Overview

Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems perspective and for people who use these interventions.

The World Health Organization (WHO) uses the following working definition of self-care: Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker. The scope of self-care as described in this definition includes health promotion; disease prevention and control; self-medication; providing care to dependent persons; seeking hospital/specialist/primary care if necessary; and rehabilitation, including palliative care. It includes a range of self-care modes and approaches. While this is a broad definition that includes many activities, it is important for health policy to recognize the importance of self-care, especially where it intersects with health systems and health professionals.

Worldwide, an estimated shortage of 18 million health workers is anticipated by 2030, a record 130 million people are currently in need of humanitarian assistance, and disease outbreaks are a constant global threat. At least 400 million people worldwide lack access to the most essential health services, and every year 100 million people are plunged into poverty because they have to pay for health care out of their own pockets. There is an urgent need to find innovative strategies that go beyond the conventional health sector response.

While “self-care” is not a new term or concept, self-care interventions have the potential to increase choice, when they are accessible and affordable, and they can also provide more opportunities for individuals to make informed decisions regarding their health and health care. In humanitarian settings, for example, due to lack of or limited health infrastructure and medical services in the crisis-affected areas, self-care could play an important role to improve health-related outcomes. Self-care also builds upon existing movements, such as task sharing, which are powerful strategies to support health systems.

Contents

• PREFACE
• FOREWORD
• ACKNOWLEDGEMENTS
• ACRONYMS AND ABBREVIATIONS
• Document Overview and Navigation Tools
• EXECUTIVE SUMMARY
• 1. Introduction
  • 1.1. BACKGROUND
  • 1.2. OBJECTIVES
  • 1.3. LIVING GUIDELINE APPROACH
  • 1.4. DEFINITION OF SELF-CARE AND SELF-CARE INTERVENTIONS
  • 1.5. SCOPE
  • 1.6. TARGET AUDIENCE
  • 1.7. VALUES AND PREFERENCES
  • 1.8. GUIDELINE DEVELOPMENT AND COMPILATION PROCESS
  • REFERENCES FOR CHAPTER 1
• 2. Essential strategies for creating and maintaining an enabling environment for self-care
  • 2.1. BACKGROUND
  • 2.2. PEOPLE-CENTRED APPROACH FOR HEALTH AND WELL-BEING
  • 2.3. KEY PRINCIPLES
  • 2.4. SAFE AND SUPPORTIVE ENABLING ENVIRONMENT
  • 2.5. CHARACTERISTICS OF THE ENABLING ENVIRONMENT
  • 2.6. PLACES OF ACCESS TO SELF-CARE INTERVENTIONS
  • 2.7. ACCOUNTABILITY
  • REFERENCES FOR CHAPTER 2
• 3. Recommendations and key considerations
  • 3.1. IMPROVING ANTENATAL, INTRAPARTUM AND POSTNATAL CARE
  • 3.2. PROVIDING HIGH-QUALITY SERVICES FOR FAMILY PLANNING, INCLUDING INFERTILITY SERVICES
  • 3.3. ELIMINATING UNSAFE ABORTION
  • 3.4. COMBATING SEXUALLY TRANSMITTED INFECTIONS (INCLUDING HIV), REPRODUCTIVE TRACT INFECTIONS, CERVICAL CANCER AND OTHER GYNAECOLOGICAL MORBIDITIES
  • 3.5. PROMOTING SEXUAL HEALTH
  • 3.6. NONCOMMUNICABLE DISEASES, INCLUDING CARDIOVASCULAR DISEASES AND DIABETES
  • REFERENCES FOR CHAPTER 3
• 4. Implementation and programmatic considerations for self-care interventions
  • 4.1. BACKGROUND
  • 4.2. HUMAN RIGHTS, GENDER EQUALITY AND EQUITY CONSIDERATIONS
  • 4.3. FINANCING AND ECONOMIC CONSIDERATIONS
  • 4.4. TRAINING NEEDS OF HEALTH WORKERS
  • 4.5. POPULATION-SPECIFIC IMPLEMENTATION CONSIDERATIONS
  • 4.6. DIGITAL HEALTH INTERVENTIONS
  • 4.7. ENVIRONMENTAL CONSIDERATIONS
  • REFERENCES FOR CHAPTER 4
• 5. Developing the research agenda for self-care interventions
  • 5.1. RESEARCH ON SELF-CARE AND SELF-CARE INTERVENTIONS CONTRIBUTING TO THE WORLD HEALTH ORGANIZATION’S TRIPLE-BILLION GOALS
  • 5.2. TOWARDS AN APPROPRIATE APPROACH TO RESEARCH ON SELF-CARE INTERVENTIONS
  • 5.3. SPECIFIC RESEARCH CONSIDERATIONS TO STRENGTHEN THE EVIDENCE BASE
  • 5.4. CENTRING HUMAN RIGHTS AND EQUITY IN SELF-CARE INTERVENTIONS
  • 5.5. ENSURING THE MEANINGFUL ENGAGEMENT OF COMMUNITIES IN RESEARCH
  • 5.6. KNOWLEDGE TRANSLATION FOR SELF-CARE INTERVENTIONS
  • REFERENCES FOR CHAPTER 5
• 6. Dissemination, applicability and updating of the guideline and recommendations
  • 6.1. DISSEMINATION
  • 6.2. APPLICABILITY
  • 6.3. UPDATING THE GUIDELINE
  • REFERENCES FOR CHAPTER 6
• Annexes
  • ANNEX 1. EXTERNAL EXPERTS AND WHO STAFF INVOLVED IN THE PREPARATION OF THIS GUIDELINE
  • ANNEX 2. METHODOLOGY: GUIDELINE DEVELOPMENT PROCESS
  • ANNEX 3. SCOPING REVIEW: WHO SELF-CARE DEFINITIONS
  • ANNEX 4. GLOSSARY
  • ANNEX 5. SUMMARY OF DECLARATIONS OF INTEREST AND THE MANAGEMENT OF CONFLICTS OF INTEREST
  • ANNEX 6. PRIORITY QUESTIONS AND OUTCOMES
  • ANNEX 7. PUBLISHED REVIEWS
  • ANNEX 8. GUIDELINE DEVELOPMENT GROUP JUDGEMENTS ON NEW RECOMMENDATIONS
• Web Annex. GRADE Tables

Suggested citation:

WHO guideline on self-care interventions for health and well-being. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.

General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use.