Advertisement

Health without formal Education?

Health Literacy, Quality of Life and Health Behavior Among Male Heads of the Household in Four Districts of the Ghazni Province, Afghanistan
Chapter
Part of the Gesundheit und Gesellschaft book series (GESUND)

Abstract

In this chapter, we contribute to the expanding knowledge on health literacy in developing countries by presenting rare data from Afghanistan. We conducted a cross-sectional study with multi-stage random sampling of (literate and illiterate) male heads of the household (N = 502) in four districts in Ghazni Province, Afghanistan. The questionnaire in Dari and Pashtu consisted of the HLS-EU-Q16, the WHO QoL and questions on socio-demographic data, infrastructure, help-seeking and health-related behavior. Most male heads of the household have an inadequate or problematic level of health literacy, which is considerably lower than in other Asian countries. Education and quality of life are more closely associated with socio-demographic and contextual determinants and health-promoting behavior than with health literacy. Despite the assumption that people with low (health) literacy behave less healthily, we found no empirical evidence and our study revealed unique insights into their health-promoting behavior. Nonetheless, the general low levels of health literacy and health behavior indicate that these are public health challenges in Afghanistan worth addressing urgently. For future health literacy research in developing countries, the illiterates are, in our view, of special interest for comprehensive public health strategies.

