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By Farmata Seye, Program Associate, Self-Care project, PATH, Senegal; and Ida Ndione, Senior Program Officer, Noncommunicable Diseases, PATH, Senegal
The urgency of centering people as advocates for their own health has never been greater as health systems contend with the COVID-19 pandemic and other crises. Self-care has been receiving more attention as an approach to reduce pressure on strained health systems, reduce health access inequities, and improve health outcomes, particularly for the most vulnerable. Adequately supported self-care in areas including noncommunicable diseases (NCDs), sexual and reproductive health, and maternal and child health can help people manage their own health and enable systems to be better equipped to achieve universal health coverage (UHC).
Crucial to making self-care available is country stakeholder engagement and planning for policy and program integration. While self-care interventions already exist to some degree in many national health systems, a number of ministries of health have expressed interest in scaling up self-care in light of the pandemic and in response to the World Health Organization’s (WHO) Guideline on Self-Care Interventions for Health and Well-Being.
Senegal is one country leading the way to make this happen in Francophone Africa.
Building on global momentum, the Senegal Ministry of Health, PATH, and partners are working to advance self-care through policy action and partner coordination, increasing awareness and political will for self-care, and ensuring alignment among partners. With support from PSI and the Children’s Investment Fund Foundation, we started this work in 2020 with a series of consultative events to increase awareness of self-care, disseminate WHO self-care guidelines, and identify country-specific advocacy and learning priorities.
Out of this initiative a group was formed: the Self-Care Pioneers. Formally launched by the Ministry of Health, the Pioneers group comprises a spectrum of global and local stakeholders representing the government, civil society, nongovernmental organizations, youth groups, patient associations, and other groups.
The Pioneers lead communication, awareness-raising, and advocacy efforts to support the introduction and extension of self-care interventions within health care systems by:
Advancing Senegal’s national self-care guideline is central to the Pioneers’ work. This is among the first national self-care guidelines in the world, and first in Francophone Africa, alongside Anglophone countries such as Nigeria and Uganda. It serves as a key step toward adopting self-care as an approach to achieve universal health coverage.
In the past year, we have made great strides in the self-care guideline development. After months of work and discussion, in November 2021, more than 30 Pioneers group members gathered for a two-day workshop to validate the draft guideline. Once member feedback from the workshop is integrated, a revised draft will be presented to the Senegal Ministry of Health. Ultimately this document will serve as a critical component to inform our national self-care strategy and its implementation.
Along with a review of legal frameworks to facilitate self-care implementation, the guideline focuses on the following self-care components:
A significant focus in the guideline is NCDs—a major public health challenge with increasing prevalence in countries around the world, including Senegal. From the beginning of the guideline development process, Senegal health authorities and other Pioneers group members agreed that self-care interventions are critical for patients’ management of chronic diseases such as cancers, diabetes, cardiovascular and thromboembolic diseases, blood diseases, respiratory diseases, and renal failure. Self-care for these conditions can improve quality of life and reduce complications that contribute to significant strains on health systems. Some of the interventions for NCDs listed in Senegal’s draft guideline include: self-screening for early detection of breast cancer, self-monitoring of cervical cancer symptoms, self-monitoring of blood pressure, and self-management of asthma and home oxygen therapy. We are honored to have this opportunity to collaborate with the Pioneers. Our work together has been a great example of what can be achieved when a diverse group of stakeholders commits to building a more sustainable and effective health system—a symbol of progress toward achieving UHC. If you are interested in joining the Pioneers group or hearing more about our work, please contact [email protected] or [email protected].
Banner photo description: Members of the National Association of Senegalese Women Doctors who participated in the Self-Care Pioneers group’s national self-care guideline development workshop in Saly, Senegal.
Banner photo credit: Mamadou Sow
Par Farmata Seye, Associée de Programme, projet auto-soin, PATH, Sénégal ; et Ida Ndione, Chargée de Programme principale, maladies non transmissibles et auto-soin, PATH, Sénégal.
L’urgence de placer les individus en tant que défenseurs de leur propre santé n’a jamais été aussi grande au moment où les systèmes de santé doivent faire face à la pandémie de COVID-19 et à d’autres crises. L’auto-soin fait l’objet d’une attention accrue en tant qu’approche permettant de réduire la pression exercée sur les systèmes de santé mis à rude épreuve, de réduire les inégalités d’accès aux soins et d’améliorer les résultats en matière de santé, en particulier pour les personnes les plus vulnérables. Un appui approprié de l’auto-soin dans des domaines tels que les maladies non transmissibles (MNT), la santé sexuelle et reproductive et la santé maternelle et infantile peut aider les individus à gérer leur propre santé et permettre aux systèmes de santé d’être mieux équipés pour atteindre la couverture sanitaire universelle (CSU).
