Self-care interventions for sexual and reproductive health and rights for advancing universal health coverage

Figures & data

Table 1. List of organizations and listservs to whom GVPS was disseminated

	Name of the organization/listserv	Date sent
1	WHO self-care SRHR ethical and social concerns Brocher meeting participants	2018-07-13
2	HRP/ RHR	2018-07-13
3	IBP initiative	2018-07-13
4	PMNCH Adolescent and Youth Constituency	2018-07-13
5	WHO self-care SRHR intervention scoping review meeting participants	2018-07-13
6	WHO Young health professionals meeting participants	2018-07-13
7	UNAIDS Youth Constituency	2018-07-13
8	Restless Development	2018-07-13
9	IFMSA – International Federation of Medical Students’ Associations	2018-07-13
10	FP2020	2018-07-13
11	Youth Coalition on Sexual and Reproductive Rights	2018-07-13
12	IPSF – International Pharmacy Students Federation	2018-07-13
13	SVRI
14	AWID Newsletter
15	Reproductive HIV listserv
16	IFFS – International Federation of Fertility Societies	2018-07-13
17	WRI women’s research initiative	2018-08-29
18	WHO website	2018-08-25
19	Sex workers of Winnipeg Action Coalition	2018-10-12
20	Sex workers Education and Advocacy Taskforce	2018-10-12
21	Sex Workers Outreach Project Los Angeles	2018-10-12
24	African Sex Workers Alliance	2018-10-12
25	The Sex Workers Project	2018-10-12
26	Global Network of Sex work Projects	2018-10-12
27	Sex Worker Advocacy and resistance movement	2018-10-12
28	Caribbean LGBT Community (Facebook group)	2018-10-18
29	LGBT Argentina (Facebook group)	2018-10-20
30	Orgullo LGBT Argentina (Facebook group)	2018-10-24
31	Be Positive (Facebook page)	2018-10-24
32	OUT LGBT Well-Being (Facebook page)	2018-10-24
33	Marsa Sexual Health Center (Facebook page)	2018-10-24
34	Women’s Global Network for Reproductive Rights (WGNRR) (Facebook page)	2018-10-24
35	PinkDot SG (Facebook page)	2018-10-25
36	The Asian-Pacific Resource & Research Centre for Women (ARROW) (Facebook page)	2018-11-01
37	Women for a Change Cameroon	2018-11-09
38	AfA Singapore – Action for AIDS	2018-11-14

Figure 1. Number and selected characteristics of respondents to the global values and preferences survey on self-care interventions for SRHR

Figure 2. Healthcare providers and layperson responses per key outcome of the GVPS

Table 2. Characteristics of lay persons and healthcare provider participants who provided qualitative feedback in a global survey regarding self-care interventions for sexual and reproductive health and rights (n = 326)

