A step towards health equity

In a recent perspective article published in Natural medicineResearchers explored the potential of self-care interventions to improve the health and well-being of girls and women to promote equity, gender equality and human rights.

Study: Self-care interventions for women’s health and well-being. Image Credit: PeopleImages.com – Yuri A/Shutterstock.com

Background

Everyone has the right to good health, but it is estimated that half of the world’s population lacks access to essential health services.

Women are often disproportionately affected, with many living in poverty or beyond the reach of public health systems, and therefore unable to afford health care.

Those who have been displaced by war or conflict, living with human immunodeficiency virus (HIV), are incarcerated or institutionalized, are homeless, or belong to indigenous communities or other minority groups are particularly vulnerable.

Importance of self-care interventions

The coronavirus disease 2019 (COVID-19) pandemic has demonstrated how to prioritize access to self-care interventions, including distribution of contraception without the need for prescriptions or telehealth services for women pregnant, could allow women to take control of their health.

Although these interventions were launched during a global crisis, experts are calling for their integration into routine health care to promote women’s health and well-being in supportive and safe environments.

To this end, the World Health Organization (WHO) has developed evidence-based global guidelines, emphasizing the importance of self-care interventions alongside facility-based health services in all economic contexts, with frameworks and detailed monitoring indicators.

The building blocks of this system are institutions, organizations, health workers and resources that come together to ensure protection from financial and social risks, responsive services, improved efficiency and equitable and better health outcomes. .

Integration into traditional health care

Long before modern formal health systems existed, people engaged in various forms of self-care to manage illness or disability, maintain good health, or prevent disease; they continue to do so either alone or with the support of family or health workers.

Their practices vary depending on the context and are influenced by their social environment, their capacity for action and their knowledge about health, as well as the information to which they have access.

Increasing health literacy can mobilize communities and improve citizens’ ability to take charge of their health.

Effective self-care interventions strengthen health services that support communities across the lifespan and address determinants of health beyond curative care. This is done through a people-centered approach, whether people are caring for themselves or others.

People should be able to access relevant information and technologies, and interventions should be inexpensive and effective. Health personnel should be trained to promote self-care through capacity building and skills-based training.

Some promising areas of intervention concern reproductive and sexual health, mental health, chronic diseases and COVID-19. Noncommunicable diseases can be significantly reduced through self-care strategies, including physical exercise, a low-sodium, heart-healthy diet, avoiding obesity, and avoiding smoking.

Self-injectable contraceptives are another cost-effective strategy in remote rural areas, as women do not need to travel to distant health facilities and enjoy greater privacy and freedom of choice. act; once trained, they can practice this form of self-care with minimal support from providers.

Self-testing for HIV and other sexually transmitted infections has also enabled many women to know their status and seek treatment.

Barriers to effective self-care

It is critical to ensure that interventions increase access among underserved communities and reduce inequities rather than reinforce existing power structures.

Different age groups may require different advice; for example, older women may suffer from interrelated conditions, including hypertension, diabetes, and arthritis, each of which requires distinct actions.

The costs of interventions with users must also be considered. If access to an intervention involves out-of-pocket costs, efficiency and equity can be improved by instituting financial protection or subsidy programs.

Beyond the healthcare system, affordability is also a challenge. For example, low-income mothers may not be able to afford a healthier diet consisting of fiber, vegetables and fruits. Menstrual management also involves costs such as purchasing menstrual cups, tampons and sanitary napkins.

Due to inadequate promotion, female condoms have not been widely used despite their demonstrated effectiveness. efficiency. In parts of Senegal, Nigeria and India, knowledge related to emergency contraception is limited and many respondents believe prescriptions should be required to access it.

Women’s healthcare decisions continue to be affected by social stigma, including the blame and judgment that young women face due to their sexual activity, which can prevent them from accessing HIV testing. pregnancy.

Similarly, there is a lack of awareness about the sexual health of older women, particularly as it relates to menopause, which can lead to stigma and suboptimal care. In the United States, access to abortion has become a politically charged issue.

Conclusions

Self-care interventions have the potential to disrupt and strengthen traditional health systems, thereby improving outcomes for women and other underserved populations.

They are not intended to replace the care provided in establishments but rather to complement them. However, we must ensure that these interventions reduce inequalities rather than exacerbating them.