Health includes wellness. The WHO definition of Health, 1948 uses the term wellbeing to mean that health is not just the absence of diseases but includes mental and social wellness. The standard textbooks of preventive and social medicine have long acknowledged the importance of spiritual wellbeing as a determinant of health. The concept of ‘social determinants of health’ says that not only the biological or physical environmental factors, but the social environment of an individual or a population is also responsible for disease causation and good health. So, the concept of wellness is not new.
There is a new-found interest in the concept of wellness by Government of India. As though ‘Health’ is not inclusive enough, ‘Wellness’ has been pushed to the forefront as a kind of branding. It is planned to convert all sub centres in the country into ‘Health and Wellness Centres’ (HWC) in the country in a phased manner. If implemented well, it will boost the health care delivery through provision of better skilled manpower and wider package of health services at the grassroots. But inserting the term ‘wellness’ begs for an explanation as there is only one activity which has been promoted to cover this nomenclature change: Yoga. In these HWCs, there should be a wellness room for yoga. Having a wellness room is mandatory. If there is no space in the health centre, it can be arranged in some nearby place. Promoting wellness through yoga is conceptualized as follows:
• Yoga is planned to be mainstreamed into the health care delivery system
• Close coordination with Ministry of AYUSH/Department of AYUSH at the state and district level
• Pool of Local Yoga Instructors at the HWC level to be identified
• Training and certification of local Yoga Teachers to be steered by Department of Ayush
• Weekly/monthly schedule of classes for Community Yoga Training at the HWC
• Provision for additional remuneration to in house yoga teacher or in sourced yoga instructor.
Through conversion of Sub Centres, it is planned to take Yoga to the grassroots level. Each school will have two Health and Wellness ambassadors (school teachers). That is how, all schools will be reached. Is Yoga mandatory? Guideline doesn’t say it is mandatory and guidelines are not binding. States with rich local resources are able to modify guidelines to suit the context, but many states are at the mercy of the central government. For the government, Wellness = Yoga and there is no alternative offered. Arm-twisting by the funding source is not uncommon in any program implementation and promotion of wellness is planned around Yoga.
Pushing a controversial activity which is not acceptable by entire populations is hardly the best plan to promote wellness. Promotion of wellness in a multi-cultural multi-religious nation should be open ended so that states may plan how best they can deliver services to the people. Hence, the State government also has an important role to take a stand and protect the interest of the people and plan the best way to deliver services which is appropriate to the context.
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