1. Identify the problem and evaluate your context
This exercise would give a general idea of the starting point.
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.
The key drivers depend on each specific context, however a review of the literature point towards some of most common drivers relating to Urinary tract infection.
Some of the key drivers could be:
The incidence of Urinary tract infection among the population.
Urinary tract infection (UTI) is a common ailment, particularly among young women. It is estimated that around 10–20% of women will experience a symptomatic UTI at some time . Men have a lower incidence (estimated 3-10% men aged 50 or older) .
Its incidence rises with age for both sexes. It is estimated that 10% of men and 20% of women over the age of 65 years have asymptomatic bacteriuria .
Since the appearance of UTI can be reduced with appropriate hygiene practices and healthy lifestyle behaviours incidence of UTI can be a strong driver for self-care promotion.
Recurrence rate of UTI.
UTI is prone to recurrence, it is estimated that more than 20% of no pregnant women with UTI will experience a recurrence. Among these, 80% are due to reinfection (new infection) and 20% to relapse in 6 months .
Untreated UTI can cause complications and/or lengthen the cure.
Improve adherence to treatment.
Those drivers for change are just suggestions and need to be adapted to each context.
1.2. Identify whether those issues are related to a specific minor conditions or a general approach to self-care
The strategies to address the drivers of a self-care promotion strategy for UTI are quite specific to this condition.
Regarding its incidence, the particularities of each condition require a specific approach. In the case of UTI it is also estimated that the high recurrence rate, potential severity of the infection are topics that will need to be addressed from a specific strategy.
The improvement of adherence to treatment is a driver that can be shared with other minor conditions (See for example Athlete’s foot) and thus could more easily be part of a general approach to self-care of minor conditions.
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 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
- Workplace related stakeholders
The table included in the general guideline exemplifies some of the different key stakeholders at local, regional and country level.
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.
Regarding the key issues that have been highlighted regarding Urinary tract infection the following resources could be particularly useful if available:
Budget allocated for material to be developed, personnel required to implement self-care strategy, etc.
Use in the health system of antibiotic treatments in single-dose administration.
General access of the population to internet (to access web portals or similar services), etc.
Training in specific skills, particularly communication skills of professionals that could be involved in the strategy (GPs, primary care nurses, pharmacists, professionals staffing phone and online consultations…).
If the professionals don’t have the training in the specific skills needed for your self-care promoting strategy consider whether training could be developed and included in continuous professional development schemes or similar schemes.
Existence of health web portals, health advice lines, etc. in your context (could be from public institutions but also consider Patient Organisations web portals, etc.).
Consider also:Are there any tools/information to help promote patterns and healthy lifestyles (health education)? Are they well-known and used?
Are these websites multi-lingual and take into consideration most frequent languages in the communities that you want to address?
The following table illustrates a possible way to summarize the basic characteristics of an evaluation of the context for the self-care strategy.
If possible, completing this review with all stakeholders might prove useful.
Note that depending on your position (policy decision maker; healthcare professional, member of patient organisation…) you might have different possibilities and ability to involve other stakeholders.