Interventions to improve health literacy in Nigeria: systematic review of effectiveness and policy recommendations

ABSTRACT

Background: Health literacy plays a crucial role in enabling individuals to navigate and make informed decisions within the healthcare system. It encompasses the ability to understand, interpret, and act upon medical information and instructions, as well as the capacity to source and analyse relevant health information for preventive measures and self-care. This paper explores the interventions aimed at improving health literacy in Nigeria and synthesizes policy recommendations for the Nigerian government. Method: A systematic literature review based on the PRISMA methods was carried out to identify published interventions and reported effectiveness in the Nigerian population. A search strategy using key words health literacy and health interventions was executed in PubMed, Embase and African Index Medicus. A total of 268 records were screened for relevance and 18 were identified. Results: Of the 18 reports identified, 13 interventions were effective, 3 interventions had mixed results reporting effectiveness in some domains and ineffectiveness in other important domains, while 2 interventions were not effective. The nature of effectiveness in the interventions was based on the outcomes as reported in the identified studies. Conclusion: The health literacy situation in Nigeria provides a background into some of the challenges faced in achieving universal health coverage and promoting health in Nigeria. Low literacy rates, particularly in its many rural areas, the lack of functional, communicative, and critical health literacy competencies among many adults, as conceptualised in literature pose a significant obstacle to health literacy development in Nigeria. Many of the health literacy interventions have been effective to address various aspects of health literacy on a rather small scale. To comprehensively address the problem, collaborative efforts involving the government, healthcare professionals, non-governmental organisations, media, and the community are necessary.