Self-care

Self-care is any treatment or therapy used without a physician’s prescription or direct recommendation by a healthcare professional. Encompassing the decision not to consult professional healthcare provider (i.e., no treatment or nursing care only), it involves self-diagnosis by noting symptoms and treatment actions based on the association of symptoms with successful treatment outcomes in the past. Other self-treatment practices include: retaining and reusing old medications, purchasing scheduled drugs without prescription, using common remedies (traditional or modern) available within the household for what are perceived to be recurring illnesses, or experimenting with medicines recommended by a relative or friend.

Self-care is found to be an important therapeutic activity undertaken in Bangladesh by the disadvantaged populations for managing illnesses in consistence with other rich and poor countries alike (. Self-care was also practiced in the context of microcredit-based integrated intervention (IV). The importance of engaging in ‘self-care with competence’, is emphasized in the literature. This is also supported by recent policy changes in the National Health Services in UK (e.g., NHS Direct) to deregulate prescribed medicines and the introduction of telephone helpline services so as to promote self-medication. Again, empowering people through support for self-care is expected to make health services work for the poor by providing services corresponding to their needs and increased leverage over providers.

Use of self-care is also justified depending upon the type of illness and standardization of its treatment so that the common people can use it safely and effectively. For example, in case of minor illnesses of short duration such as uncomplicated fever, watery diarrhea or pain and body aches, self-care may be effective and practical. However, self-care involves risks such as incorrect self-diagnosis, absence of knowledge of alternative treatments, irrational use of drugs including selection, incorrect dosage and duration as well as side-effects and neglect of interactions with other drugs. This is especially important in a population with low literacy level like Bangladesh where self-care is largely uninformed, and may be harmful due to the above risks. The free availability of ‘prescription only drugs’ in the unlicensed and unregulated drug retail outlets also exaggerates risks inherent in self-care. While people taking responsibility for their own health has gained increasing acceptance from the health profession, it remains critical that healthcare decisions and actions taken by sick individuals or their care-givers are both safe and appropriate. Enhancing people’s capacity for safe and informed self-care along with the capacity to assess services available locally, to judge provider competence and to evaluate whether costs are justified and reasonable, are needed.