Abstract
Health literacy is a determinant factor for population health. It is important both for the prevention of health problems and the better management of those problems and unexpected situations that happen. Low health literacy has been consistently associated with poor health outcomes. This study aimed to develop a health literacy indicator for Angola and to analyze pertinent demographic characteristics related to it. Data were obtained from the first Angola Demographic and Health Survey conducted in 2015/16; we included 10 questions related to the American National Academy of Medicine definition of health literacy. Using factor analysis, we extracted one i indicator corresponding to four dimensions of health literacy. The indicator was dichotomized, and we used Logistic Regression to estimate factors associated with health literacy level: we obtained data from 19,785 adolescents and adults, aged 15–49 years. The internal consistency of the i indicator was reliable (Cronbach’s α = 0.83). Adjusting for other variables, males with complete secondary education or above and living in urban areas were more likely to have a high level of health literacy. There were substantial differences between the 18 regions. This is the first study evaluating health literacy in Angola using the American National Academy of Medicine definition and a Demographic and Health survey. Our study shows unfavorable results for women, individuals living in rural areas and those less educated.
Highlights
The American National Academy of Medicine (ANAM) refers to health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions [1,2].Sorensen et al, 2012 [3] and Okan et al, 2019 [4] revisited the concept of health literacy, emphasizing the ability to access, understand, evaluate and apply health information to decision-making.Poor health literacy can be viewed as a hidden risk factor as it is associated with many adverse health outcomes [5–8]
This study aimed to develop and test the internal consistency and content validity of a health literacy indicator, based on data from the first Demographic and Health Surveys (DHS) conducted for Angola (2015/2016)
This is a cross-sectional study using secondary data collected from the first Demographic and Health survey conducted in Angola in 2015/16 [25]
Summary
Poor health literacy can be viewed as a hidden risk factor as it is associated with many adverse health outcomes [5–8]. These include limited participation in cancer screening programs [9], increased hospital admissions, poor adherence to treatments and increase in late presenters at hospital emergency rooms that result in unfavorable outcomes [10]. Inadequate health literacy can contribute to reduced participation in prevention activities, higher prevalence of risk factors, worse self-management of chronic diseases [11] and poor disease outcomes [12,13], reduced effectiveness in communication with healthcare professionals [14], increased healthcare costs, worse functional status and poor overall health status [15]. The consequences of low levels of health literacy can be severe in low or middle-lower
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