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INTRODUCTION

The National Health Policy of India asserts that ‘focus on sensitizing ISM is placed in, in today’s urban India is presented through nine
practitioners of each system to the strengths of the others’ is key themes7. These outline the area of exploration and grounds for
important in the development of the nation’s integrative medical this project, further leading to some essential questions to be
capabilities. ‘Further the development of sustainable livelihood addressed through this project. This set of frameworks and key
systems through involving local communities […] will also be themes will together serve as a guide for further enquiry and work
supported by this policy.’ Hence, there is seen to be a national level on the design challenge as defined in the brief. ISM is seen to be
need to bring emphasis to the unique values of ISM as a means of especially effective in treating chronic illnesses. This makes ISM all
balancing the overwhelming focus being given to allopathic the more relevant to the urban Indian context, given the growing
systems. This is to be done through interventions at the local scale, influence of urban lifestyles on chronic and non-communicable
working together with the local communities of the region to build diseases. Hence, the proposed system or service could highlight and
sustainable systems of trust in ISM, and thereby in integrative accentuate this unique benefit of ISM over allopathy to the poten-
practices of medicine. tial and current users of ISM. This would provide a fair share of
focus on ISM’s unique values and thereby enhance the chances for
Until recently, the doctor-patient relationship was seen as having an effective integration of these systems of medicine into the Indian
implicit and unquestioned dynamic of mutual trust. Evidence that healthcare system.
doctors have acted against patient’s interests has brought a shift in
these dynamics of trust. Today, with the cultural rise in the value of In terms of the user’s economic demographics, systems and services
Many of the ‘alternative’1 approaches to healthcare in modern autonomy, and the ease of access to information, including a pleth- that reach out to the lower-middle class of society8 would create a
India2 consider the physical and spiritual human body3 as being ora of medical information online that patients can consult, a new “trickle-up innovation” effect on the systems of trust in ISM. ‘... These
connected. They look at health in a holistic manner, indicating that paradigm of “calculated trust” is emerging in patient-doctor interac- reverse innovations9 are an important opportunity for learning and
diseases are symptomatic of greater imbalances in a person’s tions. This means that the patient is considered a partner in their building capacity for leading change that has the potential to
lifestyle4. On the other hand, allopathy looks at the human body as healthcare choices, and ‘trust may no longer be blind trust’ optimize resource use while also finding innovative approaches to
a combination of separate, often unrelated biological parts that (Gopichandran 2013). deliver health services in a cost effective, sustainable manner.’
can be “fixed” or “replaced” by breaking them down to their most identified design brief6 is approached through a set of frameworks (Snowdon 2015) The lower-middle class¹⁰ make up a large section
fundamental ingredients (Hankey 2010). Today, the average Indian Through initial research, the aspect of trust in relationships5 (Simp- derived through existing theories on: trust in relationships and of India’s urban population, much larger than what is referred to in
consumer of healthcare services finds themselves torn between son 2010, 264) has been identified as a key factor in the building research on the perception of ISM in the urban Indian context. general as the ‘middle-class’ population, and this would be an
these radically different “religions of health,” with few existing and sustaining of systems. When it comes to building a system that opportune section of the population to build personalised systems
systems to support an integrated approach that values the unique has integrated two other subsystems, trust between the subsystems Both of these together help to detail the essential concepts under- of trust in ISM through in-depth research and appropriately
benefits of each system of medicine. is important in ensuring that the system works smoothly. Hence, the lying trust systems in ISM. The different aspects of the context that designed systemic interventions.

6 Which seeks to design a system or service that builds trust in the unique values of ISM, so as to seamlessly integrate it with allopathy.
7 Derived from initial research in the context.
8 Who are well connected through the internet and also make up a large part of urban India’s population, and therefore, a large section of
the potential users for ISM. Currently, they are also found to have lesser access to ISM’s healthcare services.
9 Also called trickle-up innovation.
10 Also called the ‘Lower’ class according to a study by the Pew Research Centre (Kochhar 2015)