South-East Asia advances self-care for SRHR

"Self-care is not about shifting responsibility from health systems to individuals. It is about moving power and choice towards people, while strengthening the systems that support them."

[Dr Nilesh Buddha, Officer in Charge, WHO SEARO]

Self-care is increasingly recognized as an important approach to expanding access to health services while giving people greater choice and autonomy in managing their health. For sexual and reproductive health and rights (SRHR), self-care interventions can help address barriers related to distance, privacy, stigma, convenience and access to health workers.

But self-care does not mean leaving people to manage their health alone. For self-care to be safe, equitable and effective, people need access to accurate information, quality-assured health products and diagnostics, appropriate support, and clear pathways to health services when further care is needed.

Against this background, the WHO Regional Office for South-East Asia convened the Regional Meeting on Advancing Self-Care for Improving Sexual and Reproductive Health and Rights, bringing together countries, WHO and partners to examine how evidence-based self-care interventions can move from policy and pilots towards sustainable implementation.

Discussions moved beyond individual self-care products or technologies to examine the complete care journey. Participants considered medical products and diagnostics, pharmacies, workforce readiness, digital health and artificial intelligence, traditional medicine, disability inclusion, community engagement, youth leadership and humanitarian settings. Across these areas, a consistent message emerged: self-care needs to be connected to primary health care, with appropriate information, support, referral, follow-up and monitoring.

The meeting considered implementation experience across interventions including self-injectable contraception, human papillomavirus (HPV) self-sampling, supported medical abortion care, HIV self-testing and self-testing approaches for sexually transmitted infections.

Country experiences demonstrated that there is no single pathway for advancing self-care. Countries are using different entry points based on their health-system context: pregnancy self-testing and over-the-counter contraception in Bhutan; family planning kits delivered through Accredited Social Health Activists, menstrual health initiatives and digital approaches in India; community and digital approaches in humanitarian settings in Myanmar; subcutaneous depot medroxyprogesterone acetate self-injection and HPV self-sampling in Nepal; self-care platforms linked with primary health care in Sri Lanka; HIV self-testing, HPV self-sampling and telemedicine in Thailand; and HPV self-sampling and follow-up systems in Timor-Leste.

These experiences provide opportunities for countries to learn from one another while adapting implementation approaches to their own policies, health systems and population needs.

A central question throughout the meeting was how promising self-care interventions can move beyond small-scale initiatives and become part of routine health services. Participants emphasized the importance of integrating self-care within primary health care and universal health coverage.

Scale-up also requires attention to equity, accessibility, privacy, rights and informed choice throughout the care journey. Quality-assured products need to be accompanied by clear information, competent support and functioning referral and follow-up systems. Sustainable financing, workforce readiness, appropriate digital safeguards and practical monitoring will also be important as countries expand implementation.

Country ownership remains central. Implementation approaches need to respond to national priorities and capacities, while partnerships and implementation evidence can help countries determine what works, for whom and under what conditions.

Country teams used the meeting to identify priorities for 2027–2029, linking proposed actions with national policies, primary health care, financing, workforce capacity, commodity systems and monitoring. Their experience and feedback also contributed to the development of the regional roadmap for scaling up self-care for SRHR.

"The direction emerging from the meeting was clear: self-care should not develop as a separate programme. Its potential lies in being embedded within health systems while expanding people's options, autonomy and access to quality care."