An Assessment of a Public Health Initiative of Homeopathy for Primary TeethingFunding The pilot programme is funded by the Central Council for Research in Homoeopathy, an autonomous body of the Ministry of AYUSH, Government of India.
07. Juni 2018
30. August 2018
20. November 2018 (online)
Background During primary teething, children suffer from running nose, mild fever, diarrhoea and other mild irritations and inflammations. A public health programme, ‘Homoeopathy for the Healthy Child’, was undertaken on a pilot basis focusing on promotion of healthy teething by provision of home-based care through six pre-identified homeopathic medicines for complaints commonly observed during primary teething. This article assesses the feasibility of this programme and reports the impact of this initiative on teething profile in children and episodes of diarrhoea and upper respiratory tract infection (URTI).
Materials and Methods Accredited Social Health Activists (ASHAs) were trained in child care and usage of a kit comprising six medicines, namely Calcarea phosphoricum 6X (CP), Ferrum phosphoricum 3X, Magnesium phosphoricum 6X, Belladonna 30C, Chamomilla 30C and Podophyllum 30C. Calcarea phosphoricum was given regularly to each participating child from 6 months to 1 year of age. Home-based care for diarrhoea, URTI and mild fever was provided by ASHAs using the other five medicines in the kit. Dentition pattern and diarrhoea/URTI episodes were recorded over a period of the next 12 months.
Results Eleven thousand four-hundred and twenty-six children were followed up regularly. Amongst those who enrolled at 6-7 months, a larger proportion of children were approaching expected teething in successive months as compared with children enrolled at 12 months, thus indicating that teething delays, if any, were overcome during this period. Incidence of diarrhoea and URTI showed decrease in the months after enrolment. Children responded favourably to the medicines given by ASHAs at the time of diarrhoea/URTI episodes, and ASHAs expressed satisfaction with the programme.
Conclusion An approach with regular use of CP and home-based care with homeopathy through health workers for common problems in teething children is acceptable to the community and enhances outreach of services to the public at large. Observations in terms of the healthy teething period may be further validated through studies of homeopathy with suitable comparator group.
KeywordsAccredited Social Health Activist - Calcarea phosphoricum - children - dentition - diarrhoea - public health - upper respiratory tract infections
• In a public health programme, Accredited Social Health Activists (ASHAs) were trained in child care and usage of a kit comprising six medicines, namely Calcarea phosphoricum 6X (CP), Ferrum phosphoricum 3X, Magnesium phosphoricum 6X, Belladonna 30C, Chamomilla 30C and Podophyllum 30C.
• Dentition pattern in 11,426 children who were given CP regularly in the age group of 6 months to 12 months was found approaching the expected teething in the successive months, indicating that teething lags (delays), if any, were overcome during this period.
• Children responded favourably to the medicines given by the health workers at the time of diarrhoea/upper respiratory tract infection (URTI) episodes, and diarrhoea and URTI incidence showed decrease in the months after enrolment.
• Such a programme based on provision of home-based care with a limited number of homeopathic medicines is feasible and acceptable to the community at large.
RKM is the principal investigator who, along with AK, designed the programme and monitored it at all centres. He was responsible for manpower and resource management, including funding for the project, and ensured regulatory and administrative approvals. AK designed the resource material (ASHA manual, medicine kit) and study formats along with DT and coordinated the meetings and reviews at all centres. AV, SS, AKG, RM, RB, ARS and UKP were nodal officers of assigned blocks, who coordinated with local NHM officials, conducted ASHA trainings, reviews and compiled data from ASHAs within the block. ShwS, MS, RP, US, AKU, ShrS, SP and TN assisted nodal officers in their assigned blocks in review, feedback and data compilation from ASHAs. Data compilation from all centres was done by ShwS and MS. Data management and data analysis were done by DT and AK. RKM, DT and AK drafted the manuscript. All authors read and approved the final manuscript.
- 1 Sood M, Sood S. Problems with teething in children. Pediatr Oncall 2010; 7: 20 Available at: https://www.pediatriconcall.com/pediatric-journal/view/fulltext-articles/297/J/0/0/374/0 Accessed January 10, 2018 [serial online]
- 2 Memarpour M, Soltanimehr E, Eskandarian T. Signs and symptoms associated with primary tooth eruption: a clinical trial of nonpharmacological remedies. BMC Oral Health 2015; 15: 88
- 3 Ramos-Jorge J, Pordeus IA, Ramos-Jorge ML, Paiva SM. Prospective longitudinal study of signs and symptoms associated with primary tooth eruption. Pediatrics 2011; 128: 471-476
- 4 Editorial: Teething myths. BMJ 1975; 4 (5997): 604
- 5 Gibbons HL, Hebdon CK. Teething as a cause of death. A historical review. West J Med 1991; 155: 658-659
- 6 Malkiel S, Eisenstadt M, Pollak U. Say a prayer for the safe cutting of a child's teeth: The folklore of teething. J Paediatr Child Health 2017; 53: 1145-1148
- 7 Wake M, Hesketh K, Allen M. Parent beliefs about infant teething: a survey of Australian parents. J Paediatr Child Health 1999; 35: 446-449
