Exploring self-care interventions in sub-Saharan Africa
Challenge
Globally, 270 million women who want to avoid pregnancy are not using a modern contraceptive method. At the end of 2019, about 7.1 million people living with HIV were unaware of their status, and in 2018 nearly 90% of cervical cancer related deaths worldwide occured in developing countries.
To help tackle these disparities, an expanded set of products and services that were previously only accessible in health clinics under the supervision of a doctor or nurse are now being made available to individuals in the privacy of their own homes. These include self-injectable contraceptives, HIV self-testing kits and human papillomavirus self-sampling, among others. These innovations are paving the way for individuals, especially women and girls, to more actively participate in their own healthcare by practicing what is known as “self-care.”
The Self-Care Trailblazer Group (SCTG), with support from the Children’s Investment Fund Foundation (CIFF) and William and Flora the Hewlett Foundation, is building a movement around the potential for self-care to radically transform how healthcare is delivered around the world. In low- and middle-income countries and especially in the field of sexual and reproductive health, where privacy is a critical concern, self-care can help people manage their sexual and reproductive health in ways that are often beyond the reach of the health system.
Approach
Population Services International (PSI), as the Secretariat of the SCTG, approached Burness to lead a journalist workshop and a series of site visits to help educate journalists about the concept of self-care as it applies to sexual and reproductive health. Burness designed a 3.5-day program that included ‘classroom’ briefings by experts from five different organizations, representatives from Kenya’s Ministry of Health, practitioners and users of self-care tools.
Each briefing was coupled with a site visit so that journalists could better visualize what self-care looks like in practice. The three site visits took place on the outskirts of Nairobi, Kenya, and showcased different aspects of self-care managed by SCTG partners:
- A visit to pharmacies and an open-air market to showcase the distribution and use of HIV self-testing kits, managed by PS Kenya with support from CIFF.
- A visit to a health clinic to learn about a digital platform that allows 15- to 19-year-old girls to access the sexual and reproductive health services they want—including injectable contraceptives—at the provider of their choice, managed by Triggerise’s In Their Hands project.
- A visit to HOYMAS, a community-based organization serving male sex workers and men who have sex with men living with HIV and AIDS—with support from the Bridge-to-Scale project led by Jhpiego—to learn about their work providing oral Pre-Exposure Prophylaxis (PrEP) to populations at risk of contracting HIV.
- A visit to Bar Hostess Association, an organization created for and by sex workers, women having sex with women, women using drugs and bar hostesses in Kenya—with support from the Bridge-to-Scale project led by Jhpiego—to learn about their work providing oral Pre-Exposure Prophylaxis (PrEP) to populations at risk of contracting HIV.
Burness secured attendance from journalists from five key outlets, namely All Africa, BBC, the Daily Nation (Kenya), Devex and Le Monde. Burness also managed the logistics, including venue bookings, travel, local transport and all site visit arrangements.
Results and Impact
Over the course of the 3.5 days, journalists were able to gain an in-depth understanding of self-care, not only by interacting with experts and learning about international and national policies around self-care, but also through meeting with young men and women whose lives are being transformed through self-care.
The journalists wrote a series of articles showcasing self-care’s potential to address existing health care challenges, including lack of access and shortages of healthcare workers:
- All Africa, 29 November 2019: Kenya: How Self-Care Interventions are Advancing Sexual and Reproductive Health in Kenya
- All Africa, 29 November 2019: Sexual and Reproductive Health Services That Connects At-Risk Persons to PrEP in Kenya
- Le Monde Afrique, 23 November 2019: Au Kenya, une plate-forme numérique pour aider les jeunes filles à prévenir leurs grossesses
- Le Monde Afrique, 19 November 2019: Kenya : l’autodépistage, un nouvel outil dans la lutte contre le VIH
- Devex, 17 January 2020, Can self-care health interventions help countries reach UHC?