A qualitative study published in the Journal of Health Services Research & Policy raises concerns about the role of self-care in health policy as a one of the strategies to tackle antimicrobial resistance and its potential impact on those who have been marginalised and underserved by healthcare services. 

The study, led by Dr Agata Pacho from the London School of Hygiene & Tropical Medicine (LSHTM), highlights the experiences of racialised minority and low-income women in managing urinary tract infections (UTIs) without immediate professional medical assistance. 

The UK’s 2019-2024 Antimicrobial Resistance National Action Plan encourages self-care for minor infections, including uncomplicated UTIs, to reduce antibiotic overuse and combat antimicrobial resistance. However, contrasting self-care with antibiotic treatments without explicitly mentioning the role of professional advice and guidance made available to patients practising self-care may imply that self-care is separate from, or even in opposition to, professional care. This can exacerbate challenges that women from racialised minorities and women in low-income households already face in accessing health care services and obtaining the necessary resources for self-care.  

Through online focus groups and interviews with 25 women, the study found that while participants often practiced self-care before seeking professional advice, they valued consultations with healthcare professionals for managing UTI symptoms and navigating self-care options. Barriers to effective self-care included high-pressure work environments and the inability to take time off work to recover. 

Dr Agata Pacho, a sociologist specialising in the social and cultural aspects of health, with a focus on health inequities, evaluating national health and social policies in the UK, is the lead author of the paper.

She said, “It is crucial to recognise the self-care practices already undertaken by those who have been marginalised and underserved by healthcare services—practices born out of necessity rather than compliance with prescriptive policies. Women in our study frequently assessed the severity of their symptoms, demonstrating a level of expertise that positions them as valuable partners in efforts to improve antibiotic stewardship.” 

The findings indicate that while self-care can play a role in managing UTIs, healthcare policies should account for the diverse experiences and challenges of marginalised populations.