Abstract

BackgroundSelf-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.MethodsWe 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.ResultsThere 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.ConclusionsKnowledge 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.

Highlights

  • Self-care strategies for sexual and reproductive health (SRH) include practices, tools, and strategies for people to manage their health

  • Knowledge of self-care SRH strategies varies by intervention type in the Eastern Mediterranean Region (EMR)

  • Out of 30 participants who responded to the question of whether they identified as a health care providers (HCP), 16 (n = 53.3%) identified as HCP; the rest (n = 14; 46.7%) did not, and are referred to as lay persons in this manuscript

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Summary

Introduction

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. Self-care strategies offer increased access, autonomy, and reduced stigma for advancing sexual and reproductive health (SRH) [1]. Self-care interventions include practices, tools, and strategies for people to take an active role in managing their own health. The WHO developed global normative guidance in 2019 on self-care interventions for sexual and reproductive health and rights (SRHR). While some self-care strategies are widely known and available across different global settings, such as condoms, others may be less acknowledged, available, and accessible, such as abortion self-management or self-injectable long-acting contraceptives [3]

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