Low Literacy Research Articles

How do citizens with low health insurance literacy choose a health insurance policy in the Netherlands? An interview study

Various countries have implemented a choice-based health insurance system. For such systems to function as intended, it is crucial that all citizens have the opportunity to make well-informed decisions with regard to their health insurance policy. There is, however, ample research evidence to suggest that many citizens may lack the required skills to do so, thus increasing the likelihood of suboptimal insurance choices and incurring unexpected costs. The current study explored what barriers citizens in the Netherlands, with low health insurance literacy (HIL), face when selecting a health insurance policy, and what their specific needs and preferences are regarding information and support. Semi-structured interviews (online or telephone) were performed between January 2023 and April 2023 among sixteen with a low level of HIL. The data were analyzed using thematic analysis methods. Our results show that not all citizens with low HIL are sufficiently motivated to actively look for alternative health insurance options every year. This is partly due to the feeling that it is a task imposed upon them by the government, and because choosing a health insurance policy is perceived as too complicated and not sufficiently worthwhile. There is a need among citizens with low HIL for clear and practical information about health insurance policies, especially from the government and health insurers. In addition to this need, we recommend enhancing awareness regarding the consequences of neglecting to explore such health insurance options. Moreover, more personal attention for the process of selecting a health insurance policy should be offered to vulnerable groups such as those who possess insufficient digital skills.

Understanding the mechanisms underlying the socioeconomic disparities in cancer screening among Australian women

BackgroundLittle is known about individual, as opposed to area-level, variance in socioeconomic status (SES) and how this impacts screening participation. This study explores potential mechanisms underlying the relationship between SES and cancer screening amongst women eligible for breast, cervical, and bowel cancer screening.MethodsAustralian women aged 50–74 years (N = 874) took part in an online survey examining participants’ health and cancer screening behaviours. Relationships between individual and area-level SES, cancer screening participation, stress, general self-efficacy, and screening literacy were examined using structural equation modelling. Frequency of cancer screening barriers were calculated for each cancer type and compared for SES categories.ResultsThe structural equation model including stress and screening literacy as mediators yielded excellent fit, χ2 (26) = 33.322, p = .153, TLI = 0.992. Lower individual level SES was associated with higher stress and lower screening literacy. Higher stress was related to lower screening participation in all three programs, and lower screening literacy was associated with low cervical and breast cancer screening. The only significant relationship between area-level SES and screening participation was with participation in cervical screening. All indirect effects between area level SES and screening were non-significant. The types of barriers reported for each cancer screening type were similar between high and low socioeconomic individuals. In all three screening programs, intending to participate in cancer screening but not getting around to it, and not liking the screening method were commonly reported reasons for non-participation.ConclusionsThis study is the first to investigate the effects of individual level SES on cancer screening in Australia and one of the few studies to examine underlying mechanisms simultaneously across various screening programs. Reducing stress and improving screening literacy may help to improve cancer screening participation among low SES individuals. Our results also suggest that tailoring interventions to the SES background of women may not enhance their effectiveness. Interventions aiming to reduce the SES screening disparities may achieve more success through addressing underlying mechanisms as opposed to the behavioural barriers themselves.

TEHNOLOGIA BLOCKCHAIN PENTRU ÎMBUNĂTĂȚIREA TRASABILITĂȚII ȘI SUSTENABILITĂȚII ECHIPAMENTELOR INDIVIDUALE DE PROTECȚIE ÎN AGRICULTURA DIN ROMÂNIA

Blockchain technology provides a secure and transparent method to improve the traceability and sustainability of personal protective equipment (PPE) in Romanian agriculture. By enabling comprehensive monitoring of PPE across its lifecycle, blockchain addresses gaps in safety and compliance. It ensures adherence to safety standards while reducing risks of counterfeit or defective products. However, several challenges hinder adoption. High costs, limited digital infrastructure, and low digital literacy among farmers create significant barriers. Overcoming these requires targeted investments in rural digital infrastructure and training programs designed to enhance stakeholders’ skills. Public-private partnerships and pilot projects are essential to demonstrate the technology’s benefits and build trust among users. Gradual implementation, supported by collaboration between public and private sectors, can transform Romanian agriculture. Blockchain’s integration can lead to better productivity, improved safety, and greater sustainability. This study examines blockchain’s potential in PPE management, offering insights into its applications, benefits, and necessary steps for successful adoption in the agricultural sector. Through strategic action, Romanian agriculture can leverage blockchain to achieve safer practices and long-term sustainability.

