Overview

The 'National Guidelines on Self-Care for Sexual, Reproductive and Maternal Health, 2020' is a comprehensive document that establishes a framework for integrating self-care interventions into Nigeria's health system to improve sexual, reproductive, and maternal health (SRMH) outcomes. The guidelines are informed by the World Health Organization's (WHO) Consolidated Guidelines on Self-Care for Sexual and Reproductive Health and Rights, adapted to the Nigerian context. They address gaps in policy, practice, and access to services, emphasizing the need to empower individuals to take greater control over their health through evidence-based self-care practices. The document is structured into five chapters plus supplementary sections. Chapter 1 provides an introduction, covering the global context of self-care, Nigeria's response to WHO recommendations, and the national policy landscape. It highlights challenges such as high maternal mortality, unmet family planning needs, unsafe abortion, and high rates of sexually transmitted infections (STIs) including HIV. Chapter 2 outlines the purpose, objectives, and conceptual framework. The guidelines aim to provide strategic guidance for implementing self-care interventions to reduce maternal and child morbidity and mortality, and to improve SRMH overall. Key principles include person-centered care, empowerment, voluntarism, informed choice, confidentiality, quality, safety, equity, and accountability. Chapter 3 presents specific guidance for self-care interventions across key areas: antenatal, delivery, and postpartum care; family planning including infertility services; eliminating unsafe abortion; and combating STIs, reproductive tract infections, breast and cervical cancer, and other gynecological morbidities. Interventions include self-administration of injectable contraceptives, self-testing for HIV and STIs, self-assessment for pre-eclampsia, and self-management of medication abortion through telemedicine guidance. Chapter 4 focuses on creating an enabling environment for self-care, addressing health system response, service delivery, health information systems, access to products, and leadership/governance. It calls for policy reforms, regulatory updates, task-shifting, training of health workers, public education using mass media and digital platforms, and ensuring the availability and affordability of self-care commodities like contraceptives and self-test kits. Chapter 5 provides good practice statements on environmental considerations and financing. It emphasizes the need for sustainable funding mechanisms from government and partners, and the safe disposal of self-care products to minimize environmental impact. Overall, the guidelines aim to promote a paradigm shift towards person-centered health care, with self-care as a complement to facility-based services, ultimately contributing to universal health coverage and the Sustainable Development Goals.

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