Key facts
- Self-care is the ability of individuals, families and communities to promote and maintain their own health, prevent disease, and to cope with illness – with or without the support of a health or care worker.
- Self-care interventions can include medicines, devices, diagnostics and digital tools. Self-care actions include practices, habits, and lifestyle choices.
- Self-sampling of human papilloma virus (HPV) is an effective self-care intervention to screen for cervical cancer.
- Male and female condoms are highly effective self-care interventions in preventing unwanted pregnancies, and STIs, including HIV. Non-judgmental, person-centred information should be provided to support condom use.
- Self-monitoring of blood glucose is a critical part of diabetes management, and self-monitoring of blood pressure is an effective intervention for hypertension management.
- Appropriate self-care can reduce mortality and morbidity from the abuse of alcohol, substances, and tobacco.
- Regular physical activity is a form of self-care that can avert an estimated 3.9 million premature deaths each year.
Overview
WHO defines self-care as the ability of individuals, families and communities to promote their own health, prevent disease, maintain health, and to cope with illness with or without the support of a health or care worker.
It recognizes individuals as active agents in managing their own health care in areas including health promotion; disease prevention and control; self-management; providing care to dependent persons; and rehabilitation, including palliative care. It does not replace the health care system, but instead provides additional choices and options for healthcare.
What are self-care health interventions and who uses them?
Self-care interventions encompass tools that support self-care and actions that improve the care of oneself. Self-care interventions include evidence-based, high-quality medicines, devices, diagnostics and/or digital interventions that can be provided fully or partially outside formal health services and can be used with or without the direct supervision of health and care workers. Self-care actions include practices, habits, and lifestyle choices.
Some people may have good knowledge of certain self-care interventions and feel comfortable using them independently from the outset, while others may need more support and guidance before they can accept and use them independently. Self-care interventions that need initiation by a health and care worker, or additional health and care worker support (e.g. to follow up on a positive test), must be linked to the health system and supported by it in order to be safe and effective.
Scope of the problem
Every year 100 million people are plunged into poverty due to out-of-pocket expenditure for health. Furthermore, underserved and marginalized populations, often lack access to quality health information, services and products and face stigma and discrimination in healthcare. There is an urgent need to find innovative strategies that go beyond a conventional health sector response to address these challenges in accessing quality healthcare.
The COVID-19 pandemic highlighted the unique and critical role that self-care interventions can play in mitigating disease and saving lives through personal self-care actions, such as wearing masks and physical distancing, and national level prioritization of self-care interventions. Examples of quality, cost-effective self-care interventions include timely and accurate diagnostic testing for SARS-CoV-2 as an essential part of a comprehensive COVID-19 response strategy. Self-care actions to promote individual emotional resilience are also important for the well-being of health and care workers.
Challenges
Before recommending specific self-care interventions, it is important to have evidence that they are beneficial to health and cause no harm at individual and/or population levels.
Use of unregulated and substandard products, incorrect or unclear health information or lack of access to health and care workers and/or health facilities for guidance or management of side effects or complications are challenges that need to be addressed when promoting or generating demand for these interventions. Currently one of the biggest challenges is ensuring that products are available to those who need them and that they do not place added financial burden on individuals.
Assessing and ensuring an enabling environment in which self-care interventions can be made available in safe and appropriate ways must be a key initial piece of any strategy to introduce or scale-up these interventions. Creating an enabling environment not only requires action from the health sector, but also other sectors as well, for example, the education, justice and social services sectors, because self-care interventions are mostly accessed and/or used outside formal health services.
Self-care as a complement to the health system
Self-care interventions offer a strategy to improve universal health coverage, reach people in humanitarian situations, and improve health and well-being.
WHO’s conceptual framework on self-care interventions has core elements from both “people-centred” and “health systems” approaches, underpinned by the key principles of human rights, ethics and gender equality.
Self-care interventions can connect with digital platforms and technologies and be incorporated into the education of health workers for maximum scale and reach. Health literacy, including digital literacy, is also important for the uptake of self-care interventions and provides the foundation on which individuals are enabled to play an active role in improving their own health.
In addition, in times of major disruptions to the normal functioning of national health systems, caused by health emergencies, self-care interventions can provide an important alternative to the usual health facility- or health and care worker-based services.
WHO response
WHO recognizes the value and potential contribution of self-care interventions within health systems, and the rapid advances being made in services, behaviours and information that can be initiated by individuals. WHO recommends self-care interventions through a holistic approach to the care of each person, taking account of their individual circumstances, needs and desires across their whole life course, as well as the environment they live in.
The WHO consolidated guideline on self-care interventions and framework support and promote these innovative approaches as ways to strengthen primary health care (PHC) to accelerate attainment of universal health coverage (UHC) and the Sustainable Development Goals (SDGs). The framework and normative guideline are grounded in and advocate for a strengthened, comprehensive, people-centred approach to health and well-being, including for sexual and reproductive health and rights (SRHR); communicable diseases (CDS); and non-communicable diseases (NCD).
The WHO global guideline is relevant for all settings. When implementing the global guideline, WHO regions and countries can adapt the recommendations to the local context, considering economic conditions, existing health services and healthcare facilities, and the needs and rights of underserved populations.