Analisis Yuridis tentang Perlindungan Konsumen pada E-Commerce di Indonesia: Pendekatan Yuridis-Normatif

This study focuses on the juridical analysis of consumer protection in e-commerce transactions in Indonesia, considering the sector's rapid growth, which reached a total transaction value of IDR 631 trillion in 2023. On the other hand, consumer complaints have continued to rise, involving issues such as fraud, defective products, and data privacy violations. This study aims to evaluate the effectiveness of existing regulations, such as Law No. 8 of 1999 and its supporting regulations, in protecting consumer rights. Using a normative-juridical approach, the study examines the legal substance, implementation, and gaps between national regulations and international standards like the European Union's General Data Protection Regulation (GDPR). The findings indicate that although national regulations provide basic protections, their effectiveness is considered low, particularly in the aspect of personal data protection, which only achieves 40% effectiveness, significantly lagging the GDPR at 95%. Additionally, inefficient complaint mechanisms and weak coordination among government agencies are major obstacles to resolving consumer disputes. Low digital literacy among consumers further exacerbates the ineffectiveness of the protection provided by existing regulations. The study concludes that national regulations require significant reform to be more adaptive to digital challenges. Policy recommendations include adopting GDPR principles, strengthening government oversight, and enhancing consumer education. This study's contribution is expected to strengthen a safe, transparent, and equitable e-commerce ecosystem in Indonesia while boosting consumer trust in online transactions.

Individual, household, and community-level determinants of undernutrition among pregnant women in the northern zone of the Sidama region, Ethiopia: A multi-level modified Poisson regression analysis.

In Ethiopia, maternal undernutrition is a major public health concern. However, comprehensive evidence is lacking in the southern part of Ethiopia, specifically the household and community-level related determinants of undernutrition. Besides, the evidence about the prevalence and determinants of undernutrition is not yet documented in the current study setting. Thus, this study aimed to determine the prevalence of undernutrition and identify its determinants among pregnant women in Hawela Lida district of the Sidama region, Ethiopia. A community-based cross-sectional study was conducted on a sample of 515 pregnant women from June 1-25, 2024. A multi-stage sampling method was utilized to select eligible pregnant women. We collected data using a structured and pretested interviewer-administrated questionnaire and an anthropometric measurement. Data were collected using the Open Data Kit smart phone device and exported it to Stata version 17 for further processing and analysis. A multi-level mixed-effects modified Poisson regression analysis with robust variance was used to account for confounders and between and with cluster effects. The prevalence of undernutrition among pregnant women was 41.7% (95% CI: 37.3-45.6). The prevalence of undernutrition was associated with planned pregnancy (adjusted prevalence ratio [APR]: 0.80; 95% CI: 0.66-0.98), household food insecurity (APR: 1.64; 95% CI: 1.26-2.13), inadequate dietary diversity (APR: 1.79; 95% CI: 1.43-2.25), and women's poor knowledge of nutrition (APR: 1.68; 95% CI: 1.32-2.12) at individual levels. The identified determinants of undernutrition at the community level were low community literacy rates (APR: 4.62; 95% CI: 1.13-18.79) and low community wealth status (APR: 1.91; 95% CI: 1.10-3.31). Two in five pregnant women had an undernutrition problem in the study setting. Individual and community-level determinants contributed to the high prevalence of undernutrition. Thus, any prevention and control approaches to undernutrition should consider inter-sectorial collaboration to account for determinants at various levels. Besides, any program must emphasize the delivery of nutrition education about dietary diversity, particularly targeting pregnant mothers who have poor knowledge of nutrition and unplanned pregnancy at the individual level. Moreover, creating a small business reform for the community with low wealth status using agricultural extension workers must be considered.