- 8 Barlow BS, Kanellis MJ, Slayton RL. Tooth eruption symptoms: a survey of parents and health professionals. ASDC J Dent Child 2002; 69: 148-150 , 123–124
- 9 Lakshminarayanan S, Jayalakshmy R. Diarrheal diseases among children in India: current scenario and future perspectives. J Nat Sci Biol Med 2015; 6: 24-28
- 10 Selvaraj K, Chinnakali P, Majumdar A, Krishnan IS. Acute respiratory infections among under-5 children in India: A situational analysis. J Nat Sci Biol Med 2014; 5: 15-20
- 11 Chapman JB, Schüssler WH. Biochemistry: A Domestic Treatise on the Application of Schussler's Twelve Tissue Remedies. St. Louis, MO: F. August Luyties; 1897
- 12 Boericke W, Dewey WA. The Twelve Tissue Remedies of Schüssler, Comprising the Theory, Therapeutic Application, Materia Medica, and a Complete Repertory of These Remedies. Homoeopathically and Bio-chemically Considered. Philadelphia, PA: Boericke & Tafel; 1914
- 13 Boericke W. Care, Feeding and Homoeopathic Treatment of Children. San Francisco: Boericke & Runyon Co.; 1911
- 14 Gibson DM. Calcarea phosphorica, A study. Br Hom J 1969; 58: 185-188
- 15 Anshutz EP. Therapeutic By-Ways; Being a Collection of Therapeutic Measures Not to be found in the Text Books, Collected from all Sources. Philadelphia: Boericke & Tafel; 1916
- 16 Sorrar WM. A digest of 10 years work at the Children's Sanatorium, Southport. J Br Homoeopath Soc 1898; 6: 82-94
- 17 Vithoulkas G. Calcarea Phosphorica. In Materia Medica Viva, Volume 6. International Academy of Classical Homeopathy; 1997
- 18 Jacobs J, Jonas WB, Jiménez-Pérez M, Crothers D. Homeopathy for childhood diarrhea: combined results and metaanalysis from three randomized, controlled clinical trials. Pediatr Infect Dis J 2003; 22: 229-234
- 19 Nayak C, Singh V, Singh K. , et al. A prospective multicentric observational study to find the usefulness of the predetermined homeopathic medicines in the management of acute diarrhoeal disease in children. Am J Hom Med 2009; 102: 122-129
- 20 Patel M, Pawaskar N, Mundra P, Tamboli P, Kothare G. An approach to acute diarrhoeal disorders through sector and constitutional homeopathic treatment in tribal children attending Balwadis. Indian J Res Homoeopathy 2010; 4: 36-48
- 21 Nayak C, Singh V, Singh K. , et al. A multi-centric open clinical trial to evaluate the usefulness of 13 predefined homeopathic medicines in the management of acute rhinitis in children. Int J High Dilution Res 2010; 9: 30-42
- 22 Nayak C, Singh VP, Singh H. , et al. A prospective multicentric study to evolve the usefulness of group of homeopathic medicines in the management of acute tracheobronchitis. Int J Biol Res 2010; 2: 9-14
- 23 Grimaldi-Bensouda L, Bégaud B, Rossignol M. , et al. Management of upper respiratory tract infections by different medical practices, including homeopathy, and consumption of antibiotics in primary care: the EPI3 cohort study in France 2007-2008. PLoS One 2014; 9: e89990
- 24 Jordan L. Could homeopathic medicine be utilised as a treatment for teething?. Aust J Holist Nurs 2005; 12: 35-39
- 25 Central Council for Research in Homoeopathy Training Manual on Homoeopathy for Mother and Child Care, Vol. III. 2009
- 26 Ministry of AYUSH. Homoeopathy: Science of Gentle Healing. 2015
- 27 Office of the Registrar General & Census Commissioner. Ministry of Home Affairs, Government of India. Available at: http://censusindia.gov.in/Census_And_You/Administrative_division.aspx . Accessed September 29, 2017
- 28 Ministry of Health and Family Welfare. National Rural Health Mission. Framework for Implementation 2005–2012. Ministry of Health and Family Welfare, Government of India. Available at: http://nhm.gov.in/images/pdf/about-nrhm/nrhm-framework-implementation/nrhm-framework-latest.pdf . Accessed September 29, 2017
- 29 National Health Systems Resource Centre. ASHA. Which Way Forward...? Executive Summary – evaluation of ASHA programme. 2011. Available at: http://www.nipccd-earchive.wcd.nic.in/sites/default/files/PDF/Evaluation_of_ASHA_Program_2010-11_Executive_Summary.pdf . Accessed September 29, 2017
- 30 Shashank KJ, Angadi MM. Assessment of roles and responsibilities of ASHA workers in Bijapurtaluk of Karnataka. Indian J Pharm Biol Res 2015; 3: 78-80
- 31 National Rural Health Mission. ASHA Module 7. Skills that save lives. Available at: http://nhm.gov.in/images/pdf/communitisation/asha/book-no-7.pdf . Accessed September 29, 2017
- 32 Central Council for Research in Homoeopathy. Training manual on health promotion during teething through Homoeopathy for ANM/ASHA & AWW 2015
- 33 Hägg U, Taranger J. Dental development, dental age and tooth counts. Angle Orthod 1985; 55: 93-107
- 34 Singh S, Kalra P, Karwasra R, Khurana A, Manchanda RK, Gupta YK. Safety studies of homoeopathic drugs in acute, sub-acute and chronic toxicity in rats. Indian J Res Homoeopathy 2017; 11: 48-57
- 35 Poureslami H, Asl Aminabadi N, Sighari Deljavan A. , et al. Does timing of eruption in first primary tooth correlate with that of first permanent tooth? A 9-years cohort study. J Dent Res Dent Clin Dent Prospect 2015; 9: 79-85
- 36 Kakatkar G, Nagarajappa R, Bhat N, Prasad V, Sharda A, Asawa K. Parental beliefs about children's teething in Udaipur, India: a preliminary study. Braz Oral Res 2012; 26: 151-157
- 37 Habicht JP, Victora CG, Vaughan JP. Evaluation designs for adequacy, plausibility and probability of public health programme performance and impact. Int J Epidemiol 1999; 28: 10-18