Building on the Self-Care Movement: Advances in Sexual and Reproductive Health

Authors: Madison LangrinHannah Rubens

Most people would say they’re familiar with the concept of self-care. Dominating the self-care space are multi-step skincare routines, bubble baths, gratitude journals, smoothies, cleanses and countless other low-cost, self-pampering activities usually offering immediate physical and emotional benefits. Colloquially, self-care has come to typify a handful of popularized behaviors and trends, but it also holds a much larger potential to empower autonomy over our well-being at both an individual and preventative level. 

Consider the World Health Organization’s definition of self-care: “the ability for individuals, families, and communities to promote, maintain health, prevent disease and cope with illness with or without the support of a healthcare provider.” What the WHO is truly conveying is the concept of self-determination with the assistance of, rather than dependence on, a health system. According to the WHO, self-care is reliant on the three pillars of self-management, self-testing, and self-awareness — all of which afford people agency over their own health. This broadened notion of self-care acknowledges, for example, the dual importance of flossing as well as having access to a dentist in empowering individuals with agency over their health and wellness.  

The aspiration towards greater agency is particularly relevant and important in the stigmatized sphere of women’s sexual and reproductive health (SRH). Despite stigma falling under the realm of psychosocial barriers to healthcare, we know that it can also manifest itself physically, keeping individuals from the care and information they require. Self-care in the context of SRH is empowering people with the means to take charge of their education and advocate for themselves, while also making access to self-administered and self-testing products a reality. Quite a few groups are spearheading the self-care and SRH dialogue: from holistic contributions from PATH in advancing women-led contraceptives and women’s empowerment, to the groundbreaking work of the Self-Care Trailblazer Group and its partners like PSI on the self-care agenda and movement. 

CAMI Health seeks to join the conversation surrounding self-care by highlighting the unique contributions and benefits of self-initiated multipurpose reproductive health products to address the intrinsic links between risks for unintended pregnancies and acquiring HIV or another sexually transmitted infection (STI). As the Secretariat of the Initiative for Multipurpose Prevention Technologies (IMPT), CAMI Health works to expand global research and education around Multipurpose Prevention Technologies (MPTs), which are products that simultaneously prevent HIV, other STIs, and/or unintended pregnancies. 

If you’re thinking about putting “purchase MPTs” on your list of errands this week, keep in mind that the only product currently on the market is the condom. While very effective — if used correctly and consistently — the condom (both internal and external) presents a variety of inter-relational barriers to ensuring the full protection of the health and choice of sexually active people. These hurdles often arise from the negotiation of condom use; a dialogue which holds inherent complexities. CAMI Health is dedicated to encouraging and assisting the development of a wide variety of MPTs with the goal of expanding contraceptive and preventative options that place individuals at the center of their decision-making — regardless of their circumstances. Also, in addition to expanding options for comprehensive protection, MPTs aim to offer the ease and accessibility of a one-stop shop for a person’s SRH needs.

Self-care is interwoven with the goals and values of CAMI Health. Driving advancements in the MPT field, CAMI Health’s work with the IMPT can be understood as directly enabling self-care practices among women. In a not-so-futuristic world with diverse and streamlined options for protection, women will be empowered with ownership of their health, and the control to choose prevention products that align with their unique social and life circumstances.  

With a few exceptions, MPTs are self-administered, meaning users can independently manage and decide how, when, and what products they use to protect their SRH, without relying as heavily on a physician, or even their partner, to use them. The self-administered MPTs in development take the form of fast dissolving inserts, vaginal films, vaginal and rectal gels, intravaginal rings and oral pills/tablets. Long-acting products in development, such as injectables and implants, also enhance this pipeline of autonomous options that remove one’s dependence on their sexual partner for prevention. This innovative approach addresses women’s and sexual and gender minorities’ historically-rooted reliance on external systems and people to meet their health needs. Offering these groups an active role in their own healthcare is an exciting and important development within the domain of sexual and reproductive health. Check out this comprehensive database for details on all MPT products in active development!

In addressing the unmet need for combined contraception and HIV/STI prevention, the IMPT and its partners in the MPT field place a particularly important emphasis on amplifying women’s voices and needs through elevating socio-behavioral research. This focus further promotes a self-care environment by ensuring the MPT products in development are deeply informed by, and acceptable to, potential end-users around the world. Guided by end-users, MPTs present an opportunity for more inclusive, equitable, and people-centered health interventions across the globe.

At its core, the issue of self-care in sexual and reproductive health is not solely the concern of women and those who may one day use self-administered or long-acting MPTs. It has implications for their partners, families and society at large. Therefore, while this conversation should center the voices of potential end-users, it cannot end with them. Working towards better self-care and SRH options should begin with widespread awareness and education that needs to take place on a grassroots level. Here you have the power to meaningfully contribute to a future that offers sexual and reproductive autonomy back to the individual. 

 

Potential action items for readers:

  1. Support structural movements pushing for the development of environments that allow for self-care practices within the SRH domain
    • Explore the WHO’s guidelines to self-care interventions through videos, infographics, and current initiatives
    • The National Guidelines on Self-Care for Sexual, Reproductive, and Maternal Health in Nigeria, and the National Policy Blueprint in Australia are a model for further integration of self-care on an institutional level (credit to SCTG for developing these deliverables)
    • Join the IMPT network to help raise awareness and support for MPTs
  2. Continue learning about self-care in SRH, as well as the MPT field. This, in itself, is an act of empowerment as we strive to create a groundswell of support for MPTs, and ultimately make women’s self-care products non-niche and widely accessible