Changes in population literacy and numeracy in Ghana after three decades of free basic education

AbstractMotivationDespite increases in school enrolment, the world is facing a global learning crisis that suggests a trade‐off between the quantity and quality of education.PurposeThis case study from Ghana examines whether there has been a long‐term change in educational outcomes, measured by population literacy and numeracy rates, in the decades following the implementation of a national free compulsory basic education policy. It further determines whether there are variations by level of education in the changes over time.Approach and methodsThis study used nationally representative repeated cross‐sectional data from two Ghana Living Standards Surveys (2006 and 2017) to estimate basic literacy and numeracy.FindingsAt the same level of education for the primary and lower secondary school levels, literacy and numeracy were lower in the latter period than a decade previously. These findings suggest that the expansion in gross enrolment at the primary and lower secondary school levels has been associated with a long‐term decline in the quality of education.Policy implicationsConsidering these findings, it is crucial to consider the long‐term implications of expanding access to education on the quality of the education provided. These findings highlight the need for increased investment in quality education to complement the increase in access. This would ensure that children acquire foundational skills at the basic education level. Failure to maintain quality alongside expanded access could negatively impact workforce productivity, economic growth, and social equality.

EXPERIENCES AND CHALLENGES OF DIGITAL TRANSFORMATION IN THE INFORMAL BUSINESS SECTOR IN A RURAL SOUTH AFRICAN TOWN

South Africa has one of the highest unemployment rates in the world. This unemployment is more pronounced for those living in rural areas. As a result, many unemployed rural people turn to informal trading as a gateway to employment and economic activity. The study aims to explore the experiences and challenges of digital transformation in the informal business sector in a rural South African town. A case study design was used. Data was collected through interviews with a sample of 20 purposefully selected informal traders. The data was then analysed thematically. The study revealed that there is a lack of knowledge on digital transformation among formal traders. The study further revealed that the challenges concerning digital technology include a lack of ICT skills, network and internet connectivity problems, mistrust of technology, and fear of fraudulent activity. The study recommends greater expansion of digital technology support and training to informal traders. This study further recommends that digital technologies must be developed with the end user in mind. Moreover, the study recommends greater internet and connectivity investment in rural areas. Lastly, the study recommends the development of greater security features for digital technologies aimed at informal traders with low literacy levels. The study contributes to knowledge on the benefits and enhancement of the potential of digital technologies to assist small businesses against the background of high unemployment in the rural town of Mthatha, Eastern Cape Province, South Africa.

Ways of Improving the Family Communication Process

This paper aims at discussing several issues, both theoretical and practical, concerning family communication: theories, roles, rules, conflicts, negotiation. The authors stress the interconnection between the social, economic, psychological and cultural factors which can, through effective communication, lead to good, trust-based relationships within families/at the family level. The Literature review section approaches the concepts of communication and family, while the Case study shows the objectives, activities and outcomes of a program implemented in South Africa and focused on parents’ roles and duties within the family. It tackles issues linked to fatherhood, low literacy, domestic abuse, father absence, unemployment, and a wide array of other social and cultural factors pertaining to the social and economic conditions in this country. The paper also includes some recommendations concerning the adequate and efficient use of certain family communication forms, channels and feedback strategies.

