Reflections on WHO Classification of Self-Care Interventions webinar (1)

15 February, 2022

Neil,

I enjoyed the WHO webinar on the classification of Self-Care Interventions and had agreed to try to produce a precis summary. The recording for the webinar is now available at the HRP YouTube channel: https://youtu.be/kwty-TK9ILU

I admit that my biggest hope for Self-care is that patients and professionals will adopt and promote self-care and the patient as a team member AND that we can improve patients! - make them more interested, knowwledgable, proactive, engaged and productive in their own health care. (Doctor comes from the Latin word for "teacher" and originally referred to a small group of theologians who had approval from the Church to speak on religious matters.)

There were quite a few major and minor issues discussed in the webinar and I hope that it will be ok for me to break the report down into three sections. I have placed the references and links at the end of each message but you may only want them at the ends of the first message. Change as you wish.

I have summarised the main contents of the WHO webinar in the three messages.

1. WHO Classification of Self-Care Interventions webinar - February 14, 2022 “The WHO core principles of universal health coverage and resource enhancement - policy and obstacles to adoption”

2. WHO Classification of Self-Care Interventions webinar - February 14, 2022 ““Descriptions and adoption of self-care interventions”.

3. WHO Classification of Self-Care Interventions webinar - February 14, 2022 “Self Care -new era or culture of healthcare?”

(This last section is quite theoretical but was produced as an academic analysis of Self Care in primary care twenty years ago now and has a succinct theoretical explanation of culture change which seems to make sense when discussing the WHO Self care classification.)

1. WHO Classification of Self-Care Interventions webinar - February 14, 2022 “The core principles of universal health coverage and resource enhancement - policy and obstacles to adoption”

The foreword of the WHO Classification of Self Care Interventions writes that “A global shortage of an estimated 18 million health workers is anticipated by 2030, a record 130 million people are in need of humanitarian assistance, and there is the global threat of pandemics such as COVID-19. 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 healthcare out of their own pockets. There is, therefore, an urgent need to find innovative strategies that go beyond the conventional health-sector response.”

The forward goes on to say “The WHO classification of Self-Care Interventions is intended to be a living document that will evolve as new models of self-care interventions and evidence-based best practices become available. A feedback tab will be included, where additional or updated illustrative policy and programmatic examples, as well as other feedback on the document, can be provided.

In an introduction Dr Tedros Abhanon Ghebreyesus DG of the WHO writes:

“People have been practising self-care for millennia, and new diagnostics, medicines, and interventions, including digital technologies, are changing how health services can be delivered. Self-care and self-care interventions have also played a critical role in individual, community and national responses to the COVID-19 pandemic. In the context of overstretched health systems and shortages of qualified health workers, self-care interventions, prioritized by the World Health Organization (WHO), have contributed to improving health and well-being.”

“Self-care must work as an extension of the health system, so that while people are using self-care interventions, they can also access the health system and community support for further assistance when needed. It is also important that self-care occurs in a safe and supportive environment, to avoid the stigma, violence and negative health outcomes that can often occur when seeking care in isolation.

Dr Tedros goes on to write “This guideline on self-care interventions is based on the core principles of universal health coverage, including a people-centred approach to health that views people as active decision-makers in their own health, not merely passive recipients of health services.

and “How can the right to health for all be advanced through self-care interventions? The WHO consolidated guideline on self-care interventions acknowledges the important contribution of self-care and self-care interventions in improving the health and well-being of all and reaching universal health coverage (2).

Reading the introduction, the classification goes on to explain that “The ability of individuals and communities to self-care depends on the availability, accessibility, affordability and acceptability of a range of quality, evidence-based self-care interventions; and on the enablers described in the WHO conceptual framework (2). People might choose a self-care intervention for positive reasons, which include convenience, cost, empowerment, a better fit with values or daily lifestyle, or because the intervention provides the desired options and choice.

and “People may also opt for self-care interventions to avoid the health system, because of a lack of quality care (e.g. stigmatization by health workers) or a lack of access (e.g. in humanitarian settings or places that are geographically remote from health facilities). Self-care interventions fulfil a particularly important role in these situations, as the alternative might be that people do not access services at all.”

I will send second and third messages (““Descriptions and adoption of self-care interventions” and “Self Care -new era or culture of healthcare?” for consideration for sharing with HIFA

Here are the References and useful links provided by the WHO:

WHO health topic page on self-care interventions: https://www.who.int/health-topics/self-care

WHO Classification of self-care interventions (2021): https://www.who.int/publications/i/item/9789240039469

WHO Guideline on self-care interventions for health and well-beinng (2021): https://www.who.int/publications/i/item/9789240030909

WHO video on Self-care interventions to support UHC and PHC (2019)): https://youtu.be/hwGPJDQNyoo

For any request please send us an email to: selfcare@who.int

HIFA profile: Richard Fitton is a retired family doctor - GP, British Medical Association. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data

Email address: richardpeterfitton7 AT gmail.com