Prevalence of and factors associated with health literacy among people with Noncommunicable diseases (NCDs) in South Asian countries: A systematic review

Abstract

Problem considered Health literacy increases the ability of people living with non-communicable diseases (PLWNCDs) to read and understand medical information, access health information and health services, and involvement in shared decision-making required for improving health outcomes and health behaviours. This systematic review aimed to synthesize available evidence on the prevalence and associated factors of adequate and inadequate health literacy among PLWNCDs in South Asian countries.

Methods Based on PRISMA guidelines, a systematic review of primary studies published between 2010 and 2021 was carried out using four electronic databases and search engines, namely Medline (PubMed and EBSCOhost), CINAHL, Scopus, and Google search engines with various key search terms. Data were extracted, and the findings were narratively synthesized.

Results A total of thirteen studies were included from four countries, and most of them were from Pakistan. The review found that majority of PLWNCDs had inadequate health literacy. The prevalence of inadequate health literacy was higher among people with diabetes (26.00%–80.88%), cardiovascular disease (51.80%–83.43%), and chronic obstructive pulmonary disease (74.80%–79.00%). No studies were found assessing the level of health literacy among people with chronic kidney diseases. Various factors such as poor disease knowledge, no or less educational attainment, belonging to an indigenous or marginalised community from rural areas, and being female were found to be associated with inadequate health literacy.

Conclusion Overall, our review found that PLWNCDs had inadequate health literacy. Therefore, it is important to design and implement interventions focusing on improving health literacy among PLWNCDs, which can help promote healthy behaviours and improve the skills to self-manage NCDs in South Asian countries.