Role of Human Capital in Economic Development in India

Human capital is a key driver of economic development, as it directly influences productivity, innovation, and global competitiveness. In India, the importance of human capital is amplified by its demographic advantage, with over half of its population under the age of 25, offering a vast labour force. However, the country faces significant barriers to fully harnessing this potential, including low literacy rates, limited access to quality education, skill mismatches, and health disparities. These challenges restrict the effective contribution of India’s workforce to the economy. This research paper delves into the various dimensions of human capital, focusing on education, health, and skill development, which are essential for fostering a productive workforce. By utilizing secondary data and examining both national and international case studies, the paper identifies critical gaps in India’s human capital development. Additionally, it offers policy recommendations aimed at addressing these gaps, improving the quality of education, expanding healthcare access, and aligning skill development with market needs. These interventions are crucial to unlocking the full potential of India’s human capital, ensuring sustained and inclusive economic growth. Keywords Human capital, economic development, India, education, health, skill development, productivity

Challenges and Opportunities in Marketing Fintech Products to Rural and Semi-Urban Investors in India: A Systematic Literature Review

This study presents a systematic literature review on the challenges and opportunities in marketing Fintech products in rural and semi-urban investors in India. Through use of the PRISMA framework alongside TCM and ADO methodologies, this review analyses the current literature on the research topic to determine barriers like infrastructure issues and low financial literacy and highlights opportunities for regulatory support and innovation. The findings imply the critical role played by cultural factors and technology to enhance financial inclusion and inform on relevant applicable strategies for Fintech companies to aim at engaging underserved markets.

Implementation Of Productive Wakaf In Supporting Sharia-Based Economic Development In Urban Areas

This study aims to analyze the implementation of productive waqf in supporting sharia-based economic development in urban areas. The main focus of the study is to understand the role and potential of productive waqf in driving the economy and improving the welfare of urban communities. This study also explores the challenges and opportunities faced in the management of productive waqf. The research method used is a qualitative approach with case studies in several waqf management institutions in urban areas of Indonesia. Data were collected through in-depth interviews, field observations, and document studies. This approach allows the study to explore comprehensive information regarding the implementation strategy and impact of productive waqf on the sharia economy. The results of the study indicate that productive waqf has a significant contribution to sharia-based economic development in urban areas. Productive waqf that is managed professionally is able to create jobs, increase access to social services, and provide public facilities such as education and health. However, the study also found obstacles, such as low waqf literacy in the community, limited manager capacity, and lack of regulatory support. The conclusion of this study is that the implementation of productive waqf has great potential to support sharia-based economic development in urban areas, as long as it is managed well and supported by adequate regulations. This study recommends increasing waqf literacy in the community, strengthening the capacity of management institutions, and collaborating with various parties to maximize the potential of productive waqf in creating sustainable socio-economic impacts.

Nurse-led education for patients in plain language: Evaluation of a teaching concept for prospective nursing professionals

Nurse-led education for patients in plain language: Evaluation of a teaching concept for prospective nursing professionals Abstract: Background: Nurse-led education for patients is a core competency of nurses. A particular challenge is the education of the growing group of people with limited literacy skills. Aims: The aim of our project was to develop and evaluate a teaching concept that would gradually enable prospective nursing professionals to independently carry out nurse-led education for people with low literacy. Methods: First, a teaching concept for a nurse-led education for patients in plain language was developed, which was implemented with prospective nursing professionals of the Bachelor of Nursing programme at Charité - Universitätsmedizin Berlin and tested with a pre-post evaluation. Self-developed items were used to measure experience, confidence, competence and learning increase. Results: Before starting the teaching concept, 56% (n = 14) of the participants already had some experience with patient education. The relevance of the topic was rated as very high (Median = 9; IQR = 10-8; n = 25). After completing the teaching concept, participants felt more confident in conducting nurse-led education (T0: 36% vs. T1: 79%) and more competent in using plain language (T0: 4% vs. T1: 26%). Conclusion: A teaching concept that combines the development of nurse-led education for patients with the target group-specific approach of plain language increases the confidence of carers in their teaching skills and the self-management of people with low literacy.

