Global Naturopathic Regulation

A primer on the regulation of naturopathic practice around the globe

By Iva Lloyd, ND, RPP

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Naturopathy is practiced in more than 80 countries, spanning every world region. Regulation of the naturopathic profession currently exists in jurisdictions in North America, India, Europe, and Latin America. To be a full member of the World Naturopathic Federation (WNF), naturopathic associations must support and be working toward regulation. They must also support educational accreditation and high educational standards.

Regulatory Process

The regulation of naturopathy, like all professions, is strongly correlated with educational standards and is influenced by the political landscape in each country. Because naturopathy is a medical profession, its regulation also depends on the regulation of other traditional and complementary systems of medicine in the region. Every country or region that has naturopathy regulation is supported by a professional naturopathic association. For those countries/regions that do not yet have regulation, the WNF encourages professional naturopathic associations to engage in self-governance activities that protect the public as they work toward regulation.

Overview of Global Naturopathic Regulation

The regulation of naturopathic practitioners is diverse. It covers Naturopathic Technicians, Licensed Naturopaths, Diploma in Naturopathy, and Naturopathic Doctors. Naturopathic practitioners in Europe are referred to as Heilpraktiker or Naturopaths. In parts of North America and in India, naturopathic practitioners are regulated as Naturopathic Doctors. In Latin America, regulation exists for both Naturopathic Technicians and Doctors of Naturopathy. This difference reflects the educational differences, yet the foundational philosophy and principles are the same. The following is a summary of the global regulation of naturopathy, with links to country-specific regulations and organizations.

To be a full member of the World Naturopathic Federation (WNF), naturopathic associations must support and be working toward regulation.

Africa

Naturopathy is practiced in at least 11 countries in Africa. Of those, 2 have regulation. The practice of naturopathy in the Democratic Republic of Congo falls under the Decree of 1952, which regulates the practice of medicine and grants exemplary status for traditional medicine practitioners, which includes naturopaths. In South Africa, naturopathy has been regulated since 1982 under the Allied Health Professions Act. The professions included in this regulation include Ayurveda, Chinese Medicine and Acupuncture, Chiropractic, Homeopathy, Naturopathy, Osteopathy, Phytotherapy, Therapeutic Aromatherapy, Therapeutic Massage Therapy, Therapeutic Reflexology, and Unani-Tibb. Regulation of naturopathy requires 3 years of basic medical sciences with a 2-year specialization in Naturopathy from the University of the Western Cape.

Asia

In India, naturopathy has 2 levels of regulation: education, regulated by the health university of the respective state; and practice, regulated by the State AYUSH Department, which registers practitioners. Currently, the Bachelor of Naturopathy and Yogic Sciences (BNYS) medical degree course is conducted in 19 schools based out of 7 states of India and regulated by the respective state governments. MD (Naturopathy) is a postgraduate full-time 3-year course for BNYS graduates only. The MD program was started in 2014 and is offered currently by 3 schools in India.

The National Accreditation Board for Hospitals and Healthcare Providers (NABH), an institutional member of the International Society for Quality in Health Care (ISQUA), has recently developed accreditation standards for naturopathy hospitals and clinics in association with the Ministry of AYUSH. India’s intra-profession operational collaboration between the different systems of traditional medicine within its country is a model worth noting. In other areas of Asia that practice naturopathy, such as Nepal, there is currently no regulation.

Eastern Mediterranean

Naturopathy is fairly new to the eastern Mediterranean region. While 7 countries in the region have naturopathic practitioners, there are currently no naturopathic regulations in the eastern Mediterranean.

Europe

In Europe there are over 30 countries that practice naturopathy, yet only 3 currently have regulation. There are a couple of regulatory challenges that are common in Europe. First, some countries include the treatments common to Traditional and Chinese Medicine, T&CM, under the regulation of medical doctors, hence limiting and in some cases restricting naturopathic practitioners and other T&CM practitioners from practicing in their country. Second, some countries such as Hungary have chosen to regulate modalities (specific treatments) of medicine vs regulating systems of medicine. The WNF discourages this practice because it decreases the attention and protection of the fundamental principles that are part of every system of T&CM.

Latin America

The WNF is aware of 23 countries in Latin America that practice naturopathy. Three of those countries currently have regulation. Many of the countries in Latin America that practice naturopathy do so because naturopathic practitioners brought naturopathy back to their countries after graduating from naturopathic educational institutions in North America.

  • Brazil: Recognition of naturopathy is through the Ministry of Health under Integrative Complementary Medicine. In Brazil the competencies on a profession are divided: the ministry of labor recognizes the occupation; the ministry of education recognizes the formation; and the ministry of health recognizes and regulates the practice. The ministry of health works through the national health council within the Public Policies of the System National Health, but it is up to the National Congress to legislate on the regulation of the professional.
  • Chile: Regulation in Chile is based on passing a standardized exam. There are 2 different designations—Naturopatas and Holistic Naturopath. A Holistic Naturopath is a practitioner who has completed training in naturopathy, acupuncture, and homeopathy.
  • Puerto Rico: Puerto Rico has been regulated since 1997. It is the only jurisdiction that has distinct regulation for both naturopaths and naturopathic doctors.

