The Transformative Potential of Self-Care for Health in Africa

by Amref Health Africa

African countries benefit immensely from integrating self-care practices into national primary healthcare strategies. This approach can improve health outcomes while reducing healthcare costs for governments and households. Embracing self-care can enhance the efficiency and sustainability of health systems, a critical need given Africa’s diverse and growing populations, increasing life expectancies, rising rates of chronic diseases, constrained fiscal resources, and the looming threats of climate change.

When implemented on a large scale, self-care can significantly contribute to achieving universal health coverage and the 2030 Sustainable Development Goals for health.

The research underscores the economic benefits of self-care. A 2018 study published in Diabetes Care found that better self-care among diabetes patients could reduce healthcare costs by up to $4,000 per person annually, thanks to fewer hospital admissions and complications. Furthermore, a 2020 World Health Organization (WHO) study estimated that improving self-care could cut global healthcare costs by up to $1.2 trillion by 2030.

The Global Self-Care Federation also highlights that self-care improves health outcomes and yields substantial economic benefits. Healthier individuals are more productive and contribute more effectively to the economy. For instance, the WHO estimates that a 10% reduction in heart disease and stroke mortality could save $25 billion per year in low- and middle-income countries.

Additionally, the World Economic Forum’s 2018 report found that every dollar invested in self-care interventions for hypertension resulted in a $4.30 return in increased productivity and reduced medical costs. For African nations, adopting self-care is a strategic necessity to optimize healthcare spending, maximize health impact, and bolster their economies.

Kenya serves as a compelling example. In 2022, the country had an overall self-care readiness score 2.4 on a scale of 1 to 4 (where 1 means not self-care ready and 4 means exceptionally self-care ready). Kenya scored 2.2 on stakeholder support, 2.3 on consumer empowerment, 2.4 on self-care policy, and 2.5 on the regulatory environment. Kenya enjoys high stakeholder support for self-care among healthcare providers but less among the general public and policymakers. To address this, the country should incorporate self-care into primary healthcare guidelines and enhance self-care instructions in disease-specific guidelines for diabetes and hypertension.

Collaborative approaches involving healthcare providers, patients, and caregivers in personalized care plans, similar to the chronic care model, can strengthen stakeholder support. Additionally, broadening the alliance of self-care advocates to demonstrate the benefits of self-care investments can lead to healthier populations and lower costs, bolstering the sustainability of health systems in low- and middle-income countries. Establishing a self-care accelerator collaborative with impact investors, implementing agencies, WHO, and governments can help overcome barriers to scaling up self-care initiatives.

Leveraging Kenya’s widespread mobile phone usage and local radio reach, even in remote areas, can be instrumental in educating citizens about self-care, including disease management, lifestyle changes, and self-monitoring techniques. Deploying over 100,000 community health promoters and thousands of community groups can further this education. Embracing technology, such as mobile apps and telehealth services, that provide real-time monitoring and support, including medication reminders and symptom tracking, can accelerate the adoption of self-care practices. Adopting a people-centred design approach in developing self-care products will ensure they are user-friendly across various contexts. Adopting a self-care resolution at the World Health Assembly in 2025 will enhance consumers’ availability and quality of self-care information.

Kenya’s Health Policy (2014-2030) advocates for empowering households to take responsibility for their health and well-being and participate in managing local healthcare systems. The Kenya National NCD Strategic Plan 2021-2025 emphasizes patient empowerment and self-management of non-communicable diseases (NCDs). As previously described, the country can benefit from translating this policy intention into action by investing in consumer empowerment. The Ministry of Health should also develop a standalone self-care strategy, guided by WHO’s formative guidance, to ensure coherence across various health policies, plans, and programs.

The Ministry of Health should collaborate with the pharmacy and poisons board and other regulatory agencies to facilitate the scaling up access to self-care products and devices. This can be achieved by approving reclassification guidelines and creating an environment that incentivizes innovation. Allowing direct-to-consumer advertising for self-care solutions can also promote greater awareness and adoption of self-care practices. By prioritizing these strategies, Kenya—and other African countries—can optimize healthcare spending, improve health outcomes, and bolster their economies through effective self-care practices.

Authored by Dr Meshack Ndirangu, Country Director, Amref Health Africa in Kenya, and Kennedy Wakoli, Family and Reproductive Health Program Specialist.

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