A Strategic Training Model for Building Cultural Literacy of Broadcasting

Background and Aims: Cultural literacy in broadcasting is essential for representing varied audiences, promoting inclusivity, and avoiding prejudices. Develop a cultural literacy training strategy to equip broadcasters to engage with different cultures, improving audience communication and trust. The research objectives of the Strategic Training Model for Building Cultural Literacy in Broadcasting are as follows: 1) To investigate the knowledge and practical needs of broadcasting hosts to improve cultural literacy. 2) To develop and implement a strategic training model for building cultural literacy and broadcasting talent. Methodology: Questionnaires, structured interviews, and assessment forms were used. We examined data using percentages, averages, the pre-test, and post-tests. Results: The research indicates the low cultural literacy of broadcasting talents in Guangxi universities. It also shows that most universities, including Guangxi University for Nationalities, College of Arts, and University of Foreign Languages, are still behind in their plans to improve it. it is urgent and necessary for both students and teachers to enhance the cultural quality of broadcasting talents. The results suggest that this methodology improves broadcasting talent culture and professional education. A systematic endeavor to increase strategic training for broadcasting students' cultural literacy demands instructors' persistence and inventiveness. Through differentiated guidance, diversified practice, school-enterprise cooperation, and systematic implementation, we can comprehensively and deeply improve broadcasting students' cultural literacy, developing more excellent broadcasting and hosting talents for society. Conclusion: The study emphasizes how crucial it is to improve cultural literacy among Guangxi universities' broadcasting talent, as they are currently falling behind in this regard. The development of more skilled broadcasting professionals can be achieved through the implementation of strategic training, differentiated guidance, diversified practice, school-enterprise cooperation, and systematic efforts to improve cultural literacy and professional education.

From digital literacy to digital competence: The structure of Teacher Digital Competence (TDC)

ABSTRACT This study investigates the impact of digital literacy on the digital competence of 380 Chinese university teachers. Using the Scale of Digital Literacy (SDL) and Scale of Teacher Digital Competence (STDC), the study implements a training programme based on the Teacher Digital Competence (TDC) framework. Results show that higher digital literacy correlates with increased STDC indicators. Group A, with lower initial digital literacy, sees minimal improvements, emphasising the importance of baseline digital literacy. However, Groups B and C, with intermediate to advanced digital literacy, exhibit significant enhancements in all sub-scales. The study highlights the effectiveness of tailored training for teachers with varying digital literacy levels, offering valuable insights for educational initiatives.

EHealth Literacy and Health-Related Internet Use Among Swedish Primary Health Care Visitors: Cross-Sectional Questionnaire Study.

Digitalization has profoundly transformed health care delivery, especially within primary health care, as a crucial avenue for providing accessible, cost-effective care. While eHealth services are frequently highlighted for improving health care availability and promoting equality, it is essential to recognize that digitalization can inadvertently exclude individuals who lack the prerequisites to use eHealth services, that is, those with low eHealth literacy. Previous research has identified lower eHealth literacy among older individuals, those with lower educational levels, and those who use the internet less frequently. However, in a Swedish context, only a few studies have investigated eHealth literacy. This study investigated eHealth literacy and its association with health-related internet use and sociodemographic characteristics among primary health care visitors. This cross-sectional study used a quantitative, descriptive approach. Swedish-speaking patients visiting a primary health care center participated by answering the multidimensional eHealth Literacy Questionnaire (eHLQ) and questions regarding sociodemographic characteristics and internet usage. The study compared mean scores using the Mann-Whitney U test and the Kruskal-Wallis test. A logistic regression analysis also explored the associations between eHealth literacy and significant independent variables identified in the univariate analyses. As a group, the 172 participants rated highest in understanding and engagement with their health (median eHLQ score 3, IQR 2.8-3.4), as well as in feeling secure about the confidentiality of eHealth services (median eHLQ score 3, IQR 2-3), while they rated lower in motivation to use eHealth (median eHLQ score 2.6, IQR 2-3), the suitability of eHealth services to their personal needs (median eHLQ score 2.75, IQR 2-3), and their perceived ability to understand and use health-related internet information (median eHLQ score 2.6, IQR 2-3). The logistic regression analysis identified that lower eHealth literacy was associated with older age, particularly in domains related to finding, understanding, and using health-related internet information (odds ratio [OR] 1.02, 95% CI 1-1.05; P=.03); digital technology use (OR 1.05, 95% CI 1.02-1.08; P<.001); and accessing well-functioning eHealth services (OR 1.02, 95% CI 1-1.05; P=.03). Additionally, in the logistic regression analysis, perceiving health-related internet information as not useful was linked to lower literacy in all eHLQ domains except one. Our findings regarding the primary challenges within our sample underscore the importance of developing and tailoring eHealth services to accommodate users' individual needs better, enhancing motivation for eHealth use, and continuing efforts to improve overall health literacy. These measures, which both eHealth developers and health care professionals should consider, are crucial for addressing the digital divide and expanding access to eHealth services for as many people as possible.

