The term ‘literacy’
is defined in overall as the capacity to read and write, whereas a ‘Literate
Person’ is said to be an individual
“Who can with understanding both read and write a short simple
statement on his or her everyday life”.
Similarly, literacy is defined as the skill to
understand and improve in critical judgement. However, the comprehensive definition is that
which was provided by National Institute for Literacy, which defined literacy
as the capacity to read, write and speak in English, calculate and also solve
problems at levels of ability necessary and be able to achieve set goal and
improve on one’s potential or knowledge.
Health Literacy as a term was first used in 1974 following the proceeds of a health education conference in which health education was discussed as a social policy issue. Since then, there has been a rapid increase of interest to health literacy and its concepts. Individuals with inadequate health literacy accounts to general poor health issues, not able to use medical services, poor understanding of medical treatment, more likely to be hospitalised thereby causing a massive financial liability to the health care scheme. Therefore, a good knowledge of an individual’s health literacy is important in adapting health-related service/ information and also in designing a positive health education program. However, over the past years, the term “Health Literacy” has been described in several ways. In defining health literacy, Ad Hoc Committee on Health Literacy defines health literacy as the ability of an individual to read and write. The author however, here retains the original understanding of the word ‘Literacy’ and transfers its skills to the health care domain. Additionally, the World Health Organisation defines health literacy as the
“cognitive and social skill, which determines the motivation and
ability of individuals to gain access to, understand and use information in
ways that promote and maintain good health”.
However, the most quoted definition of health literacy in existing literature's is that by Healthy People, which define health literacy as one’s knowledge of the process in obtaining, processing and understanding basic information and services that are health related. This definition further explains that this knowledge aids in making the individuals best decision and consists of various strategies and goals which support/ enables health individuals in achieving objectives in other related areas aside from health literacy. In fact, Institute of Medicine reiterated this definition and further explained that health literacy also incorporates writing, numeracy and the ability to also question and communicate. This ensures that one who is health literate should be able to make health related decisions, potentially manage difficult health issues and recognise risk.
Although information on health related issues
are often conflicting, biased or incomplete, and potentially complex; doctors,
health educators, medicine labels, and pamphlets convey them through different
media such as radio, television. While inadequate health literacy has a
detrimental effect on health decision making e.g. it results in poorer choices
when it comes to health related issues and poor understanding of medical condition.
Also, individuals with an adequate level
of health literacy are able to seek a myriad of information and take full
responsibility of their own health related issues. However, inadequate levels
of health literacy can also cause a reduction in the efficiency of health care
system, an increase in the chance of unhealthy lifestyles and eventually
inadequate utilisation of health care services.
Health Literacy in Nigeria remains below optimum standards when compared with more developed countries and the existing discourse on health literacy remains scant in Nigeria. In fact, research by the World Health Organisation states that access to improper health care services, inadequate health care workers such as, doctors and nurses, impatience attitude of medical personnel hinders patients understanding of health information, influences inadequacy of health information and behaviour among individuals in the rural area of Nigeria. Although Health literacy still constitutes a huge concern in Nigeria, the government through the federal ministry of health initiated health policies in response to the inadequate health literacy among its citizens especially in the rural areas. Furthermore, they National health policy which was initiated in 1996 and reviewed in the year 2006, has health education as one of its main priorities in tackling the issue of health literacy, However, it has being argued that their still exist a limited attention in Nigeria’s health care system with no serious improvement in effectively eliminating the lack of health information among the rural dwellers. On a positive note, the government and various Non-governmental Organisation’s (NGO’) including; Health and Life Africa healthy-living initiative (HALA), Women and health Literacy Association (WHLA) and Live well Initiative (LWI) are currently embarking on various health education programs especially among the rural dwellers in educating them on the importance of proper health information, health literacy, in order to improve the general standard in respect of the poor health services existing in the country. Despite this effort, the various literacy interventions have failed to achieve expected goals and outcomes.
Health care literacy awareness delivered by NGO’s, and the Nigeria Federal Ministry of Health included; educational programs, seminars, workshops especially in the rural part of the country were the rate of health literacy is on the increase. These educational programs consists of various information on health relevant to the populate such as, Exclusive breastfeeding amongst women, the use of highly visible mass media campaign in the popular radio, television and newspaper houses which are targeted to both the rural and urban populace of the country. Notwithstanding, findings identified two main factors, which hinder the implementation of mass media campaigns including; poor road conditions, which limits access to the rural parts of the country, and corruption in the health, sector which leads to poor organisation. It has being pointed out that the main reason while most people in the rural areas still believe in the traditional system of health care which still exists in most part of the country, most of the individuals especially among women in the rural areas having issues understanding some of the health information materials distributed during health training which are written in English Language.
