Health systems are under growing financial pressure. Billions of people still lack access to essential health services, while out-of-pocket health costs push many households into poverty. At the same time, declining development assistance and constrained public budgets are increasing pressure on governments to deliver better health outcomes with limited resources.
This policy paper is the main paper in UNU-CPR’s series on self-care and health financing. It makes the case for publicly financed, supported and regulated self-care as an underutilized tool for advancing Universal Health Coverage (UHC) and broader development objectives. Self-care encompasses evidence-based interventions that enable people to promote health, prevent disease, diagnose conditions and manage illness, with or without direct support from a health worker.
The paper sets out three mutually reinforcing pathways through which investment in self-care can generate fiscal and economic returns: reducing health-system costs and pressures by shifting appropriate care closer to homes and communities; reducing out-of-pocket expenditure and strengthening household financial security; and supporting productivity, economic participation and sustainable growth.
It also introduces a four-stage self-care financing-systems maturity spectrum, assessing progress from policy recognition through to full integration within UHC financing, reimbursement, regulation and accountability systems. While policy adoption is growing, the analysis finds that financing and institutional integration continue to lag.
The paper argues that self-care should not substitute for public investment in health. Its potential depends on governments financing and integrating it effectively, with safeguards to prevent costs being transferred to households or underserved populations being excluded. It identifies three priorities for action: finance self-care, institutionalize it within UHC systems, and strengthen its governance, measurement and sustainability.
