The United for Self-Care Coalition made calls to expand the current World Health Organization’s (WHO) guidelines on self-care during a panel event, “Self-Care a Foundational Component of Health System Sustainability,” at the 76th World Health Assembly on Wednesday.

The United for Self-Care Coalition, a new coalition of like-minded groups and experts, marked their call to action with a panel hosted by coalition member the Global Self-Care Federation (GSCF) to discuss 

“We are in a unique moment, as we see it from a federation standpoint as it pertains to the role of self-care in overall health care systems,” GSCF Chair Manoj Raghunandanan told those in attendance. 

A rise in chronic conditions, an ageing population, and the COVID-19 pandemic have all impacted already-overstretched resources over the past few years, he said.

For Raghunandanan, the COVID-19 pandemic has changed how people view self-care due to the amount of time spent in lock downs and, for many people, an inability to see medical practitioners in person.  

“The COVID-19 pandemic was the great accelerator,” Raghunandanan said. “We had a period where consumers and patients were relying upon themselves to care for themselves, to adjudicate their care to provide for themselves, and during that time, we realised that in many cases, they could be successful at doing this.”

What is self-care?

Self-care is defined as the ability of individuals, families and communities to promote health, prevent disease and mental health, and cope with illnesses and disability, with or without the support of health workers.

United for Self-Care Coalition has called on the WHO to boost health literacy, promote digital health, enhance self-care capacity and guidance, recognise self-care as an enabler of UHC and invest in self-care. The coalition is already part of the UHC2030 platform, which aims to increase Universal Health Coverage by 2030. 

Democratising access to self-care interventions

Many see the current WHO guidelines as simply needing to do more.

Manjulaa Narasimhan, a scientist in the Department of Reproductive Health and Research at WHO, explained, “We look at things like how can we reduce the levels of violence, stigma, discrimination and coercion, that many people face even within health systems. We look at what kind of education and support they might need, including psychosocial support and other types. What kind of access to justice might people need?”

Self-care practices can hold enormous potential to improve people’s quality of life, helping to manage the burden of non-communicable diseases (NCDs) while helping to develop health systems’ sustainability and reduce increasing costs. 

One such way forward could be increased telemedicine, health-related services and information available via electronic devices and technologies. This allows longer-distance patient-clinician contact, care, advice, reminders, education, intervention, monitoring and remote admissions.

Academic Austen El-Osta gave examples to the panel, including the UK National Health Service, who, he told the audience, “bought a quarter of a million blood pressure monitors and distributed these to patients. These patients are effectively self-caring, releasing pressure from primary care and the health system. Of course, we’re all familiar with the many fantastic digital health apps and tools that we use and excellent med tech.

“The big question is how do we democratise access to self-care interventions and best practices?” El–Osta said. “We have the guidelines; we’ve got some anecdotal evidence. We’ve got a lot of work on NCDs and technology. So all of these are coming together now.”

Another example explored was how pharmacists could help unburden struggling health systems. 

“Often pharmacy and pharmacists are the patient’s first point of call in any healthcare inquiry that they have,” stated Mariet Eksteen, Global Lead for Advancing Integrated Services at Advancing Pharmacy Worldwide. “Pharmacists could be an exceptionally well-positioned resource to support the concept of self-care because we could assist patients with a rising level of health literacy as well as knowledge in their communities, which as a result, could also lead to increased levels of preventative care.”

Why a WHO resolution is needed

A WHO resolution on self-care, as opposed to guidelines, would provide the following:

• A framework for its integration into future economic and health policies.
• Promoting awareness.
• Political commitment.
• The mobilisation of resources.

There would then be better support for the UH2030 goals. 

Sandy Garçon, the founding director of the Self-Care Trailblazer Group, echoed calls for the WHO to work on the current guidelines, stating, “There needs to be the right kind of policies, the right kind of funding, and the correct type of programming. Many countries are already moving in this direction, but we need more.”

“We always welcome political and legal policy and standards framework that we can rely on to help us create that ecosystem we want,” agreed Kawaldip Sehmi, CEO of the International Alliance of Patients’ Organisations. “From patients of self-care first, then health professionals second. Now it’s time to take care of ourselves.”

Image Credits: Screenshot.