Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh.
Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh.
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DOI：
10.1186/s12889-017-4097-y
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发表时间：
2017-02-16
影响因子：
4.5
通讯作者：
Bhuiya A
中科院分区：
文献类型：
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作者：
Das S;Mia MN;Hanifi SM;Hoque S;Bhuiya A
健康素养（HL）帮助个人有效利用现有的卫生服务。在孟加拉国等低收入国家，服务利用不佳可能是由于HL水平低。孟加拉国的保健服务是多元化的，既有公立的，也有私营的和非正规培训的保健提供者。对人道主义的重视不够。因此，重要的是要评估HL和服务利用模式的水平。这项研究的结果旨在弥合知识差距。这项研究的数据来自2014年9月在孟加拉国农村地区Chakaria进行的横断面调查。从icddr，B（孟加拉国国际腹泻病研究中心）Chakaria研究区的80，000名人口中随机选择了1500名受访者。HL评估现有的卫生设施的知识和信息来源的卫生保健，免疫接种，糖尿病和高血压。进行了描述性和交叉表分析。86%的受访者提到，乡村对抗疗法医生的诊所，通常被称为“乡村医生”，是他们所在地区已知的卫生服务设施，其次是两个公共部门社区诊所（54.6%）和联合健康和家庭福利中心（28.6%）。儿童免疫接种的主要信息来源是政府卫生工作者。几乎所有的受访者都听说过糖尿病和高血压（分别为97.4%和95.4%）。糖尿病的三大信息来源是邻居（85.7%），其次是亲戚（27.9%）和MBBS（医学和外科学士）医生（20.4%）。高血压的来源以邻居最多（78.0%），其次为乡村医生（38.2%）、医务人员（23.2%）和亲属（15%）。糖尿病和高血压控制措施知晓率分别为40.9%和28.0%。了解糖尿病（44.4%~ 36.6%）和高血压（31.1%~ 24.2%）的女性多于男性。现代卫生服务设施、糖尿病和高血压方面的低水平HL明确表明需要系统的HL计划。相对较高的免疫接种识字率表明，通过系统的提高认识方案，有可能在教育水平低的地区加强免疫接种，从而提高服务覆盖率。
Health literacy (HL) helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh’s health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Emphasis on HL has been inadequate. Thus, it is important to assess the levels of HL and service utilization patterns. The findings from this study aim to bridge the knowledge gap. The data for this study came from a cross-sectional survey carried out in September 2014, in Chakaria, a rural area in Bangladesh. A total of 1500 respondents were randomly selected from the population of 80,000 living in the Chakaria study area of icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh). HL was assessed in terms of knowledge of existing health facilities and sources of information on health care, immunization, diabetes and hypertension. Descriptive and cross-tabular analyses were carried out. Chambers of the rural practitioners of allopathic medicine, commonly known as ‘village doctors’, were mentioned by 86% of the respondents as a known health service facility in their area, followed by two public sector community clinics (54.6%) and Union Health and Family Welfare Centres (28.6%). Major sources of information on childhood immunization were government health workers. Almost all of the respondents had heard about diabetes and hypertension (97.4% and 95.4%, respectively). The top three sources of information for diabetes were neighbours (85.7%), followed by relatives (27.9%) and MBBS (Bachelor of Medicine and Bachelor of Surgery) doctors (20.4%). For hypertension, the sources were neighbours (78.0%), followed by village doctors (38.2%), MBBS doctors (23.2%) and relatives (15%). The proportions of respondents who knew diabetes and hypertension control measures were 40.9% and 28.0%, respectively. More females knew about the control of diabetes (44.4% to 36.6%) and hypertension (31.1% to 24.2%) than males. A low level of HL in terms of modern health service facilities, diabetes and hypertension clearly indicated the need for a systematic HL programme. The relatively high levels of literacy concerning immunization show that it is possible to enhance HL in areas with low levels of education through systematic awareness-raising programmes, which could result in higher service coverage.