Health Literacy

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Research Proposal

“Mixed-methods evaluation and modelling of mother’s health literacy on child health in province of Aceh, Indonesia”

I.Background
Child health is an essential indicator of the quality of life in developing countries. Mothers’ literacy is often positively associated with improved child health and nutritional status (Glewwe, 1999). The possession of literacy increases the ability of a mother or a family to acquire more knowledge. Improvements in child health are considered as the consequences of enhanced of mother’s knowledge. In short, literacy affects health, and health affects educational achievement (Grosse, 1989). Because the correlation between literacy, health, wealth and well-being is becoming increasingly important, it is crucial to include health literacy as skills required for an adult ‘to function’ in a community (Kickbusch, 2001).

Health literacy has been recognized as a key outcome measure of health promotion interventions (Nutbeam, 1996). It can be categorized as basic/functional health literacy, communicative/interactive health literacy and critical literacy. Each level has different ‘autonomy and personal empowerment’. Individual attention is focused on developing the skills and confidence to make choices that enhance individual health outcomes (Nutbeam, 2000). As the highest level, critical literacy ideally will be achieved in which people have this capability to search for information, assess the reliability of that information and use that information to have a better control over their health determinants (Nutbeam and Renkert, 2001). Following this health literacy concept, Nutbeam and Renkert (2001) define mother’s health literacy as ‘the cognitive and social skills which determine the motivation and ability of women to gain access to, understand and use the information in ways that promote and maintain their health and that of their children’.

In terms of literacy, Indonesia has a relatively high of literacy rate of 90% (UNICEF, 2007). However, people with adequate literacy for dealing with familiar concepts and practices, such as household management can discover a considerable difficulty to understand unfamiliar issues, such as health care information (Kalichman and Rompa, 2000). For mothers, health literacy skills are important factors in predicting child health outcomes. Indonesia as a developing country still faces many child health problems. Infant, neonatal and under-5 mortality rate was relatively high (26, 17 and 34 per 1000 live births, respectively) in 2006. Child immunization coverage is still considerably low with measles coverage of 66.2%, MCV (80%), DPT (75%) and hepatitis (74%) among one-year-olds (WHO, 2009). Many studies show that low literacy is related with several adverse health outcomes (DeWalt, 2004). One of the ways to improve child health is likely by improving mother’s health literacy. Many recent studies have examined the impact of mother’s health literacy on child health (Sandiford, 1995). However, there are few studies focused on the barriers to mother’s health literacy. This study will investigate barriers are there to improve mother’s health literacy on child health and find solutions might overcome the barriers.

II. Objectives
1. To investigate the level of mother’s health literacy in province of Aceh (functional, interactive or critical health literacy of mothers toward child health care, participation in child care programme in villages or sub districts, health seeking behaviours, efforts to gain access to health services). 2. To explore what barriers are there to improve mother’s health literacy on child health 3. To evaluate solutions that might overcome the barriers in order to enhance mother’s health literacy. 4. To create a model of intervention to improve maternal health literacy

III.Methodology
This research will be conducted in quantitative and qualitative...
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