Pour rendre l’auto-soin possible, il est essentiel que les parties prenantes du pays s’engagent et planifient l’intégration des politiques et des programmes. Bien que les interventions d’auto-soin existent déjà dans une certaine mesure dans de nombreux systèmes de santé nationaux, un grand nombre de ministères de la santé ont exprimé leur intérêt pour le développement de l’autosoin à la lumière de la pandémie et en réponse aux directives de l’Organisation mondiale de la santé (OMS) sur les interventions d’auto-soin pour la santé et le bien-être.
Le Sénégal est l’un des pays qui montre la voie pour y parvenir en Afrique francophone.
En s’appuyant sur la dynamique mondiale, le ministère de la Santé du Sénégal, PATH et les partenaires s’efforcent de faire progresser l’auto-soin par le biais de l’action politique et de la coordination des partenaires, en augmentant la sensibilisation et la volonté politique en faveur de l’auto-soin, et en assurant l’alignement entre les partenaires. Avec le soutien de PSI et de la Fondation du Fonds d’investissement pour l’enfance, nous avons commencé ce travail en 2020 avec une série d’événements consultatifs pour accroître la sensibilisation sur l’auto-soin, diffuser les directives de l’OMS sur l’auto-soin et identifier les priorités de plaidoyer et d’apprentissage spécifiques au pays.
Un groupe a été créé à partir de cette initiative : les Pionniers de l’autosoin. Lancé officiellement par le ministère de la santé, le groupe des Pionniers comprend un éventail de parties prenantes mondiales et locales représentant le gouvernement, la société civile, les organisations non gouvernementales, les groupes de jeunes, les associations de patients et d’autres groupes.
Les Pionniers mènent des actions de communication, de sensibilisation et de plaidoyer pour soutenir l’introduction et l’extension des interventions d’autosoins au sein des systèmes de soins de santé :
L’avancement des lignes directrices nationales pour l’auto-soin du Sénégal est au cœur du travail des Pionniers. Il s’agit de l’une des premières directives nationales d’auto-soin au monde, et la première en Afrique francophone, aux côtés de pays anglophones comme le Nigeria et l’Ouganda. Elle constitue une étape clé vers l’adoption de l’auto-soin comme approche pour atteindre la couverture sanitaire universelle.
L’année dernière, nous avons fait de grands progrès dans l’élaboration du guide National pour l’auto-soin. Après des mois de travail et de discussion, en novembre 2021, plus de 30 membres du groupe des pionniers se sont réunis pour un atelier de deux jours afin de valider le projet du guide. Une fois les commentaires des membres de l’atelier intégrés, un modèle révisé sera présenté au ministère de la Santé du Sénégal. En fin de compte, ce document servira d’élément essentiel pour informer notre stratégie nationale d’auto-soin et sa mise en œuvre.
En plus d’un examen des cadres juridiques visant à faciliter la mise en œuvre de l’auto-soin, le guide National se concentre sur les composantes suivantes de l’auto-soin :
Le guide national met l’accent sur les MNT, un défi majeur de santé publique dont la prévalence augmente dans les pays du monde entier, y compris au Sénégal. Dès le début du processus de développement du guide, les autorités sanitaires du Sénégal et d’autres membres du groupe des pionniers ont convenu que les interventions d’auto-soin sont essentielles pour la gestion par les patients des maladies chroniques telles que les cancers, le diabète, les maladies cardiovasculaires et thromboemboliques, les maladies du sang, les maladies respiratoires et l’insuffisance rénale. L’autosoin pour ces maladies peut améliorer la qualité de vie et réduire les complications qui contribuent à peser lourdement sur les systèmes de santé. Certaines des interventions pour les MNT énumérées dans l’ébauche du guide National du Sénégal comprennent : l’auto-dépistage pour la détection précoce du cancer du sein, l’autosurveillance des symptômes du cancer du col de l’utérus, l’autosurveillance de la pression artérielle et l’autogestion de l’asthme et de l’oxygénothérapie à domicile.
Nous sommes honorés d’avoir l’opportunité de collaborer avec les Pionniers. Notre travail ensemble a été un excellent exemple de ce qui peut être réalisé lorsqu’un groupe diversifié de parties prenantes s’engage à construire un système de santé plus durable et efficace – un symbole de progrès vers la réalisation de la CSU. Si vous souhaitez rejoindre le groupe des Pionniers ou en savoir plus sur notre travail, veuillez contacter [email protected] ou [email protected].
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We support health systems in shaping the policy and regulatory environment for self-care interventions and ensuring self-care is included as an essential part of healthcare services.