Keywords

Health literacy Afghanistan HLS-EU-Q 16 

References

  1. Bittlingmayer, U. H., Islertas, Z., Sahrai, E., Harsch, S., Bertschi, I., & Sahrai, D. (2020). Health Literacy aus gesundheitsethnologischer Perspektive. Wiesbaden: Springer VS.CrossRefGoogle Scholar
  2. Bittlingmayer, U. H. & Sahrai, D. (2010). Gesundheitliche Ungeichheit: Plädoyer für eine ergänzende ethnologische Perspektive. Aus Politik Und Zeitgeschichte. (45/2010), 25–31.Google Scholar
  3. Bittlingmayer, U. H., & Sahrai, D. (2018). Health literacy for all? Inclusion as a serious challenge for health literacy. In U. Bauer, O. Okan, P. Pinheiro, D. Levin-Zamir, & K. Sørensen (Eds.), International Handbook of Health Literacy: Research, Practice and Policy across the Lifespan (2019).Google Scholar
  4. Bröder, J., Okan, O., Bauer, U., Bruland, D., Schlupp, S., Bollweg, T. M., ··· Pinheiro, P. (2017). Health literacy in childhood and youth: A systematic review of definitions and models. BMC Public Health, 17.  https://doi.org/10.1186/s12889-017-4267-y.
  5. CIA (2019). World Fact Book Afghanistan. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/af.html.
  6. Duong, T. V., Aringazina, A., Baisunova, G., Nurjanah, Pham, T. V., Pham, K. M., ··· Chang, P. W. (2017). Measuring health literacy in Asia: Validation of the HLS-EU-Q47 survey tool in six Asian countries. Journal of Epidemiology, 27(2), 80–86.  https://doi.org/10.1016/j.je.2016.09.005.
  7. European Commission (2014). European Citizens’ Digital Health Literacy. Retrieved from http://ec.europa.eu/commfrontoffice/publicopinion/flash/fl_404_en.pdf.
  8. Ghaddar, S. F., Valerio, M. A., Garcia, C. M., & Hansen, L. (2012). Adolescent health literacy: The importance of credible sources for online health information. The Journal of School Health, 82(1), 28–36.  https://doi.org/10.1111/j.1746-1561.2011.00664.x.CrossRefGoogle Scholar
  9. Haerian, A., Moghaddam, M. H. B., Ehrampoush, M. H., Bazm, S., & Bahsoun, M. H. (2015). Health literacy among adults in Yazd, Iran. Journal of Education and Health Promotion, 4(1), 91.  https://doi.org/10.4103/2277-9531.171805.CrossRefGoogle Scholar
  10. Haghdoost, A. A., Rakhshani, F., Aarabi, M., Montazeri, A., Tavousi, M., Solimanian, A., ··· Iranpour, A. (2015). Iranian Health Literacy Questionnaire (IHLQ): An instrument for measuring health literacy in Iran. Iranian Red Crescent Medical Journal, 17(6).  https://doi.org/10.5812/ircmj.17(5)2015.25831.
  11. Harsch, S., Jawid, A., Jawid, M. E., Saboga-Nunes, L., Bittlingmayer, U. H., Sahrai, D., Sørensen, K. (2020 (submitted)). Health Literacy and Health Behavior among Women in Ghazni, Afghanistan.Google Scholar
  12. Jordan, S., & Hoebel, J. (2015). Gesundheitskompetenz von Erwachsenen in Deutschland: Ergebnisse der Studie “Gesundheit in Deutschland aktuell” (GEDA) [Health literacy of adults in Germany: Findings from the German Health Update (GEDA) study]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 58(9), 942–950.  https://doi.org/10.1007/s00103-015-2200-z.CrossRefGoogle Scholar
  13. Jovanić, M., Zdravković, M., Stanisavljević, D., & Jović Vraneš, A. (2018). Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure. International Journal of Environmental Research and Public Health, 15(8).  https://doi.org/10.3390/ijerph15081761.
  14. Levin-Zamir, D., Leung, A. Y. M., Dodson, S., & Rowlands, G. (2017). Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective. Information Services and Use, 37(2), 131–151.  https://doi.org/10.3233/ISU-170834.CrossRefGoogle Scholar
  15. Malik, M., Zaidi, R. Z., & Hussain, A. (2017). Health Literacy as a Global Public Health Concern: A Systematic Review. Journal of Pharmacology & Clinical Research, 4(2), 555632.  https://doi.org/10.19080/jpcr.2017.04.555632.
  16. Nutbeam, D. (1998). Health Promotion glossary. Health Promotion International, 13(4), 349–364.  https://doi.org/10.1093/heapro/13.4.349.CrossRefGoogle Scholar
  17. Nutbeam D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259-267.  https://doi.org/10.1093/heapro/15.3.259.
  18. Okan, O., Bröder, J., Pinheiro, P., & Bauer, U. (2017). Gesundheitsförderung und Health Literacy. In A. Lange, C. Steiner, S. Schutter, and H. Reiter (Eds.), Springer Reference Sozialwissenschaften. Handbuch Kindheits- und Jugendsoziologie (pp. 1–21). Wiesbaden: Springer.  https://doi.org/10.1007/978-3-658-05676-6_48-1.
  19. Papen, U. (2009). Literacy, Learning and Health – A social practices view of health literacy. Literacy and Numeracy Studies, 16/17(2/1), 19–34.  https://doi.org/10.5130/lns.v0i0.1275.
  20. Parker, R. M., Baker, D. W., Williams, M. V., & Nurss, J. R. (1995). The test of functional health literacy in adults. Journal of General Internal Medicine, 10(10), 537–541.  https://doi.org/10.1007/BF02640361.CrossRefGoogle Scholar
