Self care

Health and social care

Technologies
Week 7
Technology in the
news
The most
controversial
shoe ever?
 Rubber sole - Pebax
 Combined with carbon fiber plates that work together to absorb and
then return a percentage of the energy that the runner puts into them.
 Literally spring runners forward and help elite runners shave precious
seconds off their times
 independent and Nike-sponsored studies - increase athletes'
energetic efficiency by 4% or more = good for marathon length
distances!
 leaves legs less sore because it's absorbing the energy – reducing
impact of this high impact sport
 Technological doping = shoes give athletes an unfair advantage over
competitors who are not equipped with the same technology
 Not who is the best athlete, it's who has the best shoes on
 5 fastest marathons of all time, run in the past 16 months by athletes
wearing variations of Vaporfly technology
  Less impact on the body – less injury
 Fair?
 Impact on amateur athletes
Links to health  Inequality?
and social care  Policy at Athletics level
 Ethics of such technologies
 Unintended consequences
Technology in
the news
 Easy to set up
 Cheaper than other formal options eg B&B
 Set up costs - no insurance, fire alarms, safety checks
 No contribution to services eg bins
 Noise
 Impact on community
 Pricing out locals
 Growth of short term lets mediated online has a direct link to
many health and social care issues
What is self-care?

 Self-care is the ability of individuals, families and communities to promote health,

prevent disease, maintain health, and cope with illness and disability with or
without the support of a healthcare provider (WHO, 2019).
 The scope of self-care includes health promotion; disease prevention and control;
self-medication; providing care to dependent persons; seeking
hospital/specialist/primary care if necessary; and rehabilitation, including
palliative care.
 It includes a range of self-care modes and approaches.
 WHO, 2019, WHO Consolidated Guideline on Self-Care Interventions for Health Sexual and Reproductive Health and Rights EXECUTIVE
SUMMARY. https://apps.who.int/iris/bitstream/handle/10665/325719/WHO-RHR-19.14-eng.pdf?ua=1
Self-care
 “Self-care” not a new term or concept, self-care
interventions have the potential to increase choice,
when they are accessible and affordable.

 Opportunities for individuals to make informed decisions

regarding their health and health care.

 In humanitarian settings, lack of/ limited health

infrastructure and medical services in the crisis-affected
areas, self-care could play an important role to improve
health-related outcomes.

 Self-care also builds upon existing movements, such as

task sharing and task shifting, which are powerful
strategies to support health systems
Brain storm as many
self-care
interventions in 5
minutes as you can
think of using the
model opposite
  Worldwide - estimated shortage of 18 million health workers is
anticipated by 2030
 130 million people are currently in need of humanitarian assistance
 Disease outbreaks = constant global threat.
Why self  At least 400 million people worldwide lack access to the most
care? essential health services.
 Every year 100 million people are plunged into poverty because they
have to pay for health care out of their own pockets.
 Urgent need to find innovative strategies that go beyond the
conventional health sector response
 Self-care interventions =self responsibility
 New and greater self-efficacy, autonomy and engagement in
health for self-carers and caregivers.
 Risk and benefit calculations may be different in different settings
and for different populations.
 Self-care interventions offer strategies that promote active
participation of individuals in their health and an exciting way
forward to reach a range of improved outcomes, including:
 increased coverage and access;
 reduced health disparities and increased equity;
 increased quality of services;
 improved health, human rights and social outcomes; and
 reduced cost and more efficient use of health-care resources and
services.
WHO self-care

 Https://youtu.be/lPOaCZ1VwY
Conceptual
framework for self-
care interventions

Narasimhan, et al. (2019)

