Good nutrition & healthy eating is one of the most fundemental pillars of self-care. More work should be don in that space to promote vitality in ageing
hi all, I am Dr Elise Dallas, I am a GP working within Babylon Health, a digital first healthcare service provider
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There seem to be four potential overall benefits:
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Economic (fair bit of emerging evidence around savings in terms of less trips to the doctor, savings to govts of OTC prescriptions)
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Innovation thrives - use of big data and tech to help solve challenges - as seen with online/AI triage and GP appointments or Apps that can track blood sugar levels and heart rates, or 3D printing for orthotics etc etc;
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Equality - reaching those who may not normally come to a health-care setting - from adolescent girls needing contraception in refugee camps to elderly people during COVID-19 who have been able to receive care in the safety of their own homes
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Empowerment - increased knowledge and awareness of you and your communities health will result in healthier choices and outcomes.
Do you agree with these four? Are there any others?
Global health systems are under unsustainable pressure. An aging population, an increasing number of lifestyle-related diseases, and rising costs are inhibiting healthcare access for more and more people, leaving the worldâs underserved communities vulnerable and taking a particularly hard toll on women and children. Expanding access to self-care builds a healthier future for the next generation, lowers costs, and offers a lifeline to communities where self-care is both the first and last option for healthcare.
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A1: Self-care is the boldest expression of a paradigm shift in healthcare, one COVID has certainly accelerated. This supports individuals to exercise greater autonomy and control in meeting their health needs. While there is so much to say about this, and of course there are pitfalls, Iâd like to highlight two essential benefits at the individual and health systems level:
First, at the âindividual levelâ self care increases coverage and access particularly for stigmatized services and populations. HIV Self Testing is a great example to reach people at high risk for HIV who may not otherwise test, such as sex workers and men. To give a practical example, a range of donors and partners in an initiative called [STAR] (https://www.psi.org/project/star/) have distributed nearly 5m test kits across southern Africa with a large % increase in people now knowing their status. This same acceleration is happening in contraceptive and STI services, such as self-injection and HPV self-sampling. This wonât serve every need. But it serves many needs.
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If we focus on the nutrition side of Self-care interventions, the benefits are many and wide. Take for example what may be an extreme of self-care as relating to the prevention, early detection, and treatment of a serious disease such as Acute Malnutrition.
Half a decade ago, a field study in Niger revealed that interventions in which the diagnosis of acute malnutrition was made by the parents, being provided guidance and a Middle upper arm circumference tape (MUAC) to regularly monitor nutritional status of children under five, yielded not only savings on personnel but affected the most important indicators for a programme: i.e. average MUAC at admission (marker of how early cases are detected and admitted in the programme) reduced default in the programme and improved cure rate and needing less hospitalisation. https://www.alima-ngo.org/uploads/ef0dadb70ce22a1674dc2c12747bac02.pdf
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Absolutely. Self-care can help individuals prevent, self-manage or delay the appearance of many diseases. Through self-care, please can live longer & healthier life and remain productive & vital well into old age. Self-care can also vastly improve the quality of life of individuals.
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HERproject is rolled out in the form of a womenâs empowerment workplace program (covering personal health, gender and financial inclusion). We work in industries that employ primarily women and, in line with the composition of the workforce, our primary beneficiaries are low-income women. Our experience highlights that a healthy, empowered and financially included workforce not only increases the personal self-esteem, knowledge and access to products and services of our beneficiaries but contributes to workplace performance and productivity. Hereâs a quick snapshot of the business and individual benefits reported from our health program (HERhealth): 
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A1. The COVID-19 pandemic has called into focus the resilience and sustainability of countriesâ health systems and economies as an overriding global priority. We have seen that health systems have been overwhelmed and that some health services were simply not provided or disrupted. In this context, self-care is not an option but a must.
Self-care has great potentials and contributes to increase participation and empowerment to individuals and patients. It helps improve their health and better manage their wellbeing. Self-care has benefits throughout peopleâs journeys: from taking pro-active decisions and actions to protect health and wellbeing to cure or disease management.
Practicing self-care could also have great impacts on mental health; by taking care of ourselves, we are also more aware of our own self which could result to self-improvement, self-confidence and self-accountability.
A study from Deloitte has shown that global health care expenditures are expected to continue to rise as spending is projected to increase at an annual rate of 5.4 percent between 2017-2022, from USD $7.724 trillion to USD $10.059 trillion. To remain sustainable, we need a new model when it comes to healthcare management. Self-care should be part of this new model or paradigm that will help reduce expenditures and âunclogâ health systems. The NHS stated that more than 51 million âunnecessaryâ GP visits occur each year. A study conducted by BlueCross Blue Shield of Massachussetts compared two groups: one group who received a DecisionCare Guide and a second group who did not. The results of the study showed a significant decrease in emergency room visits for the group who received the guide. Savings for the economy and the patient are significant.
