreover, on extensive review of literature, it is observed that there is no any literary or clinical study has been carried out to rectify this issue. So there is unavailability of such published evidences to pursue above said aim & objective. However, it is highly needed to generate literary evidences in order to enhance the wide acceptance of these therapies. Therefore, a novel attempt has been made through this study in order to make awareness regarding the knowledge of Panchakarma in ASHA workers based on specific designed Panchakarma module.

Role of Asha Workers in Community
1. ASHA workers are selected by community, out of residents within the community. They are working on voluntary basis, although compensation would be provided to them for specific activities and services.
2. Most villages have health and sanitation committee. The committee members including ASHA have responsibility to make and implement village health plans. While formulating the plan they can facilitate inclusion of AYUSH initiative in the Village Health Scheme. In addition they can bring people together, persuading them to use AYUSH remedies for diabetes as they are available in the kitchen and near their homes. Uses of house hold remedies for many ailments including diabetes which can be easily managed by AYUSH systems at house hold level may be encouraged by them.
3. AYUSH systems have holistic approach to solve the health related problems and promote healthy & prolonged life. ASHA/ Health workers may aware people to prevent and manage Diabetes with simple remedies. 4. Once ASHA understands the strength of the AYUSH system, she can create awareness in the community to refer them to AYUSH doctors/medicines available in rural areas. 5. ASHA and field level health workers will provide Primary Health Care for minor ailments like diarrhea, constipation, worm infestation, abdominal discomfort with locally available medicinal plants and products. They should be able to provide little advice on Do's and Don'ts for prevention and management of common ailments. She should also able to recognize when to refer the patient to the doctor. 6. In every village, the Health & Nutrition Day is being organized by ASHA on a particular day. The AYUSH common remedies may be distributed for diabetes mellitus. These drugs can be procured from PHC/CHC where AYUSH medicines are available along with AYUSH medical supervision officer.
7. They will encourage and guide the community for plantation of medicinal plants in their surroundings and use of home remedies available in their homes [5]. Many studies on Community health issues [6][7][8] and need of trained community healthcare cadre [9][10][11] were reported.
The aim of this study is to assess the Knowledge about Panchkarma among ASHA Workers in Wardha taluka. The training modules of ASHA include general introduction and advantages of Panchakarma which is considered to be effective in preventing the onset and management of common ailments for diseases .
So, we can first trained to ASHA Workers , We will be giving the training lectures for awareness and knowledge about Panchakarma . Therefore present study will conduct to access the knowledge about Panchakarma in ASHA workers based on specific designed Panchakarama module.

STRENGTH AND LIMITATION
The main motto of the project is to create awareness in the society about Panchakarma. Therefore, training in awareness of Panchakarma services that follow healthy life path described in Ayurveda. This knowledge is being imparted along with conducting individual training programmes for local people through ASHA workers.

CONCLUSION
Conclusion will be drawn by suitable analyzed data.

SCOPE AND IMPLICATIONS
The main motto of this project is "Complete health to the door steps of Indian villages". ASHA will be as a facilitator for promoting awareness in the community about Panchakarma.
In Ayushman Bharat, Government of India's Programme, a more emphasis given on Ayush component and formation of health and wellness centers