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Self-care interventions for sexual and reproductive health : a strategic health systems investment

Sundewall, Jesper LU ; Williams, Andrea ; Strauss, Michael and George, Gavin LU (2025) In BMJ Global Health 10(Suppl 6).
Abstract

Self-care interventions for sexual and reproductive health (SRH), including HIV self-testing, self-injected contraception and self-managed abortion, offer promising pathways to advance universal health coverage, particularly in low- and middle-income countries. While often framed as cost-saving measures, this paper argues that self-care should be understood as a strategic investment in health system performance. Drawing on costing and financing analyses and previous literature, we explore how self-care interventions can enhance efficiency, resilience and equity of health systems. We propose a costing framework that outlines cost components across development, implementation and scale-up, emphasising both system and individual-level... (More)

Self-care interventions for sexual and reproductive health (SRH), including HIV self-testing, self-injected contraception and self-managed abortion, offer promising pathways to advance universal health coverage, particularly in low- and middle-income countries. While often framed as cost-saving measures, this paper argues that self-care should be understood as a strategic investment in health system performance. Drawing on costing and financing analyses and previous literature, we explore how self-care interventions can enhance efficiency, resilience and equity of health systems. We propose a costing framework that outlines cost components across development, implementation and scale-up, emphasising both system and individual-level considerations. We argue that sustainable scale-up of self-care requires diversified financing models, including tax-based funding, insurance mechanisms and reduced out-of-pocket costs for users. Successful integration also demands governance structures that prioritise quality, equity and continuity of care. By reframing self-care as a health system investment rather than a cost-containment tool, policymakers can better harness its potential to improve access, reduce burden on facilities and empower individuals in managing their health. Self-care interventions for SRH, when embedded within broader health system strengthening efforts, have the potential to be transformative for SRH outcomes and for progressing towards universal health coverage.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Health services research, Health systems, Universal Health Care
in
BMJ Global Health
volume
10
issue
Suppl 6
article number
e019030
publisher
BMJ Publishing Group
external identifiers
  • scopus:105014533857
  • pmid:40866081
ISSN
2059-7908
DOI
10.1136/bmjgh-2025-019030
language
English
LU publication?
yes
id
05d9f328-bd42-4091-bb61-2ffed678236d
date added to LUP
2025-10-20 14:35:27
date last changed
2025-11-17 16:37:20
@article{05d9f328-bd42-4091-bb61-2ffed678236d,
  abstract     = {{<p>Self-care interventions for sexual and reproductive health (SRH), including HIV self-testing, self-injected contraception and self-managed abortion, offer promising pathways to advance universal health coverage, particularly in low- and middle-income countries. While often framed as cost-saving measures, this paper argues that self-care should be understood as a strategic investment in health system performance. Drawing on costing and financing analyses and previous literature, we explore how self-care interventions can enhance efficiency, resilience and equity of health systems. We propose a costing framework that outlines cost components across development, implementation and scale-up, emphasising both system and individual-level considerations. We argue that sustainable scale-up of self-care requires diversified financing models, including tax-based funding, insurance mechanisms and reduced out-of-pocket costs for users. Successful integration also demands governance structures that prioritise quality, equity and continuity of care. By reframing self-care as a health system investment rather than a cost-containment tool, policymakers can better harness its potential to improve access, reduce burden on facilities and empower individuals in managing their health. Self-care interventions for SRH, when embedded within broader health system strengthening efforts, have the potential to be transformative for SRH outcomes and for progressing towards universal health coverage.</p>}},
  author       = {{Sundewall, Jesper and Williams, Andrea and Strauss, Michael and George, Gavin}},
  issn         = {{2059-7908}},
  keywords     = {{Health services research; Health systems; Universal Health Care}},
  language     = {{eng}},
  number       = {{Suppl 6}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Global Health}},
  title        = {{Self-care interventions for sexual and reproductive health : a strategic health systems investment}},
  url          = {{http://dx.doi.org/10.1136/bmjgh-2025-019030}},
  doi          = {{10.1136/bmjgh-2025-019030}},
  volume       = {{10}},
  year         = {{2025}},
}