Self Care Interventions Bring Health Services To People

We have all been urged, instructed, supported and directed to practise self-care and to ‘do our bit’ to protect everyone else from the COVID-19 pandemic.

A new paper by the Mitchell Institute at Victoria University in Australia ‘Self-care and health: by all, for all’, calls for the lessons from the COVID-19 experience to make self-care a central component – for the sake of everyone’s health.

There is now also global pressure by a number of peak bodies for recognition of self-care as essential for good health for individuals and populations. The new Mitchell report, highlights the effectiveness of self-care in improving health and wellbeing for individuals and communities.

The report, notes a range of environmental, economic and social factors drive self-care capability. It says governments can play a major role in creating environments that either inhibit or enable self-care.

Self-care needs to become one of the norms that inform human social and political life, underpin human dignity, and support the common good. This requires all of us, individuals, organisations, institutions and governments, to do their bit.

Individual self-care is dependent on a range of factors including health knowledge, health literacy and socioeconomic factors such as casual employment and financial stresses.

“We know that preventable chronic disease and high rates of risks for poor health disproportionately affect individuals and communities that are socio-economically disadvantaged,” the report says.

“Self-care by all, for all, needs to become usual behaviour and practice in community life, with the same strong leadership from governments and health experts that has been so effective through the pandemic. This approach will not only help improve the health of individuals, it will build our ability to protect ourselves against infectious diseases like COVID-19.”

Governments around the world must focus on enabling health systems to embed self-care support in all health care services and to prioritise prevention and management of both infectious and chronic diseases, particularly in primary health care.

Self-care as an active health measure was and remains an implicit concept. This may be because self-care is challenging to grasp conceptually and tricky to define. When it comes to self-care, social and cultural mores may affect individual interpretation of the term, and there are widely divergent perspectives – from that of the black feminist writer Audre Lord who said that “caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare”  to the spiritual emphasis of the Daoist philosopher Zhuang Zi in the fourth Century BCE: “The perfect man of old looked after himself first before looking to help others”.

However, now is the time for a systematic approach and clear clarification on what is Self Care and what is not, led by an international agenda to enable shared responsibility between government organisations and health care professionals to tackle health inequity and support self-care for all.

Health status and health outcomes in many rural, Indigenous and socioeconomically disadvantaged communities including injured workers within workers compensation schemes around the globe are “starkly different” to those in well-resourced communities, the blueprint notes, and it presents solutions to address this.

“The concept of self-care is complementary, and central, to the concept of prevention in health,” it says.

“Targeted support for self-care through health services and within these communities through preventive health strategies and enhanced primary care capabilities would reduce health inequities and improve health outcomes in these communities.”

It presents nine priority proposals to support self-care and improve health, including developing a national health literacy strategy as well as cross-disciplinary self-care core competencies to be integrated into health professional education and training.

“COVID-19 has shown us that engaging people in understanding how to prevent infection and illness, and how to be as healthy as possible, can reduce preventable health problems,” says Kathie Melocco of WOW Self Care School.

“Self-care by all, for all needs to become standard behaviour and practice in the community,” says Kathie Melocco. In fact, before this report was published we had identified through our first responder work at WOW that people in acute stress often do not have a basic Self Care framework to fall back on in challenging times. It was from that point that we ourselves developed an emergency self care plan for others and in turn birthed WOW Self Care School, an 8 week online program that works through the social determinants of health and is evidence based and trauma informed.

Our goal at WOW Self Care School is for educators, influencers and the health care profession to take back accurate information on Self Care to their own communities. We also seek to work collaboratively with partners working in the emerging Self Care for Healthcare space.

We are particularly focused on ensuring human rights, ethical considerations and gender equity is embedded in any Self-Care intervention facilitated by healthcare practitioners and other Self-Care touch points within the community.

Within the Mitchell Report there are also several structural policy approaches in the set of proposals, including:

Implement funding and service models to support self-care,

Drive investment in preventive health and self-care,

Establish a national/international approach to enabling and supporting self-care,

Support individual and population health through all public policies.

According to the paper, the medium-term benefits of the proposed policies include informed and empowered individuals, health service models that support and facilitate self-care, a well-supported health workforce which values and promotes self-care, and supportive public policies that provide access and opportunities for self-care.

Over the long term, benefits include all services and health professionals providing self-care support as a key component of health care provision, and high rates of effective self-care behaviours across the population.