Socio-demographics for qualitative respondents	Healthcare providers (n = 252)	Lay Respondents (n = 70)	All Respondents (n = 326*)
Gender
Woman (self-defined; transgender and cisgender inclusive)	67.1% (169)	66.7% (46)	66.9% (216)
Man (transgender and cisgender inclusive)	32.5% (82)	30.4% (21)	32.2% (104)
Transgender	0.4% (1)	2.9% (2)	0.9% (3)
Age
18–29	28.7% (72)	50.7% (35)	33.0% (107)
30–39	27.5% (69)	20.3% (14)	26.2% (85)
40–49	21.5% (54)	15.9% (11)	20.4% (66)
50–59	13.9% (35)	10.1% (7)	13.3% (43)
60–69	5.6% (14)	2.9% (2)	4.9% (16)
70+	2.8% (7)	0% (0)	2.2% (7)
World Health Organization Region
African Region	34.5% (87)	23.2% (16)	32.6% (106)
Region of the Americas	32.5% (82)	27.5% (19)	31.4% (102)
South-East Asia Region	5.6% (14)	4.3% (3)	5.2% (17)
European Region	19.8% (50)	23.2% (16)	20.3% (66)
Eastern Mediterranean Region	4.8% (12)	5.8% (4)	4.9% (16)
Western Pacific Region	2.8% (7)	15.9% (11)	5.5% (18)
Sexual Orientation
Heterosexual/Straight	85.3% (214)	73.9% (51)	83.0% (268)
Sexually Diverse (LGBQ+)	12.4% (31)	26.1% (18)	15.2% (49)
Prefer not to say	2.4% (6)	0% (0)	1.9% (6)
Size of City/Town
A big city (above 1 million inhabitants)	48.0% (121)	55.7% (39)	49.7% (160)
A large city (300,000 – 1 million inhabitants)	18.7% (47)	18.6% (13)	18.6% (60)
A city (100,000 – 300,000 inhabitants)	10.3% (26)	4.3% (3)	9.0% (29)
Large town (20,000 – 100,000 inhabitants)	11.9% (30)	8.6% (6)	11.2% (36)
Town (1000 – 20,000 inhabitants)	7.5% (19)	7.1% (5)	7.5% (24)
Small town or hamlet (less than 1000 inhabitants)	3.6% (9)	5.7% (4)	4.0% (13)
Highest Level of Education
Completed high school	6.0% (15)	21.7% (15)	9.3% (30)
A university bachelor’s degree	28.6% (72)	44.9% (31)	32.0% (103)
A graduate degree	64.7% (163)	31.9% (22)	57.8% (186)
Other	0.8% (2)	1.4% (1)	0.9% (3)
Employment Status (all that apply)
Full time paid employment	64.1% (161)	54.3% (38)	62.0% (199)
Part time paid employment	13.5% (34)	5.7% (4)	11.8% (38)
Self-employed	10.0% (25)	4.3% (3)	8.7% (28)
Unemployed	2.8% (7)	2.9% (2)	2.8% (9)
Currently a student	13.9% (35)	32.9% (23)	18.1% (58)
Casual labour	1.2% (3)	2.9% (2)	1.6% (5)

*Four respondents did not report if they were healthcare providers or lay people.

Table 3. Overview of themes regarding self-care interventions for SRHR from lay persons and healthcare provider participants of a global survey (n = 326)

Theme regarding self-care interventions	User perspective	Healthcare provider perspective
Benefits	Less stigma: “I think an option for self-initiated interventions is good to reduce stigma and discrimination.” (41-year-old woman, Uganda) Reduced barriers to access: “Going to a health care provider can be a major barrier for women to access reproductive health services. Putting care directly into the hands of women to manage is an important way to overcome this barrier” (29-year-old woman, United States)	Empowerment: “This can lead to improvement of knowledge and confidence.” (65-year-old man, Kenya) Increased uptake of SRHR services: “Greater uptake and adherence of interventions if self-initiated” (59-year-old woman, United States) Privacy and reduced stigma: “I think that having these interventions easily accessible and without stigmatization or shame would make these interventions easier, more pleasant and safer” (21-year-old woman, Poland)
Concerns	Stigma: “Young people are exposed to ill treatment by the doctor” (22-year-old man, Turkey) Accessibility concerns: “Confidentiality is a problem when you go to access services” (56-year-old woman, Liberia) Trustworthiness of intervention: “I would want to make sure they are trusted, not counterfeit, if I buy them online.” (35-year-old woman, United States) Potential for misuse: “an intervention led by a doctor or health care provider is safer and maintains safer reproductive health” (63-year-old woman, Pakistan)	Insufficient user knowledge: persons would have “incomplete information to make a really informed choice” (43-year-old woman, Spain) Stigma: there is the need for “accessibility to self-interventions without prejudice” (32-year-old man, Nigeria) Accessibility concerns: people experience “lack of access to health services when needed even if they exist due to many barriers” (56-year-old woman, Italy) Side effects/ complications: concerns regarding “handling of complications” (54-year-old man, Kenya)
Implementation considerations	Knowledge and information: “Self-initiated interventions requires awareness, good educational background and community participation” (70-year-old man, India) Accessible interventions and linkages to healthcare: “Some interventions need counselling before they are used, how will that happen in self-initiated interventions?” (44-year-old woman, Uganda)	Healthcare linkages: “this should be an integral part of all interventions with clear guidance provided on all platforms of how to access services if needed” (56-year-old woman, Italy) Increased community engagement: “spreading information about that in the community” (21-year-old woman, Poland)

Figure 3. Health systems and people-centred strategies to support self-care interventions for SRHR