Advancing Self-Care in Uganda: Helping Individuals Take Care of Their Sexual and Reproductive Health

It is an age-old practice where individuals provide themselves with information, products, or services to maintain, preserve, and promote their health and well-being. However, new products, information, technology, and other interventions have given self-care a different application, with health areas, including SRHR, taking on the concept and practice. The COVID-19 pandemic has forced individuals to either resurrect, design, adapt, or immediately utilize solutions with the potential to relieve the burden on the already overwhelmed and under-resourced health care system. As such, self-care interventions and their use have been amplified by the effects of the COVID-19 pandemic. The pandemic has availed the opportunity to appreciate the value of self-care, elevating and bringing greater control among stakeholders. The World Health Organization (WHO) launched the Consolidated Guidelines for Self-Care Interventions for SRHR in 2019, and a revised version 2.1 was released in June 2021. Uganda is leveraging this global framework to advance self-care at the national level. The introduction of the guideline kick-started the process of structuring self-care and introducing it within the existing health care system. The onset of COVID-19 added urgency to self-care approaches to take pressure off the health care system and facilities to improve access to essential SRHR services. Uganda adopted a two-pronged approach for developing the self-care guideline. The first stage of this process was successfully completed, and the Self-Care Expert Group (SCEG) is in the process of test implementing the draft guideline. The purpose of implementing the guideline is to optimize opportunities for self-care uptake within the existing health care system. The lessons learned can then be applied to finalize and launch the National Guideline for Self-Care Interventions for SRHR. The National Guideline for Self-Care Interventions for SRHR highlights four key recommendations and respective interventions, including Antenatal Care, Family Planning, Post-Abortion Care, and STIs. Stakeholders in Uganda are prioritizing the contextualization of guidance for self-care interventions for the SRHR health area as a blueprint for other health areas. Ensuring quality in self-care is critical, and the WHO conceptual framework facilitates thinking around the complexities of promoting quality self-care. The quality-of-care framework for self-care, which is hinged on five pillars, was integrated within the National Self-Care Guideline for Self-Care Interventions for SRHR. Essential practical strategies for ensuring quality self-care include training providers in counseling clients on the proper use of commodities, counseling clients who are initiating family planning methods on side effects, providing information on opportunities for method change, and proper product storage as well as waste disposal and management. Data on self-care can be attained through village health teams, which should be trained to ensure that data is collected correctly. Other sources for self-care data may include drug shops, local and national level surveys, and monitoring of the HMIS on family planning services. Self-care interventions offer a strategy to reach people with quality health care services and information. They enable individuals to access and utilize SRHR information and services without discrimination or experiencing stigma. In addition, self-care increases confidentiality, eliminates barriers to access, improves individuals' autonomy, and enables them to make decisions regarding their own health without feeling pressured, especially among vulnerable populations like the young people. Self-care will bring improved mental well-being and increase agency and autonomy particularly for the vulnerable groups. Research suggests that self-care promotes positive health outcomes, such as fostering resilience, living longer, and becoming better equipped to manage stress. Self-care eases the stretch on the health system and enhances efficiencies in handling critical health issues.