Self-Care Health Interventions - WHO Guidelines

Why in news?

The World Health Organisation (WHO) has recently launched its first guidelines on self-care interventions for health.

What is self-care?

• Self-care would mean the ability of individuals, families and communities to access health care with or without the support of a health-care provider.
• This may include promoting health, preventing disease, maintaining health, and coping with illness and disability.
• The practice of self-care has been there for long.
• But now, increasingly, there are new diagnostics, devices and drugs that are transforming the way common people access care.
• Self-care interventions are thus gaining more importance now than before.

What are the recent WHO guidelines on?

• In its first volume, the WHO guidelines focus on sexual and reproductive health and rights.
• Some of the interventions include -
  1. 1. self-sampling for human papillomavirus (HPV) and sexually transmitted infections
     2. self-injectable contraceptives
     3. home-based ovulation predictor kits
     4. human immunodeficiency virus (HIV) self-testing
     5. self-management of medical abortion

• Self-care neither replaces high-quality health services nor are they a shortcut to achieving universal health coverage.
• Instead, the guidelines look at the scientific evidence for health benefits of certain interventions that can be done outside the conventional sector.

What is the need for self-care?

• Millions of people, including in India, face the twin problems of acute shortage of healthcare workers and lack of access to essential health services.
• WHO reports that over 400 million across the world already lack access to essential health services.
• Also, around 1 in 5 of the world’s population could be living in settings that are experiencing humanitarian crises.
• Reportedly, there will be a shortage of about 13 million health-care workers by 2035.
• So, self-care offers the possibility to meet the health care needs with or without reliance on health-care workers.

What is the WHO’s observation?

• Self-help would mean different things for people living in very diverse conditions.
• For people of the upper strata who have easy access to healthcare facilities, self-help would mean convenience, privacy and ease.
• In contrast, for those living in conditions of vulnerability and lack access to health care, self-help becomes the primary, timely and reliable form of care.

• These include people who are negatively affected by gender, political, cultural and power dynamics and those who are forcibly displaced.

• Given this, the WHO recognises self-care interventions as a means to expand access to health services.
• So soon, the WHO would expand the self-help guidelines to include other self-care interventions.
• These could include prevention and treatment of non-communicable diseases.
• WHO is also establishing a community of practice for self-care, and will be promoting research and dialogue in this area.

Where does India stand in this regard?

• India has some distance to go before making self-care interventions for sexual and reproductive health freely available to women.
• Home-based pregnancy testing is the most commonly used self-help diagnostics in this area in India.
• Interventions also include self-managed abortions using approved drugs that can be had without the supervision of a healthcare provider.
• E.g. morning-after pills taken soon after unprotected sex, mifepristone and misoprostol taken a few weeks into pregnancy
• While the morning-after pills are available over the counter, the other two are scheduled drugs that need prescription from a medical practitioner, thus defeating the very purpose of the drugs.
• The next commonly consumed drug to prevent illness and disease is the pre-exposure prophylaxis (PrEP) for HIV prevention.
• India is yet to come up with guidelines for PrEP use and to include it in the national HIV prevention programme.
• The WHO has approved the HIV self-test to improve access to HIV diagnosis in 2016.
• But despite this, the Pune-based National AIDS Research Institute in India is still in the process of validating it for HIV screening.
• One of the reasons why people shy away from getting tested for HIV is the stigma and discrimination associated with it.
• In this context, the home-based testing provides the much-needed privacy.
• India has in principle agreed that rapid HIV testing helps to get more people diagnosed and opt for treatment, thus reducing transmission rates.

Source: The Hindu