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Self-Care in the Context of Primary Health Care

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Self-Care in the Context of Primary Health Care Self-care in the Context of Primary Health Care Report of the Regional Consultation Bangkok, Thailand, 7–9 January 2009 Regional Office for South-East Asia SEA-HSD-320 Distribution: General Self-care in the Context of Primary Health Care Report of the Regional Consultation Bangkok, Thailand, 7–9 January 2009 Regional Office for South-East Asia © World Health Organization 2009 All rights reserved. Requests for publications, or for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – can be obtained from Publishing and Sales, World Health Organization, Regional Office for South- East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi 110 002, India (fax: +91 11 23370197; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. This publication does not necessarily represent the decisions or policies of the World Health Organization. Printed in India Contents Page 1. Introduction and background ........................................................................ 1 2. General objective.......................................................................................... 2 3. Specific objectives......................................................................................... 2 4. Inaugural session ........................................................................................... 2 5. Gist of presentations...................................................................................... 4 Country presentations ................................................................................. 11 6. Group work ................................................................................................ 17 Group work 1 – “Self-care definition, mechanism for stakeholders to promote self-care” .................................................................................. 17 Group work 2: “Self-care: Key strategies, best practices and main activities for strengthening self-care in the context of PHC”................. 18 7. Conclusions and recommendations ............................................................. 21 Conclusions................................................................................................. 21 Recommendations ...................................................................................... 22 Annexes 1. Self-care in the Context of Primary Health Care .......................................... 23 2. References .................................................................................................. 46 3. Agenda ....................................................................................................... 65 4. Programme ................................................................................................. 66 5. List of participants ....................................................................................... 69 Page iii 1. Introduction and background Self-care is a deliberate action that individuals, family members and the community should engage in to maintain good health. Ability to perform self-care varies according to many social determinants and health conditions. In the series of international conferences on health promotion held in 2006 from Ottawa to Bangkok, self-care was emphasized as the key strategy for health promotion and disease prevention. Self-care is an integral part of primary health care (PHC). However, in the era of high medical technology and medical treatment, the concept has not been much emphasized and implemented. With the high burden of disease and increase in noncommunicable diseases, there is a need to refocus on health promotion, disease prevention and self-care during illness and in revitalization of PHC. In this context, a regional conference on revitalizing primary health care was convened in Jakarta, Indonesia in August 2008. The Sixty-first session of the WHO Regional Committee for South-East Asia adopted a resolution (SEA/RC61/R3) to revitalize PHC through health systems strengthening to achieve health for all with the emphasis on health promotion and disease prevention. At the regional conference in Jakarta, a new definition of Health for All was proposed : “A stage of health development, whereby everyone has access to quality health-care or practices self-care protected by financial security so that no individual or family experiences catastrophic expenditure that may bring about impoverishment”. At the Sixty-first session of the Regional Committee, the Regional Director was requested to support capacity building for strengthening equitable health systems and support capacity of Member States in formulating healthy public policy to revitalize PHC. As a follow-up of the Jakarta conference and the Sixty-first Session of the Regional Committee for South-East Asia (SEA) Region, a regional consultation was organized to reconceptualize self-care. The consultation Page 1 Report of the Regional Consultation was to determine the strategies/approaches in enhancing self-care in countries of the SEA Region in revitalizing PHC. 2. General objective The general objective of the consultation was to determine the way forward in strengthening self-care for revitalizing PHC in Member States of the SEA Region. 3. Specific objectives The following specific objectives were set forth: ¾ to review the regional and countries’ current policy and strategies on self-care; ¾ to identify and discuss the lessons learnt as well as the challenges for self-care; and ¾ to identify key strategies, best practices and main activities for strengthening self-care. 4. Inaugural session The WHO Regional Director for the SEA Region, Dr Samlee Plianbangchang, while inaugurating the regional consultation mentioned that it was one in the series of follow-up actions emanating from the Regional Conference on Revitalizing Primary Health Care, and reiterated that PHC is the key to the attainment of the social goal of health for all, and an important contribution by people of all walks of life to achieve the goal. Good self-care or effective self-care depends on knowledge and understanding of individuals, and depends on their ability to be in control of their own selves. Promotion of self-care needs policy direction and professional support, and it is best pursued within the social and cultural contexts of the community. Promotion of self-care is an educational and empowering process that ensures that people with the right information can make the right decision as far as their own health is concerned. Skills in education Page 2 Self-care in the Context of Primary Health Care and communication are indispensable for effective promotion of self-care. Access to information, the quality of information and the ability to interpret and apply information are important elements of a self-care promotion process. Self-care has to be seen as an integral part of promotive, preventive, curative and rehabilitative care. The role of community health workers and community volunteers is crucial for people to implement self-care. Health information may need to be demystified to make self-care easily understood by all people. On the other hand, health is an industry within which health-related goods and services are being marketed. People also receive information through the media and have difficulty to choose the right information. Not all available information is the right information for effective self-care, therefore it is the duty of health professionals to help people to be able to choose and select the right information in that situation. However, advancement in information and communication technology (ICT), if properly harnessed, can also greatly contribute to efficiency and effectiveness of self-care promotion. At individual and family levels, self-care can have a positive impact on the economy. If well managed on a large scale, it can substantially contribute to poverty alleviation, especially in poor communities. Self-care, if correctly practised, can contribute immensely to the rational use of medicines. “Social control of health technology” can greatly facilitate the development of effective self-care practice. Appropriate technology, which is socially and culturally acceptable, should be practised by individuals, families and communities. For all this to happen, people must be in control of the technology that is
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