The concept of self-care is multidimensional, with many defining elements. This paper describes the origin of this comprehensive concept. It examines the response of the nursing discipline to citizen self-care initiatives and the subsequent effects this response has had on the development of nursing knowledge. The evolution of self-care as a core concept within Canadian health policy is presented; the potential readiness for citizens to accept self-care as an aspect of healthcare delivery is explored, identifying potential benefits and obstacles. The paper concludes with a proposed self-care approach to healthcare reform in Canada and the subsequent influence this approach may have on the discipline of nursing. The congruency between a self-care healthcare delivery system and the theoretical foundations and perspective of healthcare delivery held by the nursing discipline is discussed. The role nurses might assume in shaping a self-care healthcare delivery system is delineated.Self-care is not a new idea. Since the beginning of humankind, people have taken action to ensure personal safety and have developed strategies to address illness and other health challenges (Haug et al. 1989;Levin 1976;Padula 1992;Saunders 1994;Woods 1989). Primitive societies developed healing rituals that sometimes involved the consumption of special foods to promote the health of particular individuals or entire communities (Hill and Smith 1985). Women assisted one another in childbirth and shared the acquired knowledge with the next generation. Implementing self-care strategies to address day-to-day concerns about health is normal and usual (Bohart and Tallman 1996;DeFriese et al. 1989;Levin 1981; Punamaki and Ascham 1994 Individuals select self-care behaviours in order to maintain an acceptable level of health or well-being, to prevent illness or injury and to promote health. These selfcare behaviours contribute to one's ability to perform a variety of tasks, ranging from ensuring survival to attaining self-actualization. Families accept responsibilities for facilitating the self-care of their members and take on self-care activities for other members who, owing to maturation, illness or other life events, are unable to complete the necessary task themselves. Community leaders support resources that enable individuals and families to carry out self-care tasks important to them. Clients at the individual, family and community levels have different self-care needs and expectations.Different beliefs (Keller et al. 1989) and individual characteristics or conditioning factors (Chang 1980;Connelly 1993;Edwardson and Dean 1999;Horsburgh 1999;McCaleb 1995) influence the self-care behaviours selected or processes used to achieve a particular level of health. As well, the type or level of client (individual, family or community) influences choice of self-care activities.Multiple descriptors of self-care result in varied definitions within and across disciplines (DeFriese et al. 1989;Health Canada 1997;Punamaki and Aschan 1994;Rew 1990)...