health literacy movements in asia -...
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2017/8/4 Thailand 4.0
Health literacy Movements in Asia
Professor Dr. Peter CHANG, MD, MPH, ScD, FRCP Secretary General, Asian Health Literacy Association AHLA. Vice president, International Health Literacy Association, IHLA Visiting Professor, Asfendiyarov Kazakh National Medical University, Almaty, KZ Visiting Professor, Dian Nouswantoro University, Semarang, Indonesia Guest lecturer, University of Southern California & Tufts University, USA Academic advisor, École des hautes études en santé publique (EHESP), Rennes, France; Thu Duc Hospital, HCMC, Vietnam
Health literacy • Health power • Health credits • For individual, family • For community, society • National agenda
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Health literacy investment • Not expensive, even save money • Essential. Without health literacy, without good health • Learning throughout life. The earlier, the better • Learning from one’s environment • Relative to one’s health system
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Health literacy researches in Asia
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PubMed Health literacy 11954 2015/ 1370
Health education 498272 2015/ 32684
PubMed HL %
Australia 1003 33.5
India 562 18.8
China 287 9.6
Japan 157 5.3
Iran 156 5.2
Pakistan 132 4.4
Taiwan 118 3.9
New Zealand 109 3.6
Bangladesh 108 3.6
Korea 102 3.4
Hong Kong 82 2.7
Thailand 53 1.8
Malaysia 48 1.6
Vietnam 33 1.1
Indonesia 24 0.8
Russia 15 0.5
Kazakhstand 4 0.1
Total 2993 ~ 25%
Health literacy google scholar 2,170,000
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Google scholar HL %
Australia 329000 15.7
India 296000 14.1
China 255000 12.1
Japan 188000 9.0
New Zealand 121000 5.8
Bangladesh 110000 5.2
Pakistan 97700 4.7
Korea 96500 4.6
Russia 89000 4.2
Hong Kong 82600 3.9
Vietnam 80500 3.8
Indonesia 79000 3.8
Thailand 78300 3.7
Malaysia 66800 3.2
Taiwan 62100 3.0
Iran 57600 2.7
Kazakhstan 12600 0.6
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2017/8/4 Thailand 4.0
2007 1st Japan mental health literacy
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• 80% websites by Google U.S. acceptable, 45.5 % for Yahoo Japan and 37 % for Google Japan. • Nonprofit organizations or public institutions ran 45.7 percent of the medical sites generated by Google U.S.,
only 15.9 % and 7.4 % Japanese-language sites on Yahoo Japan and Google Japan
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2017/8/4 Thailand 4.0
2008 1st health literacy in Taiwan mental health literacy
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Mental health literacy
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2017/8/4 Thailand 4.0
In each health contact, assist the public, through life course improve and owe adequate health
knowledge and skills ~ health literacy
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2017/7/6
17
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20+ countries, 60+ institutions, 80+ global partners 19
3rd International Conference on Health Literacy & Healthcare Efficiency
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4rd International Conference on Health Literacy & Healthcare Efficiency
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2017/7/6
Nov 2016 AHLA KKU Office Dr. Somsak
2017/7/6
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2017/8/4 Thailand 4.0
Why health literacy matters • To know health is the right of an individual • The more health they know, can manage, the healthy they are • Health literacy is part of literacy, education, culture, society, solidarity • Health literacy by the health system of the individuals • Health literacy developed by an individual? parents, families, lectures,
media, contacts with healthcare services, media, friends, et al.
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2017/8/4 Thailand 4.0
• Literacy is a human right • A tool of personal empowerment • A means for social and human development • Educational (health) opportunities depend on
literacy (health literacy) • 2003-2012 the United Nations Literacy Decade • UNESCO partnering with UN agencies and other
organizations to promote literacy, teach basic health literacy, through formal and informal educational programs in many countries.
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• Incorporating health literacy into educational programmes for youth and adult learners is vital.
• An example of a groundbreaking health literacy project is the collaboration between UNESCO, the Joint United Nations Programme on hiv/aids (UNAIDS) and other stakeholders resulting in the launching of
EDUCAIDS in 2004 –
the Global Initiative on Education and HIV&AIDS
Primary goals 1. To prevent the spread of HIV through education; and 2. To protect the core functions of the education system from the worst effects of the epidemic.