North America

In both Canada and the United States, naturopathic practitioners are considered primary care providers and are regulated as naturopathic doctors. Regulation is based on graduation from an accredited 4-year naturopathic medical program and a passing score on an extensive postdoctoral board examination for licensure or registration. Naturopathic doctors must also fulfill annual mandatory continuing education requirements and have a specific scope of practice as defined by their provincial/state regulations.

Canada

Naturopathic regulation has existed in Canada since the 1920s. There are currently 5 provinces that have full regulation and 1 province that has title protection. Three other provinces are in the process of regulation.

In Canada, the regulatory authorities regulating the practice of naturopathic doctors formed the Canadian Alliance of Naturopathic Regulatory Authorities (CANRA). The aim of the alliance is to foster collaborative and cooperative opportunities to improve the ability of its members to regulate their respective members in the public interest.

United States

Many states were regulated between the 1920s and 1950s, but due to sunset laws most lost their regulation. There has been a tremendous regulatory effort in the United States since the 1980s and currently there are 20 states, the District of Columbia, and the United States territories of Puerto Rico and the United States Virgin Islands that have licensing or registration laws for Naturopathic Doctors. Regulation is currently pending in another 6 states.

In the United States there is also a Federation of Naturopathic Medical Regulatory Authorities (FNMRA) that coordinates the efforts of all the regulatory bodies.

Western Pacific

There are at least 8 countries in the western Pacific region that practice naturopathy. Although there are no formal regulations on naturopathic practice in Australia and New Zealand, the 2 countries in the western Pacific that have been practicing naturopathy since the early 1900s, there are also no restrictions. Naturopathy in Australia and New Zealand is covered by private insurance.

In Australia, in lieu of statutory regulations, an independent self-regulatory body that mirrors the standards of government regulations has been established. The naturopathic organizations are also active in self-governance as demonstrated by the standards of practice outlined on the ARONAH website.

The table below summarizes the regulation of naturopathy around the globe, including links to country-specific regulations and national organizations.

Table. Summary of Global Naturopathic Regulation

World Region/Country Year of Regulation Hours in Naturopathic Program Protected Title(s) Defined Scope of Practice? Link to Regulations or National Organization
Africa/Democratic Republic of Congo 1952 4,450 (once institute is established)

Traditional Healer, Naturopathic Doctor

Yes http://apps.who.int/medicinedocs/en/d/Jh2943e/4.13.html
Africa/South Africa 1982 4,200 Naturopath, Natruopathic Doctor Yes http://ahpcsa.co.za/
Asia/India 1970 4,500 Bachelor of Naturopathy and Yoga Sciences (BNYS) Yes www.ayush.gov.in
Asia/India 2014 2,600+ MD (Naturopathy) Yes

www.ayush.gov.in

(Example of a University offering MD: https://www.tnmgrmu.ac.in/index.php/indian-medicine-and-homoeopathy.html)

Europe/Germany 1939 Based on passing a state exam

Heilpraktiker

No https://www.gesetze-im-internet.de/heilprg/BJNR002510939.html
Europe/Portugal 2003 and 2013 ~6,000 [8 curricular semesters including 240 credits] Profissão de Naturopata Yes

https://dre.pt/pesquisa/-/search/656122/details/maximized

http://www.pgdlisboa.pt/leis/lei_mostra_articulado.php?nid=2629&tabela=leis&so_miolo=

Europe/Switzerland 2015 4,650 Naturheilpraktier mit Eidgenössischem Diplom Yes http://www.oda-am.ch/de/beruf/abschluss-titel/
Latin America/Brazil 2012 4,000 Naturólogo No http://www.camara.gov.br/proposicoesWeb/fichadetramitacao?idProposicao=543332
Latin America/Chili 2013 3,600 Naturópata, Holistic Naturopath Yes

www.economia.gob.cl

Latin America/Puerto Rico 1997 Not outlined in regulations Naturopath and Naturopathic Doctor (2 distinct sets of regulations) Yes http://www.oslpr.org/download/en/1997/0208.pdf
North America/Canada

BC: 1923

ON: 1925

MN: 1946

ALB: 1948

SK: 1956

NS: 2008

4,000+ Naturopathic Doctor, Naturopath, Doctor of Naturopathy, ND Yes, some variability by province https://www.cand.ca/affiliations/
North America/United States Various years 4,000+ Naturopathic Doctor, Naturopath, Doctor of Naturopathy, ND Yes, some variability by state

https://www.naturopathic.org/regulated-states

           

 

About the Author

Iva Lloyd, ND, RPP, is a Naturopathic Doctor, Registered Polarity Practitioner, and Reiki Master. In 2002, she founded Naturopathic Foundations. She teaches part-time at the Canadian College of Naturopathic Medicine and writes for various journals and magazines. She is editor of the Vital Link - the journal for the Canadian Association of Naturopathic Doctors. Dr. Lloyd is the author of four books: Building a Successful Naturopathic Practice, Messages from the Body, A Guide to the Energetics of Health, The Energetics of Health, a naturopathic assessment and History of Naturopathic Medicine, a Canadian Perspective.