Self-care hygiene measures

What is self-care?

Who defines self-care as the ability of individuals, families and communities to promote health, prevent disease, stay healthy, and cope with illness and disability, with or without the support of health care providers.

The definition considers individuals as active agents in the management of their own health care, in areas including health promotion; Disease prevention and control; Self-treatment; Caring for dependents; As well as rehabilitation and palliative care.

What are self-care hygiene measures and who uses them?

Self-care health measures include evidence-based, high-quality medicines, devices, diagnostic tools, and/or digital products that can be provided in whole or in part outside formal health services and used with or without direct supervision by health care providers. For example, self-injected contraceptive injections, human papillomavirus self-sampling kits or HIV self-testing.

Some measures are well mastered by users from the start and can be used independently. Others require more guidance and support before they can be accepted and used independently. Self-care health measures should be integrated with and supported by the health system to ensure health system accountability.

Users of self-care health measures are individuals and providers of care for dependent persons. They may choose these interventions for a number of positive reasons, such as convenience, cost, autonomy, greater alignment with values or daily lifestyles, etc., or the interventions may provide desired options and choices. However, it may also be to avoid recourse to the health system because of poor quality of services (e.g. discriminatory attitudes of health service providers) or lack of access (e.g. in humanitarian crisis situations). Self-care health measures can play a particularly important role in these situations, where people might otherwise not have access to health services at all.

Scope of the problem

Marginalized and vulnerable groups such as poor, indigenous or migrant populations often do not have access to quality health services. In addition, with an estimated shortage of 18 million health workers by 2030 and a projected decline in international funding for health, and with one in five of the world's population currently affected by humanitarian crises, there is an urgent need to find innovative strategies that go beyond traditional health sector responses.

Health service providers are often the biggest beneficiaries of self-care, as it allows them to use available resources to serve more patients and apply their clinical skills in areas where they are most needed.

Challenge

Before recommending the use of specific self-care health measures in the health system, there must be evidence that they are beneficial to health outcomes and do not cause harm to the individual or population.

Unsafe use of unregulated and substandard products, incorrect or unclear health information, or lack of access to health care personnel and/or access to health facilities are potential challenges that need to be addressed in promoting or stimulating demand for these interventions. One of the biggest challenges is to ensure that products are available to those who need them and do not impose additional financial burdens on individuals.

As with all health services, self-care health measures require equity, human rights, gender equality and social determinants of health to be at the heart of their implementation. Providing a safe and supportive enabling environment is critical for those who may be neither aware of their right to health nor able to access the services they need, including vulnerable, marginalized, criminalized and socioeconomically disadvantaged populations with the worst global health outcomes.

Global impact

Self-care health measures offer a solution to support the achievement of all WHO's "three billion" goals, increase universal health coverage, help people in humanitarian crises, and improve health and well-being. Sexual and reproductive health interventions can have a significant health impact at the individual, community and societal levels by providing the following as additional options:

The self-administered contraceptive injection aims to reduce the number of unintended pregnancies annually among 74 million women and girls in low - and middle-income countries.

Self-sampling of human papillomavirus (which causes cervical cancer), designed to improve screening, could increase the number of new cases detected each year and reduce cervical cancer mortality.

HIV self-testing ensures early access to care and treatment when needed and reduces mortality rates (770,000 people died from AIDS-related illnesses last year).

Self-collection of samples for sexually transmitted infections (such as chlamydia and/or gonorrhoea) strengthens testing and links to necessary treatment.

Self-administered medical abortion aims to reduce the number of women who die each day from unsafe abortions.

Who's response

Who recognizes the value and potential contribution of self-care health measures within health systems, as well as rapid advances in services, behaviours and information that can be initiated by individuals. The WHO Framework for Self-Care Health Measures supports and promotes these innovative approaches as a way to accelerate progress towards universal health coverage and the Sustainable Development Goals.

Who's first comprehensive guidance on healthy self-care measures is a step towards putting people at the centre of health care, ensuring that high-quality interventions are delivered to people while maintaining accountability in health systems.