Self-care: Transforming the relationship between individuals and health systems

By Amy Dempsey, Communications Officer, PATH

*Header image from PATH/Will Boase

Enabling people to manage their own health requires breaking down the barriers that keep them from accessing equitable and high-quality care throughout their lives. 

A crucial driver of achieving universal health coverage (UHC), self-care can create a world in which everyone everywhere has access to the basic integrated health products and services they need. It can reduce, and in some cases eliminate, barriers to care by enhancing convenience, privacy, and confidentiality. It can also make it easier for people to seek services and continue prevention and treatment measures when necessary.

In short, self-care transforms the relationship between individuals and health systems. That is the world we want. That is the world PATH is working toward by enhancing access to self-care innovations in three ways. 

Self-testing: Bringing services closer to home

In some settings, people may use convenient at-home tests for pregnancy, blood pressure, and glucose levels—and the COVID-19 pandemic prompted a new type of self-testing for a contagious and deadly virus. 

However, tests like these have not been widely available in all settings, so PATH is increasing access to self-testing for critical health issues. In countries including Brazil, India, Indonesia, Kenya, Uganda, and Ukraine, self-testing provides confidential, safe, and effective options for health issues like HIV, tuberculosis, viral hepatitis, sexually transmitted infections, and cervical cancer.   

Since the pandemic started, PATH has been supporting private sector partners like pharmacies and ecommerce sites to deliver COVID-19 self-testing services in Vietnam through the Healthy Markets project and working with state governments to decentralize self-testing for COVID-19 in India. These partnerships help maintain access to essential primary health care services at a time when health services at facilities are limited. By taking pressure off overburdened clinics, these self-care innovations can enable countries to maintain essential services in new ways while continuing to manage the COVID-19 pandemic.

Adherence support: Enabling better treatment and management 

Challenges with adherence to medication is common in low- and middle-income settings, which can be due to supply chain challenges, medication costs, or because patients have fewer supportive resources. And the resulting health impacts and costs for health systems is high because nonadherence can lead to higher rates of morbidity and mortality.

PATH is working to improve treatment and care by using digital adherence technologies to help treat tuberculosis in India and Ukraine along with other chronic conditions. We also increase access to pre-exposure prophylaxis for key populations at risk of contracting HIV, as well as integrating mental health support for people at risk for or living with HIV. These innovations expand the management of health care needs, giving a patient control of their own health care. 

Self-administration: Supporting women and girls’ sexual and reproductive health care 

As health systems contend with limited or siloed funding, scarce human resources, and pandemic crises, the need to focus on people-centered care has never been greater. PATH’s work in sexual and reproductive health is grounded in the belief that women and adolescent girls are the experts in their healthcare and should be equipped to make their own choices about their bodies. To transform that belief into reality, we advance products like the self-injectable contraceptive subcutaneous DMPA (DMPA-SC), the Caya® diaphragm, and the Woman’s Condom. Innovations like these can have a significant impact on women and girls’ lives by increasing their autonomy, improving their health outcomes, and strengthening health systems. 

Increasing access to self-care products for UHC

Supporting self-care as part of a comprehensive health system strengthening strategy improves access to medicines, enhances efficient use of domestic funding for health, and can lead to new health care innovations. Making more self-care products available, and enabling the systems required to support their use, is a key approach to progressing toward equitable primary health care and UHC

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