Current macroeconomic and disease trends faced by healthcare systems globally necessitate the exploration of supplementary care delivery strategies. As populations age and non-communicable and lifestyle-based diseases spread, the burden on healthcare systems increases. And, as the COVID-19 pandemic has shown, infectious diseases threaten a hammer blow to health systems already facing significant pressure on their capacity to care for patients.
The situation in Malaysia is no different. As elsewhere, new approaches are needed to put the country’s healthcare service on a more solid long-term footing. One such approach is self-care, which can modify the behaviour and motivation of individuals and communities, as well as having a positive impact in a variety of areas, including the delivery, access and utilisation of healthcare, structural frameworks within the healthcare system, and government policy.
Many countries have adopted self-care strategies, each distinct to their specific needs. For instance, as part of its Long Term Plan, which is designed to bring about a range of improvements to the service over the next five years, the UK’s National Health Service (NHS) has set out moves to empower patients by increasing knowledge of how to manage healthcare issues ranging from minor ailments to long-term conditions and prevention. The NHS’s approach has not only benefited patients by reducing the risks that individuals face as a result of their medical problems, it has also alleviated crowding in healthcare facilities.
Similar benefits have been achieved in the UK through re-designating some prescription-only drugs as over the counter (OTC) medicines. Moves in the NHS Long Term Plan to reduce visits to general practitioners (GPs) will allow doctors to pay more attention to severe cases, thus improving the quality of care provided . Further evidence suggests that the UK and European countries could make significant savings on health spending and broader economic costs by rescheduling prescription-only drugs to OTC status. And Macquarie University, attempting to quantify the value of OTC medication in a study that included eight categories of the most common OTC medicines, reports that the lack of such treatments would cost the Australian healthcare system A$3.8bn (US$2.3bn) in doctors’ visits alone.
Looking beyond healthcare to the wider economic issues, reduced worker absenteeism driven by more efficient and effective healthcare delivery has contributed to increased productivity among US firms.
The specific challenges that self-care can address in particular countries must be carefully studied, as success stories in one region could be different from those in another. With this in mind, The Economist Intelligence Unit conducted its own survey of the self-care landscape in Malaysia. Its findings suggest not only that broader implementation of self-care strategies would help with a variety of existing systemic healthcare challenges, but also that healthcare staff, pharmacists and the public are all broadly positive about the prospect of a closer focus on self-care.
The findings of our survey could be used to contribute to an action plan to implement self-care as a strategic approach on a national level. This would require a focus on educating and engaging all relevant stakeholders, from healthcare professionals to government ministries to the general public, to ensure alignment on the implementation of sustainable and effective self-care strategies.
We propose the following seven multi-sectoral strategies:
1. Government policies to regulate self-care
The concept of self-care must be embedded into the existing Ministry of Health policy agenda. More broadly, its principles and supporting ecosystem must be embedded into existing law and regulations. Dialogue should be undertaken with other relevant ministries, healthcare professionals and industry associations in order to craft guidelines that are specifically applicable to Malaysia and which ensure that responsible practices and usage of self-care products are followed.
2. Boost self-care uptake through enhanced health literacy
Reliable sources of health information are ample and widely available in Malaysia. However, misinformation and unreliable sources are also easily accessible, and general health literacy is at a nascent stage in the country. Developing a multifaceted understanding of health literacy in Malaysia will help with the development of tailored, culturally appropriate approaches through which to engage Malaysians in self-care practices.
3. Platforms that encourage healthcare providers to support and facilitate self-care
Education and knowledge sharing is a key tool for healthcare practitioners looking to enhance their ability to support self-care. Medical conferences and workshops are one area through which to educate healthcare practitioners and industry members on the importance, elements and benefits of self-care for a sustainable healthcare system. The adoption of self-care practices provides benefits that go beyond the acquisition of knowledge-on offer is a potential paradigm shift that could shape the interaction that healthcare providers and the wider healthcare industry can have with the public.
4. Publicity campaigns, both online and offline
Information about self-care can be circulated through publicity campaigns via social media and other digital platforms. But it is also important to remember that focusing too closely on online-only messaging can create a barrier to care for others. Those who have less engagement with digital media may be educated and counselled on self-care practices by healthcare professionals.
5. Engage directly with communities
Awareness of self-care may be promoted through existing community programmes. This would ensure that information is shared through already-established communication channels, improving the possibility that awareness can be spread to people across different cultures and socioeconomic groups. Engagement via government ministries other than the Ministry of Health may be necessary.
6. Engage patient groups
Patient groups may lead within their own communities to more effectively spread self-care awareness to patients and their caregivers. Pre-existing awareness and trust among patients of disease-specific organisations provides a significant opportunity to advocate for and support self-care strategies among specific patient communities, while smaller, local level support groups offer the potential for grassroots exchange of general advice and emotional support.
7. Cultivate future ambassadors through the education system
The fundamental principles of self-care may be instilled in younger members of Malaysian society through existing educational platforms such as schools, thus encouraging earlier adoption of disease prevention through basic positive lifestyle practices. This awareness could be further reinforced and expanded at tertiary level, especially in pharmacy studies courses, which could include specific modules in areas such as self-care practices and counsel.
Once relevant stakeholders have been engaged, collaborations or alliances between organisations must be established to work towards creating a long-term implementation plan. Strategic stakeholder engagement between government, non-governmental organisations, professional associations and the private sector is essential to foster an environment in which a strategic approach to self-care can be adopted across the healthcare system.
In many ways, healthcare starts with self-care. Multi-level engagement and alliances between key stakeholders-including policymakers, healthcare professionals, patient groups and industry-are required for effective adoption and advancement of self-care practices in Malaysia. Self-care improves public health, helps to reduce the burden on financial and human resources, and improves the delivery of healthcare within the existing system.
Implemented correctly, self-care could become an integral component of an accessible and sustainable healthcare system, through which Malaysians would be empowered to manage and improve their health and wellbeing in partnership with healthcare providers.