However, Government, Non-Governmental Agencies (NGO) and health workers role in developing a health literate population, involves different awareness initiated by embarking on various health education programs via seminars, conferences, workshops and radio programs. For example, in 2010 the federal government implemented the adult education initiative in the northern part of the country aimed at educating the rural women on the value of health information and health literacy. Furthermore, one of such role of the government also is the launch the National Action Committee on HIV/AIDS in 2010. This organisation was set up to help ensure the full realisation of government programs in other to educate and raise awareness among its citizen on HIV/AIDS as well the necessity of adequate health literacy. Although the government releases huge sums of money to these organisation, several research have shown that the various channels created to spread information such as national action committee on HIV/AIDS, is still not achieving the desired result in view of the fact that in spite of all the campaigns, the rates of literacy and information still continues to rise. The Non-governmental agencies (NGO) and health workers also play a vital role by organising relevant health information education training to enable individual’s access information on issues which are more relevant in the country such as exclusive breast, HIV/AIDS and maternal mortality diseases which are rampant among women in the northern part of the country. Although, several research has shown that the government, non- governmental agencies and health workers have used several tools in trying to develop a health literate country and yet the rate of health literacy still falls below average.
Conversely, the NGO’s however, seen as a powerful agent of development and change in the country. They also play a well significant role, directly in educating and involving various communities. One of such role of the NGO’s is the Akufo Akinyele Community Literacy Foundation for Education and Self- Help. The projects aim at promoting health education, self-reliant development and literacy in rural areas. In addition, since the inception of this project by in 2011, a total of twenty-seven rural literacy and health centres have been built by the NGO. Similarly, the United Nations adoption and implementation of the Millennium development goal (MDGs) in less developed and challenged countries. In order to address the health related issues, the MDGs in 2007 adopted various health literate strategy poised in helping people interact well with health providers.
In other to develop a health literate population, the health sector in the country needs to be fully and adequately rehabilitated in all areas of the country. Health care workers and professional’s needs to also improve on their written and oral communication, adjust in demands and expectations from patients and also develop more tools and materials specially in the rural areas to understanding of health- related information . Also, they health policy of the Federal Ministry of health should be reviewed and more effort put in place to implement every aspect of the policy in respect to improving the literacy of the population. Additionally, in other to develop a health literate population, the health sector in the country needs to be fully and adequately rehabilitated in all areas of the country. Health care workers and professional’s needs to improve on their written and oral communication, adjust in demands and expectations from patients and also develop more tools and materials specially in the rural areas to understanding of health-related information. Also, the health policy of the Federal Ministry of health should be reviewed and more effort put in place to implement every aspect of the policy in respect to improving the literacy of the population. In addition, in developing a health literate population government should integrate a more community and social based intervention, which is, evidence based in other to achieve a better policy outcome. Furthermore, more funds should be injected in organising and embarking on better health education trainings were the rate of literacy is at its peak. They federal government in support of other stakeholders such as USAIDS, UNICEF, WHO and NGOs should fund and encourage researchers to identify effective, evidence and cost effective strategies to integrate health literacy awareness.
They Internet which is definitely contributing to more access and conceivably even a greater desire for health care information in developed countries such as, the United Kingdom. However, access to health related information should be made easy across the country and medical and health information needs to build informatics tools that support the patients as a partner in health care. Government should also be reassessed to integrate a more community and social based intervention which is evidence based in other to achieve a better policy outcome. Furthermore, more funds should be put in organising and embarking on better health education trainings were the rate of literacy is at its peak. They federal government in support by other stakeholders such as USAIDS, UNICEF, WHO and NGOs should also fund and encourage researchers to identify effective, evidence and cost effective strategies to integrate health literacy awareness. Also, access to health related information should be made easy across the country and medical and health information needs to build informatics tools that support the patients as a partner in health care.
Author: Chukwuemeka Ugoanyanwu
Email: chukwuemekaugoanyanwu@gmail.com
instagram: @bobby_chiemeka
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