Sexual and reproductive health self-care interventions in the Eastern Mediterranean Region: findings from a cross-sectional values and preferences survey to inform WHO normative guidance on self-care interventions

Abstract

Background Self-care strategies for sexual and reproductive health (SRH) include practices, tools, and strategies for people to manage their health. Access to SRH services has increased in the Eastern Mediterranean Region (EMR) in the past decade. The objective of this manuscript is to provide a preliminary assessment of self-care SRH interventions focusing on access, knowledge, perceived challenges, and recommendations for the future. We aim to contribute to the evidence base on knowledge and uptake of self-care SRH strategies in the EMR. Methods We conducted an online cross-sectional Global Values and Preferences Survey (GVPS) to inform WHO guideline development on self-care interventions for SRH. Recruitment was web-based and included hosting the survey on the WHO Department of Reproductive Health and Research website, and sharing the survey link to diverse SRH websites. Analyses included the subsample of respondents living in EMR countries. We first conducted descriptive statistics of sociodemographic and self-care intervention responses. We then conducted bivariate analyses to examine statistically significant differences in knowledge for each intervention between EMR and non-EMR regions. We extracted open-text responses and applied thematic analysis techniques. Results There were 53 respondents from the EMR spanning 14 countries, including16 health care providers (HCP) and 37 laypersons. Qualitative responses (n = 16) suggest that (a) perceived benefits of self-care SRH strategies include enhanced SRH access, knowledge, and improved SRH outcomes; (b) perceived concerns include misuse and safety; (c) linkage to care following self-care SRH interventions can consider mobile phone apps, hotlines, health care liaisons, and community outreach; (d) HCP want additional training on strengthening therapeutic alliances with patients and practical information on interventions; and (e) future research can focus on reproductive health, condom use, service barriers, and implementation. EMR respondents reported lower knowledge levels than non-EMR respondents on the following strategies: diaphragm/cervical cap, contraceptive patch, web-based SRH information, post-exposure prophylaxis, re-exposure prophylaxis, and HIV treatment. Conclusions Knowledge of self-care SRH strategies varies by intervention type in the EMR. Future research with larger and more representative samples can inform regional self-care SRH implementation. Knowledge dissemination, stigma reduction, accessibility, and training of health care professionals are key domains for advancing access to self-care SRH strategies in the EMR.

Barriers and facilitators to self-care practices for sexual and reproductive health among women of reproductive age

“…The benefits offered by digital tools within the realm of a multiplicity of SRH-self-care practices, as also suggested by previous studies conducted in various settings, provide the prospects for integrating digital tools into mainstream SRH service systems [5,[20][21][22]. Self-care interventions are found to be utilized and accepted more if they are offered through digital tools [20][21][22].…”

“…The benefits offered by digital tools within the realm of a multiplicity of SRH-self-care practices, as also suggested by previous studies conducted in various settings, provide the prospects for integrating digital tools into mainstream SRH service systems [ 5 , 20 – 22 ]. Self-care interventions are found to be utilized and accepted more if they are offered through digital tools [ 20 – 22 ]. Moreover, digital platforms are perceived to be less influenced by barriers, such as social stigma, and are perceived by the target groups to be safe and increase their self-efficacy [ 23 ].…”

Knowledge of self-care intervention on sexual and reproductive health and its associated factors among women in internally displaced persons camps of North Central Nigeria

“…Self-care interventions in its own right are evidence-based, quality devices, drugs, diagnostics, and/or digital products that can be made available completely or partly outside the con nes of formal health service and can be utilised with or without the explicit oversight of healthcare personnel (8). Self-care interventions are classi ed into self-management (such as self-treatment, self-medication, self-administration, and selfinjection), self-testing (which include self-sampling, self-testing), and self-awareness (which are self-help, self-e cacy, and selfeducation) (9). Others include but are not limited to HIV self-testing, self-managed medical abortion, self-injection of subcutaneous injectable contraception (DMPA-SC), and antenatal self-care which align with the WHO guidelines (10).…”