The Low Level of Digital Literacy in Indonesia: An Analysis of Online Media Content

Background of the study: The low level of digital literacy among Indonesians poses a significant challenge in the era of global digitization, particularly due to the lack of access to and understanding of information technology required to make effective use of digital libraries. Purpose: Identify factors causing low digital literacy, evaluate policies that have been implemented, and formulate effective strategies to increase digital library utilization in Indonesia. Method: This study uses a qualitative approach by analyzing online news using the keyword ‘digital literacy’, to explore the factors that lead to low digital literacy in Indonesia. Data analysis methods included coding, theme building, data reduction, and data display to identify patterns and reasons behind this phenomenon. Findings: This research reveals that Indonesia's low digital literacy is caused by a lack of infrastructure, a lack of educational focus, and low awareness of social media ethics. Collaboration between the government, academic institutions, and society is needed through technology investment, education reform, and awareness campaigns. Conclusion: Recommended follow-up includes training, digital infrastructure development, and effective awareness campaigns to improve digital literacy in Indonesia.

FinTech Implementation Challenges in the Palestinian Banking Sector

This study addresses FinTech implementation challenges in the banking industry in Palestine. This was accomplished by adopting qualitative research methods. Semi-structured interviews were conducted with interviewees from the Palestinian Monetary Authority, banks, and FinTech companies. Thematic analysis was conducted using NVivo 12 software to identify themes in the interview scripts. Research outcomes suggest that FinTech development in Palestine encounters a range of multifaceted challenges, which can be categorised using the TOE (technological, organisational, environmental) framework. On the technological front, issues such as underdeveloped IT and telecommunications infrastructure, restricted mobile frequencies due to Israeli occupation, limited IT expertise, cyber risks, low digital literacy, and minimal FinTech awareness hinder progress. Organizationally, resistance to change, inadequate agility, limited digital skills, and slow Sharia compliance updates in Islamic banking impede innovation. Environmentally, the absence of a dedicated FinTech framework, unclear regulatory guidance, limited market size, and strict AML/CFT regulations create uncertainties for non-bank entities and restrict investment opportunities. Addressing these interconnected barriers requires coordinated efforts across legal, financial, and technological sectors to foster FinTech integration and growth in Palestine.

Students Perceptions and Behavior in Responding to the Hoaxes of North Sumatra Election on TikTok

This research uses a qualitative method motivated by the rampant spread of political hoaxes through social media, especially TikTok, which is a popular platform for novice voters. The purpose of this study is to analyze the perceptions and behaviors of Medan State University students towards the North Sumatra Election hoax on TikTok. Data were obtained through an online survey using Google Form, observation, and thematic analysis. The data collected was then analyzed using the New Media Literacy theory by Jenkins et al. (2009). The results revealed that although students are quite adept at using digital media, they still have difficulty verifying political information. Their low political literacy makes them vulnerable to being exposed to and contributing to the spread of hoaxes.