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And at the health systems level⌠self-care supports more efficient use of health resources. This doesnât just mean cost savings for a Ministry of Health or individuals; it means health providers are not over stretched and are making the most of their skills and time. I should add, encouraging self care among physicians themselves is also an important piece of a strong health system!
Around 90% of the $3.5 trillion that is spent in the US on healthcare is attributable to chronic conditions â diseases like diabetes, hypertension, obesity, and various cancers. Though chronic diseases are largely preventable through approaches associated with self-care. Four risk factors â (1) eating a nutritious and balanced diet, (2) engaging in regular physical activity, (3) not smoking, and (4) avoiding excess alcohol â underpin the majority of the chronic disease burden. These self-care activities also promote mental health and resiliency. The challenge is that changing behaviors to promote health, well-being, and self-care over the long-term is hard to sustain. In fact, a series of personalized technologies are emerging to help enable self-care in this regard.
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I agree @AliceAllan.
Individuals can also get faster access to effective treatments if they donât need to wait for a GP appointment.
Babylon is on a mission to put an accessible and affordable health service in the hands of every person on Earth. According to the World Health Organisation, half the world lacks access to essential health services, we have an ageing population, increasing chronic diseases and limited numbers of doctors and medical resources healthcare. By giving people the tools in which to self care by making it accessible and affordable we start to see a transformation in the health of that individual and in turn the communities and the impact on the economy.
Self care meaning:
Lets first consider what we mean by self care. From our perspective, self-care includes anything an individual can do to manage their needs without requiring clinician interaction.
Self-care is considered to be a valid way of delivering care as it is convenient for patients and it can fit better with their values and lifestyle.
Individuals may self care when they are healthy (health care) or when they are sick (sick care).
In the Health Care Model an individual will seek selfcare through self awareness. Individuals want advice about healthy living but are not sick at the time e.g. they may want cholesterol or BP checked or they have turned 50 and feel they need âa MOTâ. Many of these can be delivered through self-care but it would be helpful if this could feed into their medical records.
In the Sick Care care model individuals may have symptoms and start the self care journey through Self examination or self testing where patients conduct their own private tests. They may begin to Self monitor their sleep, mood or their chronic disease (this has been explored by a number of researchers who have concluded that self-care works well in self-monitoring). Individuals often self-diagnose but this only works if the patient trusts the mechanism through which the diagnosis was made. Self-diagnosis can occur through - symptoms checker, searching the internet, previously had the condition, friends and family. And finally, self treatment where patients consult self treatment guides and get over the counter treatments.
Model of Healthcare that we have:
Secondly, to see why self care benefits the individual and the economy we need to consider the model of âhealthcareâ that we have. This healthcare model is not working or sustainable. Every healthcare system currently works within a sick care model. At Babylon, everything we do is to serve what we believe is one of the worldâs most important poorly met need: accessible and affordable healthcare for every person on earth. Healthcare systems around the globe often fail to meet this need, because they are organised in disjointed silos to provide expensive emergency sick care, and they do so by and large in non-replicable, un-automated, inefficient ways. To put it simply, most systems wait until things go wrong, and then manage sickness, emergencies and crises, with a corresponding âpay for service modelâ that incentivises the âsick-careâ system.
The basic insight around which we built Babylon was that if we provided high-quality access and managed someoneâs health better upstream, they would consume less sick-care downstream, where most of the expense resides. The solution we want to champion globally is to take responsibility for a personâs healthcare end-to-end, so we can afford to provide a higher quality of care and access early to reduce the incidence of emergency or complication later to save cost. We call this âWe call this digital-first careâ. This is known in the healthcare sector as Value Based Care. Our familiar Circle of Care was designed from the very start of Babylon to deliver every component of a value-based solution.
Our entire model is built on enabling a patient to self care and we have always seen it as an essential part of the healthcare continuum, encouraging people to look after their own health as well as bringing the first point of contact with the healthcare system closer to the person and their community.
This approach of treating down stream - where you fix or prevent the health problem before it becomes a bigger more expensive problem then this reduces pressure on strained health systems, improves individual health outcomes and empowers individuals and communities in the process.
Benefits to individuals:
By treating upstream - we can prevent people becoming sick or improve their chronic conditions so that their individual health outcomes the best they can achieve and empower individuals to manage their health.
Self-care also offers a global opportunity to increase vulnerable populations access to healthcare - whether be they low income families struggling to afford healthcare services in developed nations or those unable to access basic healthcare services in low resource communities or during humanitarian crises.
Economies:
If you treat the problems upstream this will save on treating the expensive downstream costs of a crisis or emergency. We built a company to deliver that contrarian insight. By treating upstream this approach can reduce pressure on strained health systems, communities in the process. This is the only way to make healthcare sustainable.
