RESUMO
BACKGROUND: The periodic and seasonal outbreaks of cholera in Ghana make the disease a vital health concern. The country is cholera endemic with several communities within cholera hotspots. This study, therefore, assesses health literacy on cholera and the association between health literacy competency and health outcome. METHODS: The study adopted a health literacy framework that theorized the pathways between health literacy and health outcomes controlling for confounding factors. A survey questionnaire was administered to a representative sample of 401 individual household heads in James Town, Accra, Ghana. Reliability analysis was undertaken to ascertain the internal consistency of the instrument. Bivariate methods of analyses used were chi-square tests, ANOVA, Mann-Whitney U test, and Kruskal-Wallis test. Binary logistic regression models were run to examine the relative effects of health literacy competency on health outcome (having not had cholera). RESULTS: There are substantial knowledge gaps about environmental risk factors for cholera like the presence of the cholera germ in coastal water, as well as the likelihood of contracting cholera due to overcrowded spaces. However, better knowledge on cholera risk factors was found to be associated with better health literacy competency (food safety and personal hygiene practices). An increase in health literacy competency score was associated with lower likelihood of having had cholera, after controlling for intermediate factors. CONCLUSION: Furthering health literacy on cholera environmental risk factors as well as a deliberate and targeted effort in encouraging consistency in the translation of disease knowledge into healthier practices may improve the well-being of the people.
RESUMO
BACKGROUND: Although substantial progress has been made in reducing total mortality resulting from foodborne diseases, diarrheal illness are still the second most common illnesses among children. In Ghana, foodborne diseases have consistently been among the top 20 causes of outpatient illness over the last couple of decades. This study, therefore, examines health literacy on foodborne diseases and the relative effects of health literacy on self-rated health. METHODS: Foodborne diseases are major causes of morbidity and mortality globally. A mixed-method approach was used for this study. A survey questionnaire and an in-depth interview guideline were administered to samples of 401 and 30 individuals, respectively. We undertook reliability and validity analyses. ANOVA and chi-square tests were undertaken to assess bivariate association between health literacy and demographic variables as well as health status. Ordinal logistic regression models were used to examine the relative effects of health literacy on self-rated health status controlling for individual characteristics. RESULTS: The instrument was internally consistent (Cronbach alpha = 0.744) and valid. On health literacy, 40% of the respondents reported not to require help when they are given information on foodborne diseases to read by a doctor, nurse, or pharmacist. Approximately 60% of respondents need help with completing or filling out hospital documents. Educational level was found to be positively related to functional health literacy. Ordinal logit regression models showed that health literacy is a predictor of self-rated health after controlling for demographic variables. CONCLUSION: Functional literacy is relatively low in the community. There is a positive association between educational level and functional health literacy. The study has also demonstrated the direct positive relationship between health literacy and health status controlling for covariates. Subsequent studies will need to examine multiple level dimensions of health literacy with direct link between specific foodborne diseases and health literacy.