Self-care can be a key strategy in tackling the global crisis of non-communicable diseases that are responsible for three-quarters of premature deaths globally and 86 percent of early deaths (before age 70) in low- and middle-income countries (LMICs). Moreover, dentists, pharmacists and community health workers are trained professionals who can provide innovative forms of self-care advice and guidance – reaching communities and individuals that are often beyond the reach of mainstream medicine, noted experts at a recent Global Self-Care Federation (GSCF) webinar held in the leadup to September’s High-Level meeting on NCDs.

Through these groups, countries are finding innovative ways to deliver informed self-care knowledge and tools to individuals and commnunities, which could help prevent many NCDs related to unhealthy diets and lifestyles – as well as making other disease conditions easier to diagnose and treat.

“I think it is important that society understands that the healthcare profession consists of physicians, pharmacists, dentists, and the nursing sector. It’s not just a focus on one of those four groups,” explained Greg Perry, GSCF director general. He added that it is important to look at how community health workers and other skilled health professionals can work together with individuals to expand access to self-care tools and encourage their use.

Stimulating such innovation around self-care is critical as the global health community prepares for the 2025 Fourth High-level Meeting on NCDs in New York this September, said experts from Africa CDC, patients organisations and the private sector at the recent GSCF webinar.

Inconsistent progress on self-care issues

Progress on integrating self-care into broader global strategies on NCDs has so far been inconsistent. The World Health Organization (WHO) has published a series of guidance on self-care strategies in various domains.  But so far, neither the WHO Global NCD Action Plan (2013–2030), nor the NCD and Universal Health Coverage aims of the UN Sustainable Development Goals, have sufficient emphasis on self-care strategies, critics say. At the same time, the world remains far from reaching the goals for reducing NCDs set forth in the UN SDGs or WHO action plans, and health systems, particularly in LMICs, are struggling to meet the growing demand for NCD care. GSCF has highlighted that a siloed approach to healthcare has failed in many regions.

In a new policy paper, GSCF makes the case for prioritizing self-care as a central pillar of the global NCD response. In that context, it calls for three key actions: Member states need to recognise self-care as a vital tool for easing the global burden of NCDs and reduce pressure on healthcare systems, including formally integrating certain self-care tools and tactics into national health coverage plans. Secondly, the 2025 High Level Political Declaration on NCDs should explicitly highlight the role of self-care in reducing NCD risks and improving prevention and management. And thirdly, self-care should be acknowledged as essential to empowering individuals and improving health outcomes.

According to Orajitt Bumrungskulswat, a board member of the International Alliance of Patients’ Organisations, several barriers hinder the greater integration of self-care into NCDs management. These include a lack of knowledge and skills about NCDs and self-care practices. Financial constraints also play a role, limiting access to affordable, high-quality self-care products and services. In addition, many communities face insufficient health education and a lack of supportive environments, networks, and peer groups.

Thailand’s campaign for healthier habits

In Thailand, there are 6.5 million people living with diabetes, 40 million with high blood pressure, approximately 1 million with kidney disease at various stages, 140,000 cancer cases per year, and up to 10 million people dealing with mental health issues, Bumrungskulswat said, citing Ministry of Health estimates.

“This is mainly because of individual behaviours and because people are not really aware of how to practice self-care,” Bumrungskulswat said.

To change this trajectory, the ministry launched a campaign aimed at encouraging healthier habits—such as reducing salty, oily, and sugary foods and increasing physical activity – particularly in southern Thailand’s more urbanised regions, where unhealthy diets and sedentary lifestyles are more prevalent. The campaign includes distributing prevention guidelines on social media and in communities and strengthening support networks and patient groups. These groups now collaborate closely with professionals and local healthcare centres to promote prevention and self-care education. Thailand is already beginning to see the impact of these efforts, Bumrungskulswat said.

Ireland’s dentists take the lead

Expanding the network of care providers is also proving to be a key strategy in the fight against non-communicable diseases. Dr Dympna Kavanagh, chair of the Platform for Better Oral Health, shared how Ireland has leveraged its dental professionals to support this goal.

“Embedding oral health into wider self-care and prevention frameworks, we can achieve better outcomes, not just for individuals, but for healthcare systems, populations and societies as a whole,” Kavanagh said.

In Ireland, Kavanagh’s program has redefined the free dental examination for lower-income patients to include oral check-ups, risk assessments, and lifestyle advice. Payments for delivering these services were increased by more than 25% to reflect dentists’ expanded role.

“We do see that there has been an increase of over 8,000 patients attending per month seeking treatment since introducing this change,” Kavanagh said.

Advice on smoking cessation and vaccination in oral health exams

And the same oral health checkups also support other preventative health measures, he noted, pointing out that:  “Dentists remain amongst the top three healthcare professionals providing tobacco cessation advice in Ireland.”

According to Ireland’s “Healthy Ireland” surveys, smoking rates have plateaued at 17%.

In recent years, oral health professionals have also been empowered to take on a role in advocacy around vaccinations.

Vaccination, a critical component of self-care, became a focal point during the COVID-19 pandemic. Ireland achieved high vaccine uptake in part by passing emergency legislation that authorised dentists and hygienists to administer vaccines. This policy has since been made permanent.

Today, Irish dentists are also supporting HPV vaccination efforts, which play a crucial role in preventing oral – as well as cervical – cancers.

“In our population campaigns, we are fortunate to see an uptake of 80% in girls and 76% in boys,” Kavanagh said.

