What is self-care?
The World Health Organization defines self-care as the ability of individuals, families and communities to promote health, prevent disease, maintain good health and manage illness and disability with or without the support of a health worker.
It recognizes individuals as actors in the management of their own health care in areas that include health promotion; Disease prevention and control; and self-treatment; providing care to people dependent on it; and rehabilitative care, including palliative care.
What are self-health care interventions and who uses them?
Self-health care interventions are the use of evidence-based methods that include good quality medicines, medical devices, diagnostic tools and/or digital products and can be delivered wholly or partly outside formal health services and can be used with or without direct supervision from health care staff. These include, for example, self-injectable contraceptives, self-sampling kits for HPV, or self-tests for HIV.
Users may be well familiar with some interventions and use them comfortably and independently from the beginning. While other interventions need more guidance and support before they can be accepted and used independently. Self-health care interventions should be linked to the health system and supported to ensure health system accountability.
Self-health care interventions are used by individuals and caregivers of people dependent on them. They may choose these interventions with positive justifications, such as: convenience, cost reduction, empowerment of individuals, better fit with values or patterns of daily life, or because the intervention may provide desired options and choices. However, they may also choose self-health care interventions to avoid the health system due to lack of quality (e.g. stigma by providers) or inaccessibility (e.g. in humanitarian settings). Self-health care interventions play an important role, especially in such cases, because it may not be possible for people to access health services at all.
Scope of the problem
Marginalized and vulnerable groups, such as the poor, indigenous people or migrants, often lack access to quality health services. In addition to the estimated labor shortage of 18 million health workers by 2030, which will result from an expected decline in international funding in the field of health, not to mention that 1 out of every 5 people in the world’s population currently suffers from humanitarian crises, which It makes an urgent need to find innovative strategies that go beyond the traditional health sector response.
Health care providers are often the biggest beneficiaries of self-care, as it allows them to serve the largest number of patients with existing resources and deploy their clinical skills where they are needed most.
Challenges
It is important to ensure that, before recommending specific self-care interventions in health systems, there is evidence that they will work for health outcomes and will not cause harm at both the individual and population levels.
Unsafe use of unregulated or poor-quality products, incorrect or unclear health information, or inaccessibility to healthcare staff and/or facilities are potential challenges that should be addressed when promoting or requiring these interventions. One of the biggest challenges right now is ensuring that products are available to those who need them, and ensuring that they do not impose an additional financial burden on individuals.
As with all health services, self-care interventions require equity, respect for human rights, gender equality and social determinants of health to be at the center of their implementation. Providing a safe and supportive enabling environment will be essential for people who may be unaware of their right to health or who cannot access the services they need, including vulnerable and marginalized populations, the prison population and socio-economically disadvantaged groups - those with the worst health outcomes globally.
Global impact
Self-care interventions offer a solution to support the achievement of WHO's triple billion goals aimed at improving universal health coverage and access for people in humanitarian situations and improving health and well-being. Providing the following sexual and reproductive health interventions as additional options may have a significant health impact at the individual, local, and community levels:
Self-injectable contraceptives help reduce unwanted pregnancies annually for a total of 74 million women and girls living in low- and middle-income countries
Self-sampling for the human papillomavirus (HPV) that causes cervical cancer to improve detection of this virus could increase the chances of detecting the number of new cases annually and thus reduce the mortality rate from cervical cancer.
Self-testing for HIV can ensure early access to care and treatment if necessary and reduce the death rate, which last year reached 770,000 deaths due to AIDS-related diseases.
Self-collection of samples for sexually transmitted diseases (such as chlamydia and/or gonorrhea) can improve screening and lead to treatment if necessary.
Self-managing medication abortion reduces the number of deaths among women who die every day due to unsafe abortion.
WHO response
The organization recognizes the value of self-care interventions, their potential contributions to health systems and the rapid progress made in the services, behaviors and information that individuals can provide. The WHO Framework for Self-Health Interventions supports and promotes innovative approaches as ways to accelerate the achievement of universal health coverage and the Sustainable Development Goals.
The first publication of WHO's standardized guidelines on self-care interventions in health is a step that puts people at the center of health care, ensuring access to quality interventions and maintaining health system accountability.
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