Regulatory status of complementary medicine in Qatar: An update

The prevalence of use of complementary medicine in Eastern Mediterranean region according to World Health Organization (WHO) is about 90%.¹ A published study in 2014 reported the use of complementary medicine in the previous 12 months by 38.2% of midlife women in Qatar (20–40 years) who participated in this study.²

Another study reported that 53% of patients with type 2 diabetes mellitus in Qatar used complementary medicine.³

Complementary medicine was defined as a broad set of healthcare practices which is not a part of conventional medicine.^4,5

In Qatar, A cross-sectional study of knowledge, attitudes and practice of general practitioners towards complementary medicine was conducted. 83.8% described their attitude to complementary medicine as welcoming and 97.5% were interested to learn more about it, fewer (30.1%) had practiced it before, referred patients (24.8%) or asked patients about their use of complementary medicine (34.8%).⁶

Another study in Qatar assessed knowledge and attitude of oncology practitioners towards complementary and alternative medicine for cancer care. 90% of healthcare providers were interested in complementary medicine education opportunities. The majority of them thought that complementary medicine improved patient's psychological and emotional well-being (87%), Quality of life (61%), and helped to relieve symptoms of disease (35%).⁷

Furthermore, a study recommended changes in complementary medicine courses and subjects in pharmacy colleges to support new pharmacists in helping patients in proper use of complementary medicine.⁸

According to the World Health Organization (WHO) report about the global status of traditional and complementary medicine, the percentage of public use of acupuncture was 1–19%.¹

The Specialized Committee of complementary medicine which is formulated in 2016 at the Ministry of Public Health is responsible for dealing with regulation and licensing issues of complementary medicine.¹

Currently, there are five complementary medicine practices (cupping therapy, acupuncture, chiropractic, Ayurveda, homeopathy) which are regulated in Qatar since 2016 by issuing circular No 2/2016.⁸ Complementary medicine practitioners according to this circular were regulated under supervision of Qatar Council for Healthcare Practitioners (QCHP) and Ministry of Public Health.⁹ Table 1 summarized the requirements for each practice.

Table 1.

Summary of requirements of the regulatory complementary medicine practices in Qatar.

Practice	Qualification		Experience	Note
Cupping Therapy (Hijama)	Theoretical, practical, health and safety training, and sufficient knowledge of Physiology and Anatomy. • Submit proof of having completed a satisfactory and approved training program as deemed appropriate by QCHP.		Minimum of two years recent experience (no interruption in the practice).	Circular No. (2/2021) practiced only by practitioners with health or medical background
Chiropractic	Graduates of accredited Chiropractic programs. Current license/ registration to practice as chiropractor in home country or country of last employment.		Minimum of two years recent experience (no interruption in the practice).
Homeopathy	(1) Professional Degree of Homeopathy (BHMS- Bachelor in Homeopathic Medicine and surgery)/ Accredited Homeopathic program of not less than 5 years (including internship). Current license/registration to practice in home country or country of last employment.		Experience: Not less than 2 years after internship. .
	(2) Accredited Homeopathy program of not less than 3 years full time program. Current license/ Registration to practice in home country or country of last employment.		Experience: Not less than 4 years after completion of the course
Ayurveda	(1) Approved Ayurveda degree or its equivalent from a recognized institution. Current license to practice in home country or country of last employment.		recent practice (no interruption in the practice for more than two years).
	(2) Accredited Ayurveda Medicine program (3 to 4 years) full time/ equivalent, (2500 h (classroom theory and practical sessions) followed by 500 h of supervised internship training. Current license/ Registration to practice in home country or country of last employment.		Experience: Not less than 4 years after completion of the course.
Acupuncture
Acupuncture Practitioner without medical background		An academic program of no less than 2500 theoretical and practical hours of study	Two years	Circular No. (13/2021)
Physician/Dentist limited to Acupuncture		An academic program of no less than 1500 theoretical and practical hours of study	Not required
Physician/Dentist		An academic program of no less than 200 theoretical and practical hours of study	Not required
Other Healthcare Practitioners practicing Acupuncture within his/her scope		An academic program of no less than 200 theoretical and practical hours of study	Not required

Main requirements for registration of practitioners for most of complementary medicine practices are: accredited professional academic degree/training, previous experience (not less than 2 years) and having a license from the home country.⁹

As per 2017, Complementary medicine practitioners were added to the list of allied healthcare professionals by Ministerial resolution no. 14 that has been issued in 3/8/2017.¹⁰ QCHP issued circular No. (21/2017) that allowed complementary medicine practitioner to practice in general hospitals and poly clinics.¹⁰

A new updated regulation rules was issued by Ministry of Public Health in 2021 as circular No. (2/2021) for cupping therapy (Hijama in Arabic) to be practiced only by practitioners with health or medical background to raise the standards of practice of cupping.¹¹

Furthermore, in 2021, Ministry of Public Health was issued circular No. (13/2021), to update regulation rules of acupuncture practice. The new requirements adapted recommendations of WHO for acupuncture practitioners, especially the required academic qualification and training hours for physicians and dentists. The license of physician/dentist required no previous experience in the updated regulation.¹²

Complementary medicine products such as herbal supplements were regulated since 2009 under the “Regulation for herbal medicines, dietary supplements and medicated cosmetics” which had the same safety requirements as conventional medicines.¹ By 2012, there were 2980 registered herbal and dietary supplements in Qatar which were sold in pharmacies as non-prescribed supplements.¹

Qatar followed the complementary and integrative approach to regulate these five practices beside the conventional medicine in a harmonized way and not instead of it.¹

Finally, the update process of rules and regulation is a continuing process to raise standards of practice of complementary medicine and ensure safety of patients. Additionally, there are many efforts to integrate complementary medicine practices into primary healthcare services, as suggested and supported by WHO.¹³

CRediT authorship contribution statement

Zainab AlMusleh: Writing – original draft, Writing – review & editing. Tamer Aboushanab: Supervision, Writing – original draft, Writing – review & editing.