She emphasised the need to keep oral health front and center in discussions about NCDs: “We must continue to amplify oral health as part of the global NCD agenda. We must remind policymakers and governments that prevention doesn’t begin with policy alone and doesn’t end with policy alone. It begins with empowered individuals who are supported to care for their own health by reducing tobacco and alcohol use, improving their diets, accessing vaccination and maintaining consistent oral hygiene.”

Expanding access through pharmacies

Pharmacists are another group of caregivers who can play a vital role in guiding self-care strategies and choices, according to Mfonobong Timothy, Disease Prevention and Self-Care program coordinator for the International Pharmaceutical Federation (FIP). She explained that pharmacies are widely recognised as first-line healthcare providers—personal healthcare professionals who are knowledgeable and highly accessible.

“Pharmacists are also playing a crucial role in promoting the role of vaccination in good health and wellbeing,” Timothy said. “In 56 countries and territories, we now have pharmacy-based vaccination, and we continue to advocate for this to ensure policymakers know that this is a form of self-care that we can provide to individuals towards having good health and wellbeing.”

In addition to their role in vaccination, Timothy emphasised that pharmacists provide essential hands-on guidance for using medical devices—a key part of supporting patients in their daily self-care routines.

“Without the strong support system, individuals may not feel motivated,” Timothy noted.

Community Health Workers can support shift from treatment to prevention of NCDs

In some low and middle-income countries, there has been a shift away from the traditional medical model toward a community- or society-based model of care, often led by Community Health Workers. This shift is helping societies move from treatment toward prevention – and along with that, more informed self-care practices, explained GSCF’s Perry.

“In high-income countries, we have the drugs, we have the guidelines, we have the digital tools, yet we still see that healthcare-associated costs are increasing along with life expectancy,” said Dr Adelard Kakunze, lead for the NCDs, Injuries and Mental Health Program at the Africa CDC. “The question is why? Why, if we have all the knowledge and tools, are we not able to really control these conditions?”

Kakunze believes the answer lies in the lack of personal engagement with self-care. In most countries, he said, health systems have failed to encourage citizens to practice the daily discipline required for self-care—what he describes as the “invisible work” that begins after the clinic door closes. This can include checking one’s blood pressure, adjusting one’s diet, or going for a walk – before resorting to drug-based treatments.

In Africa, however, this approach is gaining traction, he maintains. With limited access to specialists and resources, countries on the continent have been forced to innovate. At the core of this innovation is community. Kakunze noting that many African countries have strong networks of community health workers (CHWs), embedded in nearly every neighbourhood.

“We have learned that those specialized services are too expensive, so we need to rely on communities,” he said.

“We also now have a political commitment to deploy and equip 2 million community health workers on the continent, and what we’ve been seeing in many countries [is] that they have really embraced this with a contextualized, adapted training curriculum now that integrates NCDs,” he said. “Now, those community health workers can screen, counsel, and follow thousands of patients at home.”

Examples in mental health

In the mental health arena, one example is the Friendship Bench project, developed in Zimbabwe and cited by recent WHO guidance as a global model of community-based mental health support.

Using a cognitive behavioural therapy-based approach, trained community volunteers—affectionately called “grandmothers”—deliver structured problem-solving therapy to people suffering from common mental health conditions like anxiety and depression. Patients meet with the grandmothers for six 45-minute sessions on discreet wooden benches at local clinics, creating a safe and welcoming space for healing.

Since its launch, the Friendship Bench has shown impressive results. A 2016 study published in JAMA found a significant reduction in depressive symptoms amongst participants. The model’s success has inspired adaptations beyond Zimbabwe, including in Malawi, Zanzibar, and even New York City—showing how solutions developed in low-income countries can transform mental health care around the world.

More recently, community health workers have been paired with primary healthcare centres or general practitioners who can provide supervision and standardised health checklists.

“We have seen the impact of those community health workers when they are supervised; the impact is really increasing a lot,” Kakunze said.

Looking ahead, the Africa CDC is now exploring the use of advanced technologies and tools to support community health workers and enhance their effectiveness.

Kavanagh echoed similar sentiments. She noted that Europe has taken a “very siloed, very narrow” approach to the healthcare workforce, defining it strictly as doctors, dentists, pharmacists, and nurses. She suggested countries should also consider tapping into their ageing populations to broaden that workforce.

“Talented people retire, and then the country loses their wealth of knowledge,” she said.

Kavanagh also proposed that older medical professionals could be engaged to play a meaningful role in community healthcare, helping fill workforce gaps while contributing valuable experience.

Private-sector partnerships

Finally, experts say the private sector also has a vital role to play in advancing self-care.

Dr Vinayak Mohan Prasad, head of the No Tobacco Unit at WHO, noted that there are 1.25 billion tobacco users worldwide—and more than 60% of them want to quit. To address this, WHO established a consortium that brings together private companies, non-state actors, and state actors to collaborate on tobacco cessation.

“We have a pharma pillar, so all the pharma companies can come in. We have a digital tech pillar, and we have a couple of very powerful tech companies already in the consortium,” he said. “We also have a health system group. We have the research group because there are a lot of research gaps still existing.”

This collaborative model is being applied beyond tobacco control. Tamara Rogers, chief marketing officer for Haleon, highlighted how private and public actors can also partner to improve access to healthcare.

She explained that while private industry can drive innovation and develop affordable health products and solutions, non-governmental organisations can play a key role in ensuring these tools reach the people who need them most.

“I think building trustful, stable, multi-year partnerships is really pivotal in making sure that we can best maximize all of the collective resources, expertise and innovation,” Rogers said.

–Part of a supported series in collaboration with the Global Self-Care Federation

Image Credits: Caroline LM/ Unsplash, Wikimedia Commons, Cecille Joan Avila / Partners In Health, Sarah Johnson.