Written By: Rewhandamzi Boms
May 4, 2022
Health literacy is an important factor in developing strong health systems. My experience growing up in sub-Saharan Africa, a region characterised by a high infectious disease burden and weak health systems, enabled me to comprehend the worth of health literacy in a population. Several interventions with great expectations of amazing positive impacts or results have been developed to tackle the infectious disease burden. However, I have witnessed many of these interventions fail to deliver optimal results while some others completely crumble due to several factors, including poor leadership, political instability, an inadequate workforce and lack of expertise. Nevertheless, an unnoticed and neglected factor is health literacy.
Health literacy simply refers to the degree to which individuals can obtain, understand and apply health information to make informed decisions related to their health and care. Despite well-designed health interventions, the ability of the receiving population to understand their relevance and impact will ultimately contribute to attaining desired results. My experience during an internship in the antiretroviral department of a major tertiary hospital made me realise this. I noticed a high level of medication non-adherence among HIV patients, and the antiretroviral therapeutic committee kept developing strategies to promote adherence, which most times were only temporarily successful. As I reflect on the challenge and strategies developed, I realise that low health literacy could have been the crux of the non-adherence. Some healthcare professionals were probably lagging in effectively communicating health and scientific information in clear simple language and ascertaining whether their patients could understand it. Patients with adequate knowledge and understanding of the importance of medication adherence will certainly be self-motivated to adhere.
This also highlights a possible low level of health literacy even among health professionals. If health literacy is the application of health information and concerns to a health context, then non-application of health information in a health situation suggests low health literacy. So a person (including health professionals) can be literate and still have limited health literacy. The pandemic gave a perfect illustration of this. My involvement in a survey to identify the drivers of COVID-19 vaccine hesitancy revealed the reluctance of some health professionals to take the COVID vaccine themselves as one of the dominant reasons for the hesitancy, especially among the disadvantaged population with poor socio-economic status. An abundance of scientific research has acknowledged that trust and confidence play a critical role in promoting vaccine acceptance. Thus, the show of reluctance and failure of some healthcare workers to access and apply proven knowledge in combating the pandemic typically demonstrates limited health literacy among health professionals in this context. It also promotes distrust in medical professionals and the healthcare system and, consequently, worsens health illiteracy in the society.
These experiences have taught me that to reduce infectious disease burdens and improve health outcomes, health literacy could be the unifying factor that will ensure optimal results from several high-potential public health interventions. Efforts need to be intensified to enhance the ability of both professionals and the public to adopt and promote recommended preventive behaviours. Healthcare organisations should implement changes that foster an environment that strengthens professionals’ and patients’ health literacy. Healthcare professionals should ensure that people connect and understand health information by using common, simple words to be as clear as possible and minimise the risk of misunderstanding. A motivational interviewing approach should also be encouraged and utilised to strengthen peoples’ motivation for engaging in health interventions.
I reckon that increasing health literacy will positively impact health outcomes, reduce inequity and promote healthier, safer and thriving societies.