Health literacy and health promotionBy Rafael Castillo M.D.
Philippine Daily Inquirer
I share the enthusiasm of Secretary Ike Ona and other health officials that despite the challenges, we’re well on the right track to achieve universal healthcare or kalusugang pangkalahatan. The Department of Health (DOH) and the Philippine government as a whole are doing a good job in getting the obstacles out of the way for a healthier Philippines.
One key factor for a truly empowered citizenry which the DOH and all other allied governmental and nongovernmental agencies should strive to achieve is a high level of health literacy in the population. It has been shown in developed and developing countries that when a country has a high rate of health literacy, it is likely to have favorable long-term outcomes, specifically in reducing maternal and infant illnesses and deaths, and reducing the incidences of prevalent diseases.
With a high health literacy rate, the focus is shifted from curative medicine (making the sick better) to preventive medicine (keeping the people healthy and free of any major illnesses). Health literacy and health promotion go together, like horse and carriage.
Having effective programs on health education and other communication activities are imperative to achieve health literacy. However, having such programs without proper monitoring of how effective and suited they are for the target audiences could still leave a lot of gaps that do not translate into the needed positive changes in the behavior or lifestyle of the majority of the population.
I’m sure our health officials know too well that a relatively simplistic understanding of the relationship between communication by mere information transmission and behavior change won’t bring the desired results.
Health campaigns dealing mainly with the transmission of information without considering social, economic and local cultural factors are likely to fail. Different strokes for different folks, as they say. What may be an effective health campaign in Metro Manila may not be so in the provinces. What works in one province may not be suitable in the next province. Health campaigns must not come in one common, unmodifiable template. The local health officials should customize the campaign as they deem more suited for the area.
As a strong driver for health promotion, a high level of health literacy leads to a positive health-seeking behavior for disease prevention. The aptitude and attitude to prevent communicable diseases are higher, and the desire to actively seek immunization and other preventive health services is stronger. If one has developed a disease already, it can make one seek prompt consultation for early diagnosis and treatment.
Part of health literacy is knowing where to go when one has some health issues, and what benefits he or she is entitled to from government institutions. This can be quite a challenge and it underscores the biggest irony in achieving universal healthcare in our country.
Probably resigned to a fate of no one to turn to when afflicted with an illness, the poor appear uninspired in finding ways to alleviate their health burden. “The main problem with universal healthcare,” laments Secretary Ona during his interview with H&L (Health & Lifestyle) magazine, “is that those who need it the most don’t know about PhilHealth or about their benefits.”
So, a primary part of health literacy for the masses is a change in mindset to make them realize that the government, through the DOH, is doing something to give them a decent access to adequate healthcare, and they should avail of their health privileges.
Public health goal
Health literacy can impact the health condition of a population favorably; hence, it should be considered a public health goal. It should not only be limited to the educated and economically advantaged in the community, but more so to the masses or the “poorest of the poor.”
It’s heartening to note that our budget for health promotion has been increased in 2013 to close to a billion pesos. It seems to be a big amount but it only boils down to roughly P10 per Filipino. Hopefully with the additional “sin tax” revenues, this could be increased in subsequent years. Dr. Ivanhoe Escartin and his team in the DOH National Center for Health Promotion have their hands full with programs to enhance health literacy and health promotion.
However, it would be too much to expect the DOH to shoulder the gargantuan responsibility by itself. All allied governmental and nongovernmental organizations, and health stakeholders should pitch in their share. What is important though is that a system for efficient coordination is in place to make sure there is no duplication of activities, and these activities are prioritized depending on the need. So much funds, efforts and other resources are wasted because of lack of coordination.
A well-coordinated and more creative approach can go a long way in achieving health literacy and health promotion in our country. It would certainly be well worth all the effort. After all, before we can expect to be truly progressive, we have to be healthy first.