Intended for healthcare professionals

Self care interventions for sexual and reproductive health and rights

The space given to self care in health policies and national healthcare does not acknowledge how people take care of their health nor the potential self care has for improving health and wellbeing. However, recent years have seen growing interest in the production of evidence reviews and guidelines for self care.

Where self care and healthcare intersect there is potential to amplify their beneficial impact on the health of individuals and populations. This collection of articles from The BMJ and BMJ Global Health focuses on self care interventions for sexual and reproductive health and rights. This work informs upcoming WHO normative guidance that will cover people centred, evidence based recommendations for key public health self care interventions for sexual and reproductive health and rights with a focus on vulnerable populations and settings with limited capacity and resources in the health system.

It is time to recognise the importance of self care as an integral component of the health system that can support people. With this new collection we hope to stimulate the debate, contribute to evidence informed policies, and raise the profile of this important area.


Editorial:

It’s time to recognise self care as an integral component of the health system
Empowering and supporting people to manage their own health benefits everyone, say Manjulaa Narasimhan, Anya de Iongh, Ian Askew, and Paul J Simpson


Research:

Should oral contraceptive pills be available without a prescription? A systematic review of over-the-counter and pharmacy access availability
Caitlin E Kennedy and colleagues

Self-sampling for human papillomavirus (HPV) testing: a systematic review and meta-analysis
Ping Teresa Yeh and colleagues

Self-administration of injectable contraception: a systematic review
Manjulaa Narasimhan and colleagues

Self-collection of samples as an additional approach to deliver testing services for STIs: A systematic review
Yasmin Ogale and colleagues

Should home-based ovulation predictor kits be offered as an additional approach for fertility management for women and couples desiring pregnancy? A systematic review and meta-analysis
Ping Teresa Yeh and colleagues

Self-management of iron and folic acid supplementation during pre-pregnancy, pregnancy and postnatal periods: a systematic review
Shannon King and colleagues

HPV self-sampling for cervical cancer screening: a systematic review of values and preferences
Holly Nishimura and colleagues

Self-testing for pregnancy: a systematic review and meta-analysis
Caitlin Kennedy and colleagues

Over-the-counter provision of emergency contraceptive pills: a systematic review
Kaitlyn Atkins and colleagues

PrEP distribution in pharmacies: a systematic review
Caitlin Kennedy and colleagues


Analysis:

Self care interventions to advance health and wellbeing: a conceptual framework to inform normative guidance
Manjulaa Narasimhan and colleagues argue that there is a pressing need for a clearer conceptualisation of self care to support health policy

Self care interventions could advance sexual and reproductive health in humanitarian settings
Forcibly displaced people often lack access to adequate sexual and reproductive health services. Carmen Logie and colleagues examine the role of self care interventions in filling the gap

Self care interventions for sexual and reproductive health and rights: costs, benefits, and financing
Michelle Remme and colleagues argue that if costs to users are considered and their financing is right, self care interventions for sexual and reproductive health can improve equity and efficiency

Sexual and reproductive self care for women and girls: insights from ethnographic studies
Ethnographic studies examining how women manage their sexual and reproductive health can inform strategies to address unmet needs, say Anita Hardon and colleagues

Safe and sustainable waste management of self care products
A safe and sustainable waste management system for self care products requires education and multisectoral approaches say Ash Pachauri and colleagues

Human rights and legal dimensions of self care interventions for sexual and reproductive health
Understanding the user, the health system, and the environment is key to ensuring that self care interventions for sexual and reproductive health are not only available but safe and empowering for all, say Laura Ferguson and colleagues

Access to self-care interventions can improve health outcomes for people experiencing homelessness
Jon Hopkins and Manjulaa Narasimhan examine the barriers to self-care for people experiencing homelessness and how to overcome them


Feature:

Integrating transgender care into mainstream medicine
All healthcare professionals will find themselves supporting care for a transgender or gender diverse person at some point, and education and research need to be widened, write Guy T’Sjoen and Joz Motmans


Opinion:

Meaningful youth engagement in global health means equal partnership and power sharing
Michalina Drejza and colleagues

Self sampling for human papilloma virus can save lives in China
Zhou Tian and Allen Wu

Self care won’t address structural barriers to health, but it can help meet the needs of men who have sex with men
Kevin Moody

Digital self care must be approached by the health sector with eyes wide open
Patricia Mechael and Pierre Moon

Rethinking self-care through an Indigenous lens—the importance of community
Pat Dudgeon, Emma Carlin, and Abigail Bray

“Two eyed seeing”—embracing both Indigenous and western perspectives in healthcare
Nel Wieman and Unjali Malhotra


Video:

Ways of being: supporting self-care

Learn more about the power of holistic self-care through the stories of Indigenous women who balance spirituality, community connection, and traditional health perspectives with formal healthcare. In this short film a group of First Nation women in Canada, living with HIV, talk about their understanding of health and wellbeing, and how it may differ from the biomedical paradigm. The film was made by CAAN and features women from their network. By exploring the intersection of different worldviews, we can work towards a more inclusive understanding of self-care.


These articles are part of a series proposed by UNDP/UNFPA/Unicef/WHO/World Bank Special Programme for Human Reproduction (HRP) and commissioned by The BMJ. The BMJ and BMJ Global Health retained full editorial control over external peer review, editing, and publication of these articles. Article handling fees (including printing, distribution, and open access fees) are funded by HRP.

All articles from WHO employees are published under the terms of the Creative Commons Attribution, Non-commercial IGO License (https://creativecommons.org/licenses/by-nc/3.0/igo/). In any reproduction of these articles there should not be any suggestion that WHO or this article endorse any specific organization or products. © World Health Organization 2019. Licensee BMJ Publishing Group Limited.


Lead image: © Elmvh CC BY-SA-3