by Ian Askew, Director, Department of Reproductive Health and Research, including the UNDP- UNFPA- UNICEF- WHO- World Bank Special Programme (HRP), WHO, Geneva, Switzerland @IanAskew_HRP and Manjulaa Narasimhan, Scientist, World Health Organization (WHO), Geneva, Switzerland
Self-care interventions for health—including self-testing, self- diagnosis, self-management, self-medication, self-monitoring and self-educating—can transform health systems and accelerate progress toward universal health coverage. Promoting autonomy and agency through a person-centered approach recognizes people’s right to make decisions and take actions to safeguard their own health. This paradigm shift in healthcare and service availability is particularly important when stigma, inequality, discrimination and violence impede a person’s ability to access health services, medicines and technologies.
Too often, policy is divorced from practice, and up to 400 million people have no access to essential health services. This includes 214 million women in developing countries who want to avoid pregnancy, but are not using contraception; an estimated 22 million women who experience unsafe abortions worldwide each year; more than 1 million people who acquire sexually transmitted infections (STIs) every day; and an estimated 29 adolescents who are infected with HIV every hour. Furthermore, gender inequality limits access to quality health services and contributes to avoidable morbidity and mortality in both women and men. Innovative and cost-effective solutions to deliver safe and quality health interventions, medicines and biomedical and digital technologies are urgently needed. Self-initiated interventions are an exciting approach to advance sexual and reproductive health and rights.
The Sustainable Development Goals give the public health community the platform and the political mandate not just to improve health outcomes but to transform health systems. Increased autonomy can lead to people voicing their needs and making choices with regards to their healthcare, and not simply accepting the healthcare that providers decide they need.
WHO is committed to supporting greater autonomy to promote health and well-being. WHO’s first consolidated normative guidance on self-care interventions shifts its approach to healthcare from a primarily biomedical perspective to a more person-focused approach, initially in relation to sexuality and reproduction with evidence-based recommendations on interventions for maternal health, contraception, cervical cancer, fertility and STIs, including HIV and safe abortion. For countries and individuals worldwide, this shift can move the public health community from a disease prevention perspective to promoting a holistic approach to health and well-being.
This article appears in PSI’s Impact magazine, released in tandem with Women Deliver 2019, as part of an ongoing conversation about putting #PowerInHerHands.
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