Int. Handbook of Health Literacy - Ed. Okon, et al. c/o HIFA

International Handbook of Health Literacy

Dear HIFA colleagues*,

I was interested to see the publication of this new book International Handbook of Health Literacy, edited by Orkan Okan and colleagues.

Kudos to the editors and authors, who have made the content freely available here:

http://www.oapen.org/viewer/web/viewer.html?file=http://www.oapen.org/document/1005225

The early pages note: 'Besides the ongoing and tremendous public health efforts addressing health literacy in Europe, North America and the Australasian region, there is only little to no work still in Africa, very little in the Middle East, India and South America, and also very little in Russia and the Slavic countries in Europe.' Nevertheless, 'health literacy has been placed high on the agenda in the WHO Southeast Asia Region via the introduction of a health literacy toolkit for low- and middle-income countries to help communities to develop their own solutions'.

There is a chapter on 'A stated preference discrete choice health literacy intervention framework for the control of non-communicable diseases (NCDs) in Africa' by Kenneth Yongabi Anchang and Theckla Kwangsa Mbunwe.Selected extracts below:

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The function of health literacy in ensuring a healthy condition in individuals and communities is especially relevant in Africa, which is plagued with high endemic diseases, and in settings in which healthcare resources and infrastructure are, for the most part, limited (O’Sullivan et al, 2003; Remais et al, 2012).

Current health promotion interventions in current use in Cameroon and Africa at large are inadequate as they are too exo-centric in style, language and construction – a health literacy intervention culled from a very exo-centric set-up and tailored for the European context, for instance, may not be transferable to Africa.

Health promotion exercises in Africa are currently too linear in application. Linearity here means providing a solution to a certain problem without taking into account the contextual barriers of its wider implementation, which may be entirely different from what the researcher or facilitator wants to provide, as well as its perceived urgency and necessity.

Individuals in Africa for the most part grow up either with no health knowledge, little health notion or wrong health information that has been passed on from their parents. Some health information is misconstrued and parcelled into local beliefs systems and superstitions, thus making it difficult to dispel over time and space.

In a community whose priority is potable water, a health literacy intervention on curbing diabetes and cancer may not be quickly be accepted and sustain. This urgent need may mask the need for a literacy programme that addresses hypertension or cancer. To this effect, a joint intervention approach of providing potable water and then educating people on hypertension and cancer is the way to go.

Interventions for health literacy and promotion must always be built first on the ‘available local health knowledge’ that might, for the most part, differ from what researchers and health literacy providers would consider as evidence or knowledge.

Best wishes, Neil
HIFA

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Some reflections:

This is a very welcome text and step for health literacy. Even in a tome of 766 pages (I have not read it all) it is difficult to address all themes of significance within the field; and in turn please everyone. That is the case here.

It's not that I've got an axe to grind: I've two axes - in #h2cm.

How far is it between lifespan and life course on one-hand; and health career and life chances on the other? Especially when these are examined critically in the context of the sustainable development goals and the social determinants of health.

Chapter 42
Salutogenesis and health literacy: The health promotion simplex!
Luis Saboga-Nunes, Uwe H. Bittlingmayer and Orkan Okan

When examining the scientific discourse around health literacy, we are surprised to see that while scholars have been extensively discussing the ‘literacy’ component of the composed term ‘health literacy’, discussion of the ‘health’ element is hardly to be found. ... Today, broad literacy concepts addressing functional, interactive and critical literacy are added to the health literacy discourse, giving way to multiliteracies and social literacies to merge with health literacy (see Chapters 14, 18, 36 and 39, this volume). This was not only the impetus for multiple research strains that broadened the theoretical and conceptual discussion, but also facilitated the uptake of health literacy by various research disciplines, such as healthcare, medicine, public health, education, psychology or sociology (p.649).

The need to rethink, and maybe also construct, the health component of the health literacy concept and its social representation needs to consider that health can be understood and approached in different ways (p.650).

As a volume of recent developments in health literacy, that includes an Integrative Model of eHealth Use (p.277, 278) there is (imho) a need for a generic conceptual framework upon which to base the local, global and glocal theory, practice, management and policy of health literacy.  Not only that but how health literacy relates to other forms of literacy. If not you are more likely - conceptually bound - to loose your footing socio-technically. As Saboga-Nunes et al. note, a normative framework is needed (p.651). Negotiating forms of literacy invariably entails questions about design and in chapter 39 avatars extends this to ethics. Hodges' model can readily encompass and incorporate simplicity, continua, complexity: health and literacy.

There is much more here in this great resource, to which I will return e.g. Chapter 43, Figure 43.2 Research traditions.

*My source