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Recommendations to improve health literacy
1. Health professionals aware of education and health literacy 2. Health information user-friendly, verbal, written information
simple. Charts and pictures text-free educational methods. 3. Neutral and friendly atmosphere between the providers and the 4. Training and educating health care professionals, teachers, social
workers and community volunteers. 5. Local cultural beliefs and customs. 6. Programmes redesigned or adapted. 7. Supporting the adult education sector. 8. Policies at the national, state and local levels. 9. Empowering women and communities.
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2017/8/4 Thailand 4.0
2017/8/4 Thailand 4.0
Health literacy, a paradigm shift Private and individuals, families, communities, work in UHC
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Health literacy matters in UHC
• Universal coverage, what will be covered?
• Quality of health services essential for effective health services
• Empower patients and families, communities
• Enrich all health services, the contact points, the follow-up, outcomes, and values,
• A field work of PPP, private and individuals better health care services
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2017/8/4 Thailand 4.0
The HLS-EU Conceptual Model of Health Literacy (Sorensen et al. 2012) 38
Health Literacy Survey - EU
Domains and competences of HLS-EU-Q47
8/3/2017 39
Domains Competences
1.Finding
information on health(FHI)
2.Understanding
information on health(UHI)
3.Appraising/Judging
information on health(JHI)
4.Applying
information on health(AHI)
1.Health care
(HC)
Ability to access information on medical or clinical issues
Ability to understand medical information and derive meaning
Ability to interpret and evaluate medical information
Ability to make informed decisions on medical issues
2.Disease
prevention(DP)
Ability to access information on risk factors for health
Ability to understand information on risk factors and derive meaning
Ability to interpret and evaluate information on risk factors for health
Ability to make informed decisions on risk factors for health
3.Health
promotion(HP)
Ability to update oneself on determinants of health in the social and physical environment
Ability to understand information on determinants of health in the social and physical environment and derive meaning
Ability to interpret and evaluate information on health determinants in the social and physical environment
Ability to make informed decisions on health determinants in the social and Physical environment
(Sorensen et al., 2012)
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Global comparison in public health literacy
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health literacy lower in Asia
Lower health literacy in Asia Less participation in social community program Less interacting with social media, television, education program Male <<<< Female Lower in aging populations General HL significantly associated education, perceived social status Universal coverage, less impact from ability to pay for medication
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6.5
8.6
7.8
12.5
40.6
35.5
33.2
33.9
41.1
43.5
40.9
39.3
11.8
12.4
18.1
14.3
0% 20% 40% 60% 80% 100%
GHL
HC_HL
DP_HL
HP_HL
Inadequate Problematic Sufficient Excellent0-25 points
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> 25-33 points >33-42 points >42-50 points
• Women aged with lower HL
• Negative effect of ageing significantly
• Modified by watching health related TV programs
receiving health related training/ courses
8/3/2017 46 the APACPH 2015 Conference in Bandung, Indonesia
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2017/8/4 Thailand 4.0
HL-SF12, validated, shorter, effective quick-test Keep HC, DP, HP domains
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Domains Competences 1.Finding
information on
health(FHI)
2.Understanding
information on
health(UHI)
3.Appraising/Judg
ing information
on health(JHI)
4.Applying
information
on
health(AHI)
1.Health care
(HC)
2.Disease
prevention
(DP)
3.Health
Promotion
(HP)
Low health literacy • Overuse/ underuse of health services • Frequent ER visiting • Frequent ambulance • Multi-medication • Can not follow medical compliance • Repeat same questions, • Can not explain the health status • Difficult to choose health services • Barrier to access health information • Can not conduct self health management
•5 steps of better HL
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Hospitals or refugee camp?
Who made such hospitals?
Hospitals in transition
Hospitals in transition
Hospitals in transition
Waiting room, not wasting Healthy rooms, classrooms
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https://www.cpha.ca/sites/default/files/uploads/resources/healthlit/report_e.pdf
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2017/8/4 Thailand 4.0
2017/8/4 Thailand 4.0
2017/8/4 Thailand 4.0
2017/8/4 Thailand 4.0
1. Health literacy, global issue, local solution
2. Identify low HL and intervene
3. HL in all health aspects
Vulnerable groups -
+
High HL
Low HL 2017/8/4 Thailand 4.0