  21. Pelikan, J. (2012). Measurement of health literacy in Europe: HLS-EU-Q47; HLS-EU-Q16; and HLS-EU-Q86: The HLS-EU Consortium 2012.Google Scholar
  22. Pelikan, J., Röthlin, F., & Ganahl, K. (2012). Comparative report of health literacy in eigth EU member states. The European Health Literacy Survey HLS-EU. Retrieved from http://ec.europa.eu/chafea/documents/news/Comparative_report_on_health_literacy_in_eight_EU_member_states.pdf.
  23. Pickett, K. E., & Wilkinson, R. G. (2015). Income inequality and health: A causal review. Social Science and Medicine, 1982(128), 316–326.  https://doi.org/10.1016/j.socscimed.2014.12.031.CrossRefGoogle Scholar
  24. Röthlin, F., Pelikan, J. M., & Ganahl, K. (2013). Die Gesundheitskompetenz von 15-jährigen Jugendlichen in Österreich. Retrieved from http://www.hauptverband.at/cdscontent/load?contentid=10008.597350andversion=1395738807.
  25. Sabzwari, S. R. (2017). Health literacy in Pakistan: Exploring new ways of addressing an old challenge. JPMA. The Journal of the Pakistan Medical Association, 67(12), 1901–1904.Google Scholar
  26. Samerski, S. (2019). Health Literacy as a social practice: Social and empirical dimensions of knowledge on health and healthcare. Social Science and Medicine, 81, 1–26.CrossRefGoogle Scholar
  27. Skevington, S. M., Gunson, K. S., & O’Connell, K. A. (2013). Introducing the WHOQOL-SRPB BREF: Developing a short-form instrument for assessing spiritual, religious and personal beliefs within quality of life. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 22(5), 1073–1083.  https://doi.org/10.1007/s11136-012-0237-0.CrossRefGoogle Scholar
  28. Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., et al. (2015). Health literacy in Europe: Comparative results of the European health literacy survey (HLS-EU). The European Journal of Public Health, 25(6), 1053–1058.  https://doi.org/10.1093/eurpub/ckv043.CrossRefGoogle Scholar
  29. Stahl, H. C., Ahmadi, F., Schleicher, U., Sauerborn, R., Bermejo, J. L., Amirih, M. L., Stahl, K. W. (2014). A randomized controlled phase IIb wound healing trial of cutaneous leishmaniasis ulcers with 0.045% pharmaceutical chlorite (DAC N-055) with and without bipolar high frequency electro-cauterization versus intralesional antimony in Afghanistan. BMC Infectious Diseases, 14, 619.  https://doi.org/10.1186/s12879-014-0619-8.
  30. UNDP (2019). Human Development Report: Afghanistan. Retrieved from http://hdr.undp.org/en/countries/profiles/AFG.
  31. Ünver, Ö., & Atzori, W. (2013). Questionnaire for Patient Empowerment Measurement: Document D3.2 Version 1.0. Retrieved from https://docplayer.net/23278255-Support-users-to-access-information-and-services-document-d3-2-questionnaire-for-patient-empowerment-measurement-version-1-0.html.
  32. Wångdahl, J. (2017). Health literacy among newly arrived refugees in Sweden and implications for health and healthcare. (Doctoral dissertation, Acta Universitatis Upsaliensis). Retrieved from http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-333427.
  33. Wångdahl, J., Lytsy, P., Mårtensson, L., & Westerling, R. (2014). Health literacy among refugees in Sweden - a cross-sectional study. BMC Public Health, 14, 1030.  https://doi.org/10.1186/1471-2458-14-1030.CrossRefGoogle Scholar
  34. WHO (1996). WHOQOL-BREF. Introduction, administration, scoring and generic version of the assessment. Retrieved from https://www.who.int/mental_health/media/en/76.pdf.
  35. WHO (2015). Country Cooperation Strategy at a glance. Retrieved from http://applications.emro.who.int/docs/CCS_Afgh_2015_EN_16725.pdf?ua=1.
  36. WHO (2016). Shanghai Declaration on promoting health in the 2030 Agenda for Sustainable Development. Retrieved from https://www.who.int/healthpromotion/conferences/9gchp/shanghai-declaration.pdf?ua=1.
  37. Wilkinson, R. (2014). The Impact of Inequality: How to Make Sick Societies Healthier. New York: The New Press. https://ebookcentral.proquest.com/lib/gbv/detail.action?docID=579087.
  38. Wilkinson, R. G. & Pickett, K. (2010). The spirit level: Why equality is better for everyone (Publ. with rev). Pinguin sociology. London: Penguin Books.Google Scholar

Copyright information

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Fachmedien Wiesbaden GmbH, part of Springer Nature 2021

Authors and Affiliations

  1. 1.Institute of SociologyUniversity of Education Freiburg (Germany)FreiburgGermany
  2. 2.Institute of Mathematics and StatisticsAmerican University of AfghanistanKabulAfghanistan
  3. 3.Director Shuda Hospital, Ghazny (Afghanistan), Shuhada OrganizationGhaznyAfghanistan
  4. 4.Institute of Sociology, Public Health Research CentreUniversity of Education Freiburg (Germany)FreiburgGermany
  5. 5.School of Education, Institute of Special Education and PsychologyUniversity of Applied Sciences and Arts Northern SwitzerlandMuttenzSwitzerland
  6. 6.Director of the Global Health Literacy AcademyRisskovDenmark

Personalised recommendations