 Importance of a people centred approach = self carers/care givers are at centre
 Key principles for promoting self resilience, autonomy, and agency in any health policy guidance for
self care = recognising human rights; gender equality; and other ethical considerations; taking a
holistic approach to health; recognising that needs change across a person’s life course.
 Traditional self care practices that societies have passed on through generations, people are
accessing new information, products, and interventions through stores, pharmacies, and the
internet. Digital health/ mobile increasing as places of access & in other aspects of self care.
 Supportive and safe enabling environment for the introduction of self care interventions is essential.
In the context of a supportive legal and policy environment. This means access to the following:
 justice;
 a strong, accountable, people centred healthcare system;
 integrated and accessible services of good quality;
 protection from violence, coercion, and discrimination; s
 social inclusion and acceptance;
 and knowledge and information, appropriately tailored to different needs.
 Individuals can be in control of some self care interventions, eg condoms; others, eg +HIV self test,
require confirmation within a healthcare setting; others eg self sampling of HPV, health setting to do
the test.
 Dynamic interaction between individuals and the health system can change over time in line with the
needs and choices of individuals. The health system supporting people = integral part of self care.
 Accountability - for health outcomes reflected at multiple levels, and accountability of the health
sector = key factor in the equitable support to quality self care interventions. Meaningful community
engagement where self care is championed and advocated by patient groups = essential in success
of linkage to care.
 (Narasimhan et al, 2019) https://www.bmj.com/content/365/bmj.l688
Self-Care & SRH
 Important in all aspects of health,
important & challenging to manage – for
populations negatively affected by
gender, political, cultural and power
dynamics and for vulnerable persons.

 For SRHR - many people are unable to

exercise autonomy over their bodies and
are unable to make decisions around
sexuality and reproduction.
Sexual health self-testing
 Self-sampling - you collect your own sample, send this to
a laboratory for analysis. They make results available by
phone or text a few days later.
 Self-testing: you collect a sample, You perform the whole
test yourself. After a few minutes, you read and interpret
your own test result.
 You don’t need to see an HCP
 Use these kits wherever you want.
 Order online, some venues and vending machines
  Convenience
Opportunities  Speed of results
of self-care in  Confidentiality/ privacy
SRH: example  Not yet out / ethnic and cultural communities where MSM = taboo
 Asian MSM links with family and GP
self-testing for
HIV in MSM  Witzel, et al (2016) HIV self-testing among men who have sex with men (MSM) in the UK: a qualitative study of
barriers and facilitators, intervention preferences and perceived impacts. PLoS One, 11(9).
  Shared accommodation
 Ability to do test/ potential for errors in generating sample and interpreting results
 Complex instructions
 No tech experience
 High levels of literacy
 Fear of positive result & no support
Drawbacks of  Window period

self-care in  Types of sample – blood vs saliva

 Packaging – over produced lack quality, fit through letter box
SRH: example  Costs
 Testing free at lots of venues
self-testing for  Reduce costs

HIV in MSM  Missed time at clinics other work gets done

 Educating / supporting about sexual health
 Increase STI’s - no other screening and use self-testing as a strategy to manage HIV and avoid
condoms
 + result
 Psychological impacts
 Not link to clinical care for
  A key consideration in the development of health policy and
guidance is that the availability of self-care interventions should
not lead to care being disconnected from health services.

 There are concerns that self-care may exacerbate inequalities

Challenges to  Environmental impact

Self-care
 There are concerns that self-care presents opportunities for
violence and coercion

 In small groups - explore these potential downside of self-care

focusing on the 4 points above.
  Online support forums
 Online therapies access whilst waiting for face to face
 Digital campaigns
 Social media
 Use online appointment booking
 Telemedicine
Mental health  Sensors for monitoring
 Smart phones for self-reporting
 EHR for data
 Other datasets of interventions
 Virtual reality – phobias/ psychosis
  Home testing technologies are being trailed for coronavirus.
 A HCP comes out to your house to take the sample.
 Please read the 2 brief documents provided about the scheme.
 Develop an awareness campaign around this
 Can be a digital campaign
Coronavirus  Can be a campaign aimed around the technology
home-testing  You need to consider –
 Brain storm the issues here
campaign  Who – is your campaign targeting
 What – is your campaign doing?
 Why - are you targeting this audience? Why do you need to do this
campaign? Why now?
 Outcomes - what are you hoping to achieve? What do you want people
to do/ learn etc?
 Challenges you may face
  Sport
 Impact of activities mediated by digital technologies
 Local / national councils
 Housing organisations / homeless charities
 Policy
What sectors  Regulation

does all this  Health

 Public health/ digital health/ campaigns
happen in???
 Sexual health
 High end tech firms
 Ethics
 Disaster / emergency response