Equitable mosaic: the ideal for medical pluralism

Abstract This commentary is a reflection, through a health policy and systems lens, on the medically pluralistic workforce, particularly in low- and middle-income countries that have and utilise numerous systems of medicine, indigenous and adopted. It analyses and distinguishes integration and pluralism, and examines the interaction, and the more frequently observed lack thereof, among different systems of medicine. It highlights the implicit and express hierarchies among the different systems of medicine; the epistemic injustices, wrongs, and resultant harms to different systems of medicine, their practitioners, and the populations that could benefit from them; concomitant inequities in the administration and functioning of the workforce; and the gaps in coordination among diverse disciplines in health care. The commentary underscores the imperative for thoughtful and equitable administration of pluralistic health systems, including emic and etic enquiry, sensitisation, and participatory action, to accomplish the diverse goals of health systems, the health workforce, and the population.