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 -
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- self-sampling for human papillomavirus (HPV) and sexually transmitted infections
- self-injectable contraceptives
- home-based ovulation predictor kits
- human immunodeficiency virus (HIV) self-testing
- 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