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When it comes to healthcare, so many think of it as going to the doctor to treat an illness or get a check-up. Or having to go to the hospital. But really taking care of your health happens every day â thatâs self-care. Itâs eating right, exercising and not smoking to protect your heart. Itâs eating nutrient-rich food and taking supplements to keep your immune system healthy. Itâs taking proper care of yourself if you are pregnant, including taking micronutrients, since being a healthy mom-to-be will help give your baby the best start in life.
Making the economic case for self-care is vitally important, but there is increasing awareness that the return on investment potentnial of self-care interventions is not just in reducing costs fromthe health systemsâ persoective. Thepotential return on ivestment potentnial (ROI) from self-care can be huge - particulary in imprvein wuality of life.
For individuals, the benefits of self-care are clear: being able to fulfill oneâs life goals, mission, and purpose. This means that every individual has the opportunity to feel well, inspired, and lead a meaningful and productive life. Healthy people are also more creative and resilient, which forms the bedrock for the creation of healthy societies.
Personal benefits are often documented with our endline evaluations. For the sake of this conversation, here are several quotes to illustrate the individual benefits (including one to mark the Global Handwashing Day):
âI know women who have made big changes based on the training or on what we have told them. One of my sisters used to live near my house. My sister was always in a hurry when she arrived home from work, so she never washed her hands before feeding her baby.â
âMuslima Khatun, Peer Educator (India)
The challenge that I faced is that I did not know how to use family planning. I just heard people talking about it, but I had not started using it. I heard that at times it might harm you, at times it might react with your body, sometimes you cannot see your period completely. So I went for advice.
When I went to those who had been taught, the peer educator explained to me how I can use family planning safely. She told me that I could go and ask my doctor, and that my doctor would recommend the right method I could use. I didnât want to take the pill because I was afraid of forgetting to take it daily, so I went for the injection. My first-born is one year old now, and I have not had any more children because I am using family planning.
Iâm now a free lady. Thanks to this training, Iâve learned how to live my life without giving birth every year. I can now plan for my life, can plan when I want to have a child.
Emily Adhiambo Odongo, Peer Educator (Kenya)
How does Babylon enable self care?
Examples of effective self care interventions are the fundamental core of Babylonâs model of care -our suite of AI and monitoring products, including symptom checking, health assessments and care plans enable self care whether ill or well â âin sickness and in healthâ. At Babylon, we believe thereâs a way of delivering all of this thatâs better ,more affordable, and more satisfactory, both in terms of clinical outcome and patient experience. We call it a digital-first model of healthcare delivery, which starts with Artificial Intelligence which provide a means to self care, and then only if needed we connect that individual to a clinician virtually and if clinically necessary arrange physical examinations and intervention.
This approach of treating upstream - where you fix or prevent the health problem before it becomes a bigger more expensive problem then this reduces pressure on strained health systems, improves vulnerable peopleâs health outcomes and empowers individuals and communities in the process.
A typical journey using Babylonâs digital first technology means a member will start with the AI suite - using the Symptoms Checker to identify symptoms, and use AI and the background to start determining what potential conditions they could have. We would provide them with some advice about what treatments were available and what the next steps would be. Taking this further, looking at chronic conditions such as diabetes or COPD, an assessment and plan can be built and these conditions monitored and tracked through a coaching system including results from lab tests, wearables to start to predict and improve the outcome of the individuals condition.
We have proven our model in the UK and Rwanda - two countries at different ends of the spectrum of economic development.
Closing the health service gap in Rwanda:
Our service Babyl, is giving Rwandans one of the most progressive solutions to healthcare in the developing world. Partnering with the Bill & Melinda Gates Foundation and the Government of Rwanda, we have built digital services to suit the needs of Rwandan people. Optimised for basic feature phones, Babyl delivers phone consultations, lab tests and prescriptions all through a mobile service. Currently, Babyl has 2 million registered users, with the doctors and nurses completing over 3,000 consultations every day.
We have already demonstrated how healthcare can become highly accessible in primary care by compiling AI, virtual and physical delivery models. Only two years ago no one thought it was possible to deliver 24/7 primary care in the UK, with near-zero waiting time.
Weâve now launched in Canada and licensed our technology in South East Asia. While we aim to grow our coverage as fast as possible in other countries, we canât grow everywhere at the same time. So, this year our focus has been the US, the largest established market for healthcare, and Asia, the fastest growing.
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for want of a better word Margaux, this is very cool. The intersection between self care and workplace health care policies and practices is a fascinating one, in the sense it allows health care and self care to be advanced more deliberately and effectively
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For economies, a healthy and well population that prioritizes self-care generates the greatest return on its investment: longer and healthier lives for all its citizens and a thriving, productive society. The economic competitiveness of any country is directly linked to the health of the workforce. A healthy workforce can improve economic growth, national security, and global competitiveness. It can also maximize worker productivity, spur innovation, and reduce economic drag as fewer resources are allocated toward treating costly preventable diseases. Overall, it is undeniable that the benefits of self-care for individuals and economies outweigh the consequences.
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