Exploring physical, subjective and psychological wellbeing profile membership in adolescents: a latent profile analysis

BackgroundUnderstanding wellbeing in adolescents and within education settings is crucial to supporting young people. However, research defining and exploring wellbeing has typically taken a focus on subjective, psychological, social and emotional domains and has failed to incorporate aspects of physical health and wellbeing. This study aimed to explore how both physical and subjective and psychological wellbeing can be combined to generate different profiles of wellbeing in adolescents, and to understand the characteristics associated with this profile membership.Methods366 adolescents aged 11-16yrs (mean age 12.75) from three mainstream secondary schools across England completed an online survey capturing demographic characteristics, physical, subjective and psychological wellbeing, physical activity, emotional literacy, school belonging, and perceptions of learning ability. Latent profile analysis used a data driven approach to explore profiles of wellbeing using physical wellbeing and positive emotional state and positive outlook as predictors of profile membership. To understand profile characteristics demographics, physical activity and educational variables were added as co-variates.ResultsThree profiles were identified, (1) low wellbeing (n = 68, 19%) displaying low scores across physical wellbeing, positive emotional state and positive outlook, (2) moderate wellbeing (n = 168, 46%) characterised by average levels across physical wellbeing, positive emotional state and positive outlook, and (3) high wellbeing (n = 128, 35%) showing high score across physical wellbeing, positive emotional state and positive outlook. Compared to the high wellbeing profile, the moderate and low profiles membership was characterised by being older, being a girl, lower perceived socio-economic status, fewer hours of physical activity a week, and lower emotional literacy, school belonging and perceptions of learning.ConclusionsThe results evidence that physical, subjective and psychological wellbeing are closely inter-related, this finding coupled with increased physical activity in the higher wellbeing group signify physical health and activity are important components of overall wellbeing and should form part of a holistic approach to school wellbeing curriculums.

Determinants of non-testing for HIV among women during antenatal care follow up in sub-saharan Africa: a hierarchical analysis of recent Demographic and Health Survey datasets

IntroductionHIV/AIDS is a global public health concern that is closely related to other sociocultural problems. The prevention of mother to child transmission cascade often begins with and is integrated into antenatal care in order to ensure a high rate of case detection and optimal treatment coverage. Although guidelines suggest that all pregnant women should have HIV testing as part of their regular screening checks during antenatal care, a significant proportion of pregnant women were not tested for HIV during antenatal care follow-up in sub-Saharan Africa. Hence, this study was aimed at assessing the determinants of women not tested for HIV during antenatal care follow-up in sub-Saharan Africa.MethodA cross-sectional study was conducted to assess the determinants of non-testing for HIV among women as part of antenatal care in sub-Saharan Africa, utilizing secondary data from the 2015–2022 Demographic and Health Surveys. The study included a weighted sample of 788,421 women who had antenatal care follow-up during their most recent pregnancy within five years preceding the survey. A multilevel mixed effect logistic regression analysis was employed to identify the determinants of non-testing for HIV among these women. The adjusted odds ratios with 95% confidence intervals were calculated to determine the associations between the outcome and explanatory variables. Statistical significance was determined using a p-value of less than 0.05.ResultThe hierarchical analysis of this study identified several significant factors associated with women not being tested for HIV during antenatal care in sub-Saharan Africa. These factors include young age, low or no education, not being in a union, unemployment, and low household wealth index. Additionally, limited media exposure, stigmatizing attitudes towards people living with HIV, male-headed households, and rural residence were significant at the individual and household levels. At the community level, low media exposure and high illiteracy rates were significant, while at the country level, high fertility rates and low literacy rates were also associated with lower rates of HIV testing during antenatal care.ConclusionThis study identified significant individual, community, and country-level factors associated with women not testing for HIV during antenatal care in sub-Saharan Africa. Key factors include young age, low education, unemployment, not being in a union, low household wealth, limited media exposure, stigmatizing attitudes towards people living with HIV, male household head, rural residence, low community media exposure, high community illiteracy, high fertility rates, and low literacy rates. These findings highlight the need for targeted, context-specific interventions to improve HIV testing rates and enhance maternal and child health outcomes in the region.