Self-Care and UHC: Paving the Road to Health Equity
By Sandy Garçon, Senior Communications Manager, Population Services International and Co-Chair, Global Advocacy and Communications Working Group, Self-Care Trailblazer Group
Less than a decade ago, the idea that most countries in the world would commit to working toward achieving universal health coverage (UHC) was seen as unlikely, and certainly not a primary objective of the global health community. Today, we face an entirely different landscape. Achieving ‘health for all’ by 2030 has become one of the most pressing priorities of countries in the 21st century. But meeting this goal will be challenging as half of the world’s population lacks access to essential health services.
The world is still in the grip of the COVID-19 pandemic, which has hit vulnerable populations particularly hard and further exacerbated pre-existing inequalities. This highlights the need for countries to take every opportunity to rebuild their health systems sustainably and more equitably.
Self-care can be part of the solution. Broadly defined as the ability to manage one’s own health with or without provider support, self-care has become in recent years more firmly embedded within the larger global health and development agenda. Over the course of our 12 Days of UHC celebration, members of the Self-Care Trailblazer Group (SCTG) have shared insights and lessons on how interconnected self-care and UHC are.
In the face of the pandemic-induced movement restrictions and significant disruptions to the supply of essential health services, self-care has shown great potential in alleviating pressure on providers and enabling individuals to take charge of their own health needs. Self-care offers the potential for the full range of prevention and treatment of health issues including sexual and reproductive health, noncommunicable diseases, and mental health. While self-care is neither a panacea nor a replacement for the health system, it is more than a stop-gap to the ongoing crisis; it is an essential part of holistic- and people-centered care that is central to UHC.
We in the SCTG are fond of saying that self-care is a critical component of any comprehensive and inclusive health program. As an overall approach, it has the potential to transform and make healthcare more accessible, equitable, and user-friendly. This is especially important for vulnerable populations, including women, girls, people living with disabilities, adolescents and young people, persons of stigmazed gender and sexual identities, rural populations, those in humanitarian situations, people living with HIV and sex workers.
Self-care provides underserved and underrepresented groups with a chance to access health literacy, contraception, HIV testing and prevention, among a growing number of innovative care options, in a discreet, confidential, and safe manner free from discrimination or stigma. This can take the form of self-injectable contraceptives that remove the need to see a provider and/or for third-party authorization from a parent or spouse. Or self-testing kits that allow the user to find out their HIV status when, where and with whomever they choose. It also allows people living with a chronic condition to better manage their health needs on a day-to-day basis while working in partnership with a health provider. As such, self-care can improve health equity by removing obstacles to care and increasing power over one’s own health and body—advancing equality and shifting current power norms.
While self-care has a crucial role to play in addressing the disparities in access and uptake of health services, much work remains to be done. Gaps in availability, quality, and affordability of self-care intervention persist.
It’s no accident that the respective themes for this year’s Human Rights Day (December 10) and Universal Health Coverage Day (December 12) center on health and rights for all.
The task now before national governments is to ensure that self-care is part of systematic policies, programs and practices that reach all people. A number of countries are already taking the steps to achieve just that. Nigeria and Uganda have developed national guidelines. But there is still work to do to ensure everyone, everywhere has access to UHC including self-care. This will start by policymakers in every country recognizing that self-care is an essential part of UHC and investing in health systems that provide access to evidence-based self-care approaches.
We at the SCTG will continue to advocate at global, regional, and country levels to ensure that decision makers see the value of self-care, include self-care as essential services in health systems, and fund it adequately. And, we encourage you to join in this self-care movement for UHC by becoming a member and self-care champion—starting today.