Self-care for health and well-being

1 May 2024 | Questions and answers

WHO defines self-care as the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness – with or without the support of a health or care worker.

Self-care interventions can include medicines, devices, diagnostics and digital tools.  Self-care actions include practices, habits and lifestyle choices.

 

The WHO living guideline on self-care interventions for health and well-being includes recommendations on safe and effective interventions that should be used within a supportive enabling environment. The current recommendations cover interventions for

  • sexual and reproductive health and rights, including self-care options for improving antenatal, delivery, postpartum and newborn care;
  • providing high-quality services for family planning, including infertility services;
  • eliminating unsafe abortion;
  • combating sexually transmitted infections, including HIV, reproductive tract infections, and cervical cancer;
  • promoting sexual health; and
  • non-communicable diseases, including mental health, cardiovascular disease and diabetes.

Examples of self-care interventions include self-administered injectable contraception, self-collection of vaginal samples for HPV screening, self-monitoring of blood glucose for diabetes, including gestational diabetes; self-monitoring of blood pressure for heart disease and managing pre-eclampsia during pregnancy, and self-tests for a range of issues such as HIV, pregnancy and COVID-19. Further interventions will be regularly added to the global guideline as the evidence-base expands.

WHO’s conceptual framework on self-care interventions has core elements from both people-centred and health systems approaches, underpinned by the key principles of human rights, ethics, inclusivity and gender equality. The enabling environment includes elements, beyond health services themselves, that require attention to ensure that self-care interventions can be appropriately implemented. These include the education, justice and social services sectors, because self-care interventions are mostly accessed and/or used outside formal health services. For example, it is important for people to have enough education and sufficient health and sometimes digital literacy to understand information about self-care interventions and make informed choices about their use.

Self-care interventions provide individuals, families and communities with a way to manage their own health. They are intended as a complement to facility-based care and may require support from the health system in some instances. Some self-care actions, such as washing your hands, wearing masks and practicing good respiratory hygiene measures that protect you from COVID-19 do not need you to meet with a health or care worker. Other self-care interventions, such as obtaining a prescription for hormonal contraception or counselling during pregnancy, may need interaction with a health or care worker. Such support can be provided in different ways and will depend on the healthcare arrangements in place where you live; for example, some medicines are available over the counter without a prescription in a pharmacy, or counselling and important information during pregnancy and when caring for a newborn can be provided over the phone or online.

All WHO recommendations on self-care interventions are based on the best available evidence to date, including evidence of their safety and effectiveness when provided alongside support from the formal health system if needed. WHO does not recommend use of unregulated and substandard products. Incorrect or unclear health information or lack of access to health and care workers and/or health facilities, should they be needed, are potential challenges that need to be addressed when using self-care interventions.

In crisis settings, securing necessities such as food and shelter is the primary need. In addition, meeting people’s health needs by providing the right care at the right time can prevent or mitigate adverse health consequences. In situations where healthcare resources are scarce, self-care interventions can provide opportunities to access the appropriate care at the right time and complement limited access to facility based care. Evidence-based, high-quality self-care interventions can provide an important means of maintaining health when national health systems are disrupted and health facility or health and care worker-based services become unavailable or restricted in fragile or humanitarian settings.

In fragile and humanitarian settings, seeking and creating innovative approaches that increase efficiencies in provision, management, quality control and service integration could drive self-care interventions to becoming sustainable, accessible and effective healthcare options.

People may use self-care interventions for several reasons, including convenience, confidentiality, cost, empowerment, a better fit with lifestyle, or because they lack access to quality health services or anticipate facing stigma and discrimination. The self-care interventions and practices that WHO recommends are not intended to add to the daily workload and financial burden of individuals and communities, including those who may already be marginalized and underserved. For many self-care interventions to be effective, links to care and complementary support from the health system are essential. When integrated into health systems, self-care interventions may save money for users (including transport costs and loss of income when seeking facility based care) and health and care providers (under circumstances where complications and need for hospitalization are reduced). Blending direct user payment for self-care interventions with public subsidies and private-sector financing can help reduce large out-of-pocket expenditure on self-care for individuals and families.