Patricia Yosiya is a midwife in Malawi and works at Balaka District Hospital where she observed a disturbing trend: pregnant women taking local herbs to induce labor so that they could get back to work more quickly. Too many cases of this local tradition were leading to ruptured uteruses, heavy bleeding and sometimes even death. Patricia knew that if women just understood the risks of this practice, they’d do everything they could to protect themselves and their families. She organized health talks to educate women about the dangers of using local herbs in this way, and as a result, the incidences of ruptured uteruses have already been cut in half. This approach was successful and offers an example of promoting effective self-care.
Self-care plays a vital role in advancing health outcomes for the most vulnerable women, children and families and is an important part of primary health care. Strong primary health care systems are people-centered and ensure continuity of care, coordination, and accessibility. In a world where 830 women die every day from mostly preventable pregnancy and childbirth-related causes, and 4.5 million children die within their first year of life, it is vital that women have access to the information that will enable them to promote their own health and well-being and that of their families.
In the Global North, self-care is taken for granted. When you have a headache you take an aspirin. If your stomach is upset, you avoid or seek out certain foods and beverages. These are everyday examples of self-care — activities people pursue in order to maintain their health. However, in developing countries where health information is scarce or passed on through generations of tradition that can sometimes perpetuate misinformation, as in Patricia’s community, we must actively invest in self-care.
Self-care empowers women and their families with knowledge, skills and confidence to maintain healthy pregnancies, nurturing children and all other aspects of their health. When promoted throughout the lifecycle as an essential part of maternal, newborn and child well-being, health education helps women recognize and prevent life-threatening complications so that they are better prepared for birth and to care for their newborns. It also helps women and families understand their rights and demand they be upheld.
Studies show that most people want to engage in self-care to avoid illness and improve their health, but they often lack the knowledge and confidence to do so. They need information, skills, tools and encouragement. Self-care requires a shift in mindset to value people’s expertise about their own health.
Self-care efforts are grounded in community needs; they are participatory, and informed by local knowledge. This can help overcome structural barriers to information, leading to innovative and customized approaches that can reach the entire population.
Self-care isn’t new, but there is a new lens through which to view it. That lens is changing the way global, national and district level policy makers see self-care: as a tremendous opportunity to make progress on our most vital health goals. But, we must make a change in the way we are doing things if this opportunity is to be fully realized.
Governments must acknowledge, respect and fulfill their citizens’ right to information about self-care. National governments need to collaborate across ministries to promote self-care. Ministries — such as health, education, finance and planning — must develop strategies and targets to support self-care over the long term. And we must reframe health as a partnership between primary health care providers and health seekers that respects local knowledge and health-positive traditions.
The White Ribbon Alliance recently produced the paper Self Care: A Cost Effective Solution for Maternal, Newborn Health for All, which concludes:
The shift to a people-centered approach that prioritizes and supports self-care will not occur without concerted effort from global, national and community stakeholders to direct resources, change provider mindsets, develop community organizations and build health literacy. While this shift will require significant effort and resources, it offers the opportunity to lay the groundwork for a long-term and fundamental transformation in equipping communities and individuals to promote and preserve their health while realizing their rights.