Abstract
Health Literacy is widely discussed in ‘Western’ countries but empirical data on health literacy in low- and middle-income and conflict- and crisis-ridden countries such as Afghanistan remain scarce. As these countries and their main health concerns differ largely, a one-to-one translation of the health literacy concept and its assessment derived in Western countries might be less relevant in the given context and misleading. However to improve health by promoting health literacy, a profound understanding of the nature of health literacy relevant in a country is necessary. In this chapter, we explore health literacy in Afghanistan qualitatively and introduce an approach of how to develop a context-relevant concept of health literacy. The study draws on general health data, two major policy programs, and the expertise of health professionals in Afghanistan. After describing the data and findings, we compare them with the HLS-EU and discuss four strategies for adaptation. This study illustrates that health literacy instruments should be adapted to the situation in a particular country because then assessing health literacy goes beyond the interest of researchers and has practical implications for policy makers and program developer to improve health.
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Notes
- 1.
This estimation is based on a nationwide census published in 2011, reporting that the data was 91/1000 (AMS 2011) This is the last one available; since then all estimations have been based on these data and try to take changes into account.
- 2.
At this point an important comment has to be made concerning the accuracy of the data. Many authors explain that the objectivity, reliability and validity of the data has to be questioned, and the comparison of the results of several studies encourages a cautious interpretation of these data (SIGAR 2017).
- 3.
Some of the misconception are: breastfeeding is bad, children’s immunization makes some of them sick, giving liquids in case of diarrhoea increases it, oral contraceptive pills cause cancer, injectable contraceptive depot-medroxyprogesterone acetate are perceived as a tool to dominate Afghans (USAID 2008).
- 4.
This might be very useful because this way the content is wrapped in words that are easily understood by people but it may also happen that interpersonal issues might interfere in accepting the message of the sender.
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Jawid, A., Harsch, S., Ebrahim Jawid, M. (2021). Health Literacy in Afghanistan − Astonishing Insights Provoke a Re-Consideration of the Common Concept and Measures of Health Literacy. In: Saboga-Nunes, L.A., Bittlingmayer, U.H., Okan, O., Sahrai, D. (eds) New Approaches to Health Literacy. Gesundheit und Gesellschaft. Springer VS, Wiesbaden. https://doi.org/10.1007/978-3-658-30909-1_14
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