Health literacy: An important tool in disease prevention

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Health literacy: An important 
tool in disease prevention
By Durdana Najam

Managing human behaviour is as essential as the provision of clinical services in the healthcare system. Money has been poured in billions to provide and sustain the health system but only a sparse investment has been made for designing and implementing the Social and Behaviour Change Communications (SBCC) initiatives for healthcare professionals, patients, and their attendants. The aim of SBCC intervention is to make people health literate and empower them to make healthy choices for themselves and their families.

Health literacy has been defined 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.”

Social and Behaviour Change Communication is done through interpersonal and community-based activities. The healthcare establishments use various means of communication, such as educational guide, counselling of mothers during and after their visits to the clinic or health centres and exposure of potential patients and caretakers to key messages. The communication tools used to transmit the information could be videos, audiotapes, formal and informal discussions.

At the community level, SBCC is undertaken through health community agents who are derived from the same community to eliminate the perception of an “outsider.” These agents or volunteers visit homes for counselling and to conduct education sessions for mothers or anybody else. Similarly, print material such as guide and broachers highlighting warning signs to reinforce key practices and messages are also used. In Pakistan, Lady Health Workers, Lady Health Visitors, vaccinators and dengue workers have been inducted to educate masses on relevant information.

Human behaviour can be influenced by providing correct information and demonstrating better outcomes if the patient is terminally ill. Take the example of smoking. Over the years, a successful awareness campaign has resulted in an effective behavioural change among the smokers. According to a research conducted in Brazil, Canada, Singapore, and Thailand by the World Health Organization, a significant decline in smoking was observed when pictorial health warnings against the harmful effects of tobacco use were advertised. Same is the case with HIV/AIDS. The disease is incurable even today. However, by using medicines and adopting preventive measures the disease can be suppressed for a longer period of time.

Childcare is another area where information concerning health, nutrition and disease prevention can and has played an important role. Each year millions of children in lower and middle-income families in various countries die before reaching the age five. Seventy per cent of these diseases are due to merely five preventable and treatable conditions: pneumonia, diarrhoea, malaria, measles and malnutrition. An effective communication strategy could mitigate the factors that predispose vulnerable children to these potentially preventable diseases. Experts believe that places where people are socially empowered SBCC has produced more encouraging results.

Social norms and traditions have a deep influence on the choices we make about treatment for diseases. For almost two decades, people living in the erstwhile FATA, have been against the polio vaccination of their children arguing that polio drops were not allowed in Islam. The local fundamentalists have issued fatwas (Islamic decrees) denouncing vaccination as a western ploy to sterilize Muslim populations. Another common superstition spread by extremists has been that vaccination is an attempt to avert the will of Allah. Thousands of parents and guardians believed this wrong information, with the result that hundreds of children became paralysed because of un-abated poliovirus praying on their un-immunized bodies. To counter this menace, the government, initiated a parallel communication campaign involving religious scholars to bring about attitudinal and perceptual change.

Unfortunately, ignorance as a result of high illiteracy has pervaded almost every sphere of our lives, health being one. Although the government disseminates information concerning immunization program, family planning, diarrhoea, pneumonia, dengue, hepatitis etc. it’s lack of concentrated and focused approach on health literacy has rendered these efforts ineffective at the community level. During the recent outbreak of HIV/AIDS in Pakistan, when the parents and caretakers were asked if they knew about the disease, almost every one of them replied in the negative.

Due to poor health literacy, Pakistan falls behind on almost all health indicators. According to the Health Literacy Survey-Asia conducted under the European Health Literacy Survey Project in 2013, involving 1135 citizens above the age of 15 from five countries: Pakistan, Taiwan, Vietnam, Indonesia, and Kazakhstan, Pakistan turned out to have the lowest health index of 26.72.

Civilized societies educate their citizens to form the habit of cooperating with their healthcare service providers and vice versa. The learning usually begins at school. It has been noted that a great deal can be accomplished in this regard if doctors and other health professionals took time, at the end of each consultation, to make sure that the patient had understood the key points discussed.

In this regard, the role of media is equally important. Media in Pakistan still has a long way to go towards promoting health literacy. Channels and newspapers rarely report soft news concerning human lives to ensure that people strive for a quality life rather than sulking in distress due to preventable diseases.

The Punjab Healthcare Commission (PHC) is mandated to create awareness on the importance of quality healthcare among the healthcare service providers and the general public. The PHC has been instrumental in keeping people abreast with the information about the treatment and preventive measures on dengue, seasonal influenza, Congo virus, and hepatitis among other diseases. Relevant information is disseminated using print, electronic and social media. Depending on the severity of the disease, seminars and conferences are also conducted for family physicians, policymakers and media anchors for a better community response. 

The Commission has a regular presence on social media to increase health literacy. However, the relevant program leadership, the NGOs, public health agencies in the government and the educated people will have to come forward more robustly to induce a sense of health literacy among people. Being a health literate goes a long way in having a healthy lifestyle and a productive human resource.

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