Let's imagine that you have a university degree and are proficient in both English and Bangla. Right now, you are on a trip to Nepal, perhaps in a mountainous village very close to the Himalayas, where Nepali and Hindi are widely spoken, but English is not. Sitting at a small eatery, while enjoying the natural surroundings, you suddenly feel a pain in your stomach. You realise that the medicine you need is in your hotel room. There is no clinic, medical centre or hospital nearby. When some kind individuals do come in your aid, you see that they cannot speak a word of English or even feel your distress from the symptoms you are displaying. Thus, