Self-Care Interventions for Health: Sexual and Reproductive Health and Rights
RECOMMENDATIONS
1. Improving antenatal, delivery, postpartum and newborn care
REC 1: Health education for women is an essential component of antenatal care.
The following educational interventions and support programmes are recommended to reduce caesarean births only with targeted monitoring and evaluation.
REC 1a: Childbirth training workshops
Content includes sessions about childbirth fear and pain, pharmacological pain-relief techniques and their effects, non-pharmacological pain-relief methods, advantages and disadvantages of caesarean sections and vaginal delivery, indications and contraindications of caesarean sections, among others.
REC 1b: Nurse-led applied relaxation training programme
Content includes group discussion of anxiety and stress-related issues in pregnancy and purpose of applied relaxation, deep breathing techniques, among other relaxation techniques.
REC 1c: Psychosocial couple-based prevention programme
Content includes emotional self-management, conflict management, problem solving, communication and mutual support strategies that foster positive joint parenting of an infant). “Couple” in this recommendation includes couples, people in a primary relationship or other close people.
REC 1d: Psychoeducation
For women with fear of pain; comprising information about fear and anxiety, fear of childbirth, normalization of individual reactions, stages of labour, hospital routines, birth process, and pain relief (led by a therapist and midwife), among other topics.
REC 2: When considering the educational interventions and support programmes, no specific format (e.g. pamphlet, videos, role play education) is recommended as more effective.
Interventions for nausea and vomiting
REC 3: Ginger, chamomile, vitamin B6 and/or acupuncture are recommended for the relief of nausea in early pregnancy, based on a woman’s preferences and available options.
Interventions for heartburn
REC 4: Advice on diet and lifestyle is recommended to prevent and relieve heartburn in pregnancy. Antacid preparations can be offered to women with troublesome symptoms that are not relieved by lifestyle modification.
Interventions for leg cramps
REC 5: Magnesium, calcium or non-pharmacological treatment options can be used for the relief of leg cramps in pregnancy, based on a woman’s preferences and available options.
Interventions for low back and pelvic pain
REC 6: Regular exercise throughout pregnancy is recommended to prevent low back and pelvic pain. There are a number of different treatment options that can be used, such as physiotherapy, support belts and acupuncture, based on a woman’s preferences and available options.
Interventions for constipation
REC 7: Wheat bran or other fibre supplements can be used to relieve constipation in pregnancy if the condition fails to respond to dietary modification, based on a woman’s preferences and available options.
Interventions for varicose veins and oedema
REC 8: Non-pharmacological options, such as compression stockings, leg elevation and water immersion, can be used for the management of varicose veins and oedema in pregnancy, based on a woman’s preferences and available options.
Existing recommendation on self-administered pain relief for prevention of delay in the first stage of labour
REC 9: Pain relief for preventing delay and reducing the use of augmentation in labour is not recommended.
GOOD PRACTICE STATEMENTS
| 1. Environmental considerations |
| Adapted good practice statement on safe and sustainable management of health-care waste |
| GPS 1 (ADAPTED): Safe and secure disposal of waste from self-care products should be promoted at all levels. |
| Adapted good practice statement on environmentally preferable purchasing (EPP) |
| GPS 2 (ADAPTED): Countries, donors and relevant stakeholders should work towards environmentally preferable purchasing (EPP) of self-care products by selecting supplies that are less wasteful, or can be recycled, or that produce less-hazardous waste products, or by using smaller quantities. |
| 2. Financing and economic considerations |
| Adapted good practice statements on economic considerations for access, uptake and equity |
| GPS 3 (ADAPTED): Good-quality health services and self-care interventions should be made available, accessible, affordable and acceptable to vulnerable populations, based on: the principles of medical ethics; avoidance of stigma, coercion and violence; non-discrimination; and the right to health. |
| GPS 4 (ADAPTED): All individuals and communities should receive the health services and self-care interventions they need without suffering financial hardship. |
| 3. Training needs of health-care providers |
| Existing good practice statement on values and competencies of the health workforce to promote self-care interventions |
| GPS 5: Health-care workers should receive appropriate recurrent training and sensitization to ensure that they have the skills, knowledge and understanding to provide services for adults and adolescents from key populations based on all persons’ right to health, confidentiality and non-discrimination. |
| 4. Implementation considerations for vulnerable populations |
| New good practice statement on the life-course approach to SRHR |
| GPS 6 (NEW): Sensitization about self-care interventions, including for SRHR, should be tailored to people’s specific needs across the life course, and across different settings and circumstances, and should recognize their right to sexual and reproductive health across the life course. |
| New good practice statement on the use of digital health interventions to support the use of self-care interventions |
| GPS 7 (NEW): Digital health interventions offer opportunities to promote, offer information about and provide discussion forums for self-care interventions, including for SRHR. |
| New good practice statement on support for self-care interventions in humanitarian settings |
| GPS 8 (NEW): Provision of tailored and timely support for self-care interventions, including for SRHR, in humanitarian settings should be in accordance with international guidance, form part of emergency preparedness plans and be provided as part of ongoing responses. |
| Adapted and existing good practice statements relevant to implementation of self-care for vulnerable populations |
| GPS 9 (ADAPTED): People from vulnerable populations should be able to experience full, pleasurable sex lives and have access to a range and choice of reproductive health options. |
| GPS 10 (ADAPTED): Countries should work towards implementing and enforcing antidiscrimination and protective laws, derived from human rights standards, to eliminate stigma, discrimination and violence against vulnerable populations. |
| GPS 11: Countries should work towards decriminalization of behaviours such as drug use/injecting, sex work, same-sex activity and nonconforming gender identities, and towards elimination of the unjust application of civil law and regulations against people who use/inject drugs, sex workers, men who have sex with men and transgender people. |
| GPS 12: Countries are encouraged to examine their current consent policies and consider revising them to reduce age-related barriers to HIV services and to empower providers to act in the best interests of the adolescent. |
| GPS 13: It is recommended that sexual and reproductive health services, including contraceptive information and services, be provided for adolescents without mandatory parental and guardian authorization/notification. |
Overview
Title
Self-Care Interventions for Health: Sexual and Reproductive Health and Rights
Authoring Organization
World Health Organization