1. Identify the problem and evaluate your context
Identify the problem and evaluate your context
1.1. Define what specific issue(s) you are trying to address
The first step when deciding to launch a self-care (or any other) initiative is to clarify what is moving you to launch this initiative. Specifically, to identify what are the drivers that are moving forward this need for change.
Some of the key drivers could be the following. These could be present or not depending on the healthcare system and process organisation:
- Related with patients needs:
- Low awareness and/or knowledge of citizens on how to treat a minor condition.
- Patients with low literacy have difficulties to understand healthcare recommendations.
- Related to the strategic priorities in which you would like to act upon:
- Promotion of patient empowerment.
- Improvement of treatment and care appropriateness.
- Alignment with other stakeholders strategies.
- Improvement of patient experience.
- Linked to the current system of care for minor conditions (sustainability issues):
- High numbers of potencially avoidable GP visits related to minor conditions (with the consequent time invested).
- High numbers of ER visits for minor coditions.
- Inadequate use/overuse of antibiotics.
- High number of work leaves.
- Clinical practice variation in the management of minor conditions.
1.2. Identify whether those issues are related to a specific minor conditions or a general approach to self-care
Selecting the focus and broadness of your target can be key in determining if the self-care promotion intervention. In some cases the strategy might be better of with targeting one or two conditions; for example, if you want to address the issue that 12% of the visits to the primary care services are due to colds or lower urinary tract infections, the strategy might be more successful by specifically targeting the self-care for those specific conditions. On the other hand if you want to target the inappropriate use of antibiotics, the strategy might need a general approach to prescription behaviours, not restricted to a singular minor condition.
1.3. Identify stakeholders and resources available for the self-care strategy
Stakeholders involved for the self-care strategy: A key determinant of a successful intervention can be the inclusion of the relevant stakeholders. Anyone who wants to promote self-care should identify the stakeholders that are/could be involved and what is expected of each of them. Identifying those stakeholders at an early stage can facilitate a better coordination and a better use of all the available resources.
Stakeholders involvement could provide significant added value in multiple stages for the self-care promotion strategy, such as: identifying key drivers, identifyng self-care behaviours, the selection and implementation of the self-care interventions, their evaluation and, specially, in the evaluation of mechanisms that migh hinder or facilitate the promotion of self-care.
Stakeholders should be defined in each specific context. The following, but not limited to, key groups of stakeholders should be considered:
- Healthcare and social care professionals (and professional bodies)
- Patient organisations and other NGOs
- Healthcare managers
- Policy decision makers
- Industry, self-care medication and medical devices industry
- Workplace related stakeholders
The following table exemplifies some of the different key stakeholders at local, regional and country level.
|Local level||Regional level||Country level|
|Healthcare and social care professionals (and professional bodies)||Primary health care professionals,
Social services professionals
Relevant regional professional bodies
|National professional bodies,
|Educators||Educators in local schools (educational institutions primary and secondary level)||Regional education authorities,
Health education and promotion authorities,
|National education authorities,
|Patient organisations and other NGOs||Patient associations or local communities||Regional associations||National organisations,
|Policy decision makers||Local authorities||Regional (or equivalent) government||Ministry,
Managers and directors of the primary care centres and hospitals
|Regional/district Health authorities||National Health Authorities|
self-care medication pharma industry
|Workplace related stakeholders||Local companies||Regional companies,
|Others (ex. patients or citizens at the individual level)||Patients or citizens||Patients or citizens||Patients or citizens|
1.4. Identify the self-care support resources available in your context:
If you want to successfully promote self-care in your context, a key step can be to identify the existing resources. Some of the key resources that you might want to consider are:
- Economic resources: for material to be developed, personnel required to implement self-care strategy,
- Structural resources: which include some of the key resources for the implementation of self-care interventions such as network of community pharmacists, general access of the population to internet, etc.
- Training: consider whether there is professionals trained to implement self-care interventions.
- Technology: Existence of health web portals, health advice lines, etc. in your context (local, regional or national)