Lancet Global Health: Self-care interventions and practices as essential approaches to strengthening health-care delivery

31 October, 2022

Citation, extracts and a comment from me below.

CITATION: Self-care interventions and practices as essential approaches to strengthening health-care delivery

Manjulaa Narasimhan et al.

Lancet Global Health 2022

Open Access Published: October 25, 2022 DOI:


There is a growing evidence base on the effectiveness of self-care interventions... Guidelines exist covering conditions including depression, drug and alcohol use, stress management, migraine, hypertension, coronary heart disease, and HIV, among others. WHO's living guideline on self-care interventions has consolidated current global policy experience and information, including on COVID-19 self-testing...

Health workers have a key role in realising the potential of self-care interventions... However, the capacity of health workers for supporting their clients' self-care effectively and safely is not a given. Many are poorly equipped and trained to do so. Health workers might be unaware of what options for self-care exist or the range of self-care resources and tools they could suggest...

Ten interventions health authorities can implement to equip health workers with the skills and capacity to support self-care interventions and practices

1. Ensure that curricula for training and continuous education of health workers gives due importance to self-care.

2. Review organisational obstacles and disincentives (eg, working conditions and resources).

3. Ensure conditions for continuity of a personal relation of trust between a client and provider.

4. Coordinate and simplify user-friendly client pathways.

5. Incorporate self-care in protocols for management of priority health conditions.

6. Include a self-care dimension in information, referral, and review systems.

7. Provide training for health workers in skills for promoting self-management and problem-solving education, group facilitation, consultation technique, adult learning, and communication.

8. Ensure staff awareness of available instruments, community resources, and social care resources.

9. Incorporate self-care support efforts in staff appraisal and remuneration systems.

10. Provide information on prevalence and trends of self-care practice in the target population...

COMMENT (NPW): I would add two important points that we have much discussed previously on HIFA:

1. The concept of self-care goes beyond self-management of established chronic disease. It includes the ability of the individual and family to assess health issues as they arise, and take appropriate action, whether to arrange transport to a health facility or to provide a simple effective treatment (such as increased fluid intake for acute diarrhoea). Self-care may further be interpreted as the totality of experience, beliefs and knowledge that can help prevent, diagnose and manage disease and thereby promote positive outcomes. In low-resource settings, this is particularly important because professional healthcare advice may not be readily available.

2. The ability for health workers to provide guidance on, or for individuals to practice self-care is centrally dependent on the availability and use of reliable, relevant healthcare information, and the ability to distinguish this from misinformation. This challenge, which goes across all aspects of health, should be at the centre of all efforts.

Best wishes, Neil

Neil Pakenham-Walsh, Global Coordinator HIFA,

Working in official relations with WHO