this is how scale can happen!
The WHO guideline on Self-Care publiched last year made a number of key reocmmendatins to promote self-care. Work is currently underway to determine the extent that the guideline is being implemened in key countries. This work would illustrate extant barrers and drivers for the widespread adoption of these guideliens, an can inform an advocacy and implemtation tool to address existing barriers.
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I think people do want reassurance from a doctor in lots of instances. Especially parents when their child is unwell. PAGB has carried out surveys in the past which indicate people donāt trust pharmacists as much as GPs, so are maybe less willing to ask for advice in the pharmacy.
Health Education is critical. Understanding the barriers to behaviour change and local nuances needs much preparation and knowledge about the communities we are targeting
In UK, girls still tell each other to smoke many cigarettes if getting pregnant so the baby will be small, and the same idea is behind women refusing to take IFA pills in Eastern Asia, for example. All against every health advice but deeply entrenched in society
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This is where the work of Pharmacies in the US is very interesting both Walmart and i think CVS are developing clinics within their shops. And my mum recently had her flu jab done in a Boots in the UK so i think the role of pharmacies is only going to get greater?
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There are many elements to affordability - the chain from producing something, be it a medical technology or an idea - and it being used, is long! But that insight does provide pointers as to one of the solutions to advance more affordable self care (and healthcare!), which is that when it comes to products in particular, global partnerships and market shaping efforts are a critical piece of the jigsaw. So in contraceptive access, in HIV self testing, working with manufacturers and distributors is as important as anything done at the point of delivery. There are many actors trying to straddle both (supporting/influencing manufacturing and delivery) and my own organization PSI has done this e.g. in HIV self testing and contraceptives from Emergency Contraceptive pills to Hormonal āIUDsā
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Can see how important this is in advanced economies, Imagine the impact that self-care interventions of this type would have in teh poorest corners of the world
I think this underscores why a coordinated movement is key. The more we speak the same language, apply common science-based definitions, used common resonate messages, the more effective weāll be as a global community. There are several self-care coalitions/groups out there (e.g. Global Self Care Federation, the Self Care Trailblazer Group, the WHOās recently launched Self Care Community of Practice). How do we harness the momentum? How do we get these groups to work together? Forums like this are a good start!
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People āself careā already. They google, they chat to friends, do their own investigations. We are just taking this one step further than google. We are not saying we are replacing a doctor. Our symptoms checker for example is enabling that person to check their symptoms (as they would do in Dr Google!) and put a series of symptoms and follow the questions to get to the point where they have a better idea of what could be wrong with them. We are saying the alternative is google. The alternative was not going to see a doctor. With any self care it is the same as a clinician - the patient has to trust the source that information is coming from or they will go get a second opinion. We have to show that the information is trustworthy - this is done through multiple ways, but we welcome regulation internally and externally. The average wait to see a GP was 10 days so they were trying to see what is wrong. What we done is make the googling a lot better. But also through this process press a button, and in a few minutes he was talking to a doctor right so we never pretended that AI can solve your problem.
Our third question today:
Q3.
How do we build a broader movement in support of self-care?
Itās possible to agree that this was the convention, but this is now changing. With the use of online symptom chekcers for example, and wider availabilityof OTC medicines and point of care test devices, we are seeing the ādemocratisationā of self-care.
Doctors are increasingly interetsed inenable patients to self-care ( & that is exactly the remit of the lifestyle medcine movement).
Agree, @oscarsounicefuk! Health education is critical. We have a program in Guatemala on behalf of our treatment, Canesten, which is focused on vaginal health. We realized that many of the communities in Guatemala did not have easy access to a healthcare provider, so if a woman thought she had something like a yeast infection, it was left untreated or she had to wait awhile until a doctor visited her village. As many of you know, this is an infection that can simply be treated with an over-the-counter product. We partnered with midwives, who are trusted authorities in these communities, to roll out mobile health clinics. These clinics went into the communities to teach women about vaginal health in a way that they were receptive to. Weāre looking into a range of solutions like this, both in-real-life and digital to help reach people where it matters.
As a pediatrician and former Director of Innovation at a school of public health most recently focused on cross-sector collaboration, educational and media efforts around behavior change, and starting early continuing thru school and workforce, I wholeheartedly agree with you! Not an easy task, as different sectors speak different ālanguages,ā the benefits of interventions/changes in one sector often manifest and too often are not recognized/measured in different sector(s), people tend to think short-term rather than long-term, and people often think in terms of traditional (medical) health care instead of more broad in the realm of healthā¦and, of course, at the core - behavior change is difficult!
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Q3. It would be hard to discover here all the components necessary to build a movement in support of self-care, but taking a look at how sexual and reproductive rights were and are being fought for in the last decades, we can learn much about the need for Civil Society involvement in achieving routine access to self-care options.
Due to the impact of COVID-19, we now have many more vulnerable populations and for communities that were already considered underserved, this is only going to make things worse. The world will now face even more widespread health inequalities. Access to self-care can and should play a pivotal role in helping us rebuild better.
There are many silos of activities in self-care. We need to bring self-care groups and champions together to establish what the WHO is calling a self-care community of pracitce.
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Absolutely. Pharmacies are doing more, and I think COVID-19 has has a positive impact on attitudes to pharmacies, but I still think the role of pharmacy could and should be enhanced further. Thereās details of how in our policy paper.
The survey we did in June found that almost one in three people (31%) who would not previously have visited a pharmacy for advice before seeking help elsewhere said they were more likely to do so following the pandemic.
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I think we need to use a variety of arguments to continue to build the case - economic, health outcomes and health system strengthening. As part of this i think we continually need to emphasise that self care is part of a continuum not a replacement for good healthcare systems. As David Wilson from the World bank has noted āself-care works best when it is adjunct to a human system, not a standalone/replacement for a strong health systemā.
COVID has put self-care on the map, now we need to implement solutions. COVID has given us an opportunity to do this, to get stakeholders to think differently about self-care.
Also, ee certainly need to talk more about self-care, and to use that very term more often,
For example, thereās a lot of potential in using TV programmes (childrenās TV programmes in particular) to include appropriate self-care messages.
Itās crucial for policy makers to also start using the term self-care in a way that is acceptable. For example, there is a missed opportunity in the current COVID climate for policy makers to use the term āself-careā appropriately when they refer to practicing social distancing, and the appropriate use of personal protective equipment, regular hand washing and other good hygiene practices to limit the spread of coronavirus (and flatten the curve so to speak). They are in a privileged position to address a large number of people during regular coronavirus briefings- so it would be good to see them use the terminology in an appropriate & balanced way.
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