Self-care can mean better, more accessible, participatory, affordable, quality healthcare. In the case of the emergency contraceptive pill or acetaminophen when available over the counter, such self-care will require minimal or no interaction with a health worker. However, frequently, for COVID-19 and many health interventions, self-care requires a carefully choreographed set of interactions between health workers and individuals to enable people to take greater control over their healthcare.
Self-Care
The World Health Organization (WHO) defines self-care as “the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a healthcare provider.”
The concept of self-care is not new; however, rapid advancement in medical and digital technologies is accelerating the range of interventions that can be acquired and managed more directly by individuals. Such “self-care interventions” offer self-directed, convenient, and quality health care that can contribute to universal health coverage.
On June 24, 2019, the WHO released the Consolidated Guideline on Self-Care Interventions for Health: Sexual and Reproductive Health and Rights (SRHR) stating, “self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems perspective and for people who use these interventions.” The consolidated guideline calls for the adoption of national guidelines and includes people-centered, evidence-based recommendations for key self-care interventions for SRHR such as HIV self-testing, human papillomavirus self-sampling, and self-administered injectable contraception. The COVID-19 crisis has created a greater urgency to advance self-care work in order to offer continuity of SRHR services in low physical touch environments. On June 1, 2020, the WHO endorsed self-care approaches as a part of its COVID-19 Operational Guidance.
Image above: Self-care in the context of interventions linked to health systems, from WHO Consolidated Guideline on Self-Care Interventions for Health
In this Trending Topic, we provide a selection of tools and project examples on the topic of self-care, and we welcome our readers to upload their own materials on this topic.
Banner Image: U.S. Ambassador Ted Osius and his spouse Clayton Bond join Vietnamese government officials and celebrities to demonstrate how to do the HIV self-test. Ho Chi Minh City, August 26, 2016. Photo: Phuong Nguyen/USAID. Retrieved from https://www.flickr.com/photos/49951534@N08/29129213082 on July 14, 2020.
Resources
This policy brief is based on a review of literature and interviews with community health, quality-of-care, self-care and MNCH experts.
Population Services International (PSI) and a consortium of organizations under the auspices of the Self-Care Trailblazers Working Group have developed a Quality of Care Framework for Self-care aligned with the WHO Consolidated Guideline on Self-Care Interventions for Health.
This roadmap is the result of a series of in-country advocacy workshops and consultations held between July 2019 and January 2020. The advocacy roadmap development was facilitated by White Ribbon Alliance’s Global Secretariat in collaboration with the Self-Care Trailblazer Group (SCTG)—coordinated by Population Services International.
The Women and Girls Health and Rights Power Model (Power Model) and accompanying project planning materials were developed by White Ribbon Alliance (WRA) to support the advocacy and community engagement efforts of WRA National Alliances and other partners and stakeholders.
Going Online is a vision and evolving framework for how HIV programs can use online and mobile platforms to accelerate impact toward meeting their HIV education, prevention, testing and treatment objectives.
Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems perspective and for people who use these interventions. The World Health Organization (WHO) uses the following working definition of self-care: Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health- care provider
Establishing self-care as a global policy priority to improve health outcomes and address the sustainability of health systems around the world is both necessary and achievable.
Global male life expectancy is four years lower than female and the ‘sex gap’ is widening. There are also significant variations in men’s health outcomes between and within countries. Improved men’s self-care practices would result in better health for men as well as for women and children. They would also help achieve UN’s SDGs and reduce costs for health systems.
This case study describes a pilot project in Cote d'Ivoire which promotes HIV self-testing via barbershops. Preliminary human-centered-based research resulted in a finding that barbershops were a key gathering point for men in Côte D’Ivoire. The HIV self testing promotions were also communicated via religious leaders and social media.
This commentary follows the publication of Marie Stopes International's randomized control trial in Bangladesh which showed that mHealth to promote contraceptive use increased women’s report of gender-based violence.
This study highlights the importance of hotlines, combi-packs and clear packaging for ensuring that people can safely self-administer reproductive health medications.
The World Health Organization (WHO) defines self-care as the ability of individuals, families, and communities to promote and maintain health, prevent disease, and cope with illness with or without the support of a healthcare provider.
This study took place between August and October 2017 within 5 study sites in Niger, Senegal, and Burkina Faso.
This study details the impact of the introduction of Sayana Press, an injectable contraceptive, in Madagascar. The study began in 2015.
Recent evidence from African countries indicates that DMPA-SC may help reduce service delivery costs by catalyzing community-based distribution and remote provision of injectable contraception. Moreover, self-injection of DMPA-SC—when compared with clinic administration of traditional injectables—is not just cost-effective but cost saving when accounting for costs to both women and health systems.
A study was performed to assess the cost-effectiveness of self-injected subcutaneous depot medroxyprogesterone acetate (DMPA-SC) compared to health-worker-administered intramuscular DMPA (DMPA-IM) in Uganda.