For “Nundy,” a mother of two living in South Africa’s Khayelitsha township, going to the doctor more than once a year is not an option.

She would have to pay 50% of her total household income in a month in order to see a doctor, so she saves up all of her medical questions and then makes one appointment, at which she tries to collect as much information as possible to take care of her 18-year-old son, two-year-old daughter and ailing mother.

In the meantime, she buys over-the-counter health products and tries to treat her families ailments herself.

“She told us a story of having many products and she told us all the ways she used them. And she was not sure what their expiry date was or exactly what they were for … but she knew she had to do something,” said Manoj Raghunandanan, global president of self-care and consumer experience at Johnson & Johnson.

He met Nundy a few years ago during a visit to the area.

Raghunandanan was speaking Wednesday at the launch of the Global Self-Care Readiness Index (SCRI) 2.0, the kick-off session of the Global Self-Care Federation World Congress 2022, which runs until Thursday.

“She was a consumer that deserved better,” Raghunandanan said, “someone that deserved access, affordability and the right to take care of herself, her family and her loved ones in a responsible way.”

How to improve self-care health policies and practices for people like Nundy was the topic of the congress and the focus of the SCRI report, which is published by the Global Self-Care Federation (GSCF).

The index is 89 pages long and covers 10 additional countries, which supplements the original set of countries examined in the 2021 edition and covers at least one from each of the World Health Organization’s (WHO) six regions: Africa, the Americas, Southeast Asia, Europe, the Eastern Mediterranean, and Western Pacific.

The index is supported by the WHO and forms part of the working plan between itself and GSCF. It aims to arm healthcare decision-makers and professionals with the data they need to increase self-care in their own countries and around the world.

Regulatory environment

The self-care industry has sometimes come under fire for making far-fetched claims about products to encourage people to spend money on things that don’t work, but GSCF director-general Judy Stenmark said that is something her organization is working to fix.

“Consumers become aware of the products or activities mainly through marketing and advertising, especially online,” she told Health Policy Watch. “We must ensure that we continue with our self-care literacy education efforts, especially in the digital sphere, including product guidance and e-labelling.”

SCRI 2.0 highlights the regulatory environment as one of the key enablers of self-care, advising countries to “focus on regulations and processes governing approval of new health products, from prescriptions to over-the-counter medications.”

Stenmark also stressed that while some people think of self-care as providing consumers with over-the-counter medicines, it is a multi-dimensional concept, which encompasses different notions, starting from self-medication to maintaining a healthy diet and raising health literacy levels.

WHO resolution by 2025

In order to help persuade policymakers of the importance of self-care, GSCF is working to have a self-care resolution adopted by WHO by 2025, something Stenmark said would provide a clear articulation of self-care and outline the value for health systems, governments and a people-centered care network.

It would also help facilitate member states’ development and effective implementation of national self-care strategies and provide them with direction on aligning resources.

“If we pass a resolution, things start to change, and then we get self-care embedded in policy,” she stressed. “That is why we want a WHO resolution. We want to build the political wheel for self-care.”

Socio-economic benefits

Currently, half the world lacks access to adequate healthcare, according to Dr Bente Mikkelsen, WHO’s director of non-communicable Diseases, who spoke at the beginning of the launch event.

According to the SCRI report, the sector could be improved by increased support and trust of self-care behaviors and products by healthcare providers, patients, consumers and regulators; increased health literacy; and policymakers’ recognition that self-care has economic value.

Low- and middle-income countries, often plagued by disease, have the highest potential to benefit from self-care policies.

Africa faces the “largest and biggest disease burden of all the regions in the world,” said Skhumbuzo Ngozwana, Chief Executive Officer of Kiara Health in South Africa. Some 90% of malaria deaths take place on the continent, tuberculous is still common and there is a “burgeoning and exploding” non-communicable disease problem,  Ngozwana said.

“Clearly Africa has a major problem,” he said. “All of this is in the context of significant infrastructure challenges, constrained budgets and that less than 3% of global healthcare workers are deployed on this continent. If people have to spend 50% of their monthly income on doctors, it makes it impossible.”

GSCF has also put out a supplementary report, Global Social and Economic Value of Self-Care,  which shows the potential socio-economic benefits of self-care around the world and specifically in sub-Saharan Africa.

If proper self-care policies were put into practice, the report showed, it would represent a $4 billion savings on annual healthcare costs in sub-Saharan Africa by 2030. Moreover, it could save individuals a collective 513 million hours in time savings and physicians 44 million hours. It would also reduce welfare spending by $31.5 billion.

Globally, the numbers are even greater: $179 billion in healthcare cost savings and $2.8 trillion in welfare spending.

“Self-care integration has significant long-term economic benefits for health budgets and health systems in general,” GSCF told Health Policy Watch. “Integrating self-care into the healthcare continuum allows for better resource allocation, alleviates burden placed on health systems, and ultimately improves the quality of care provided.”

Image Credits: The Global Social and Economic Value of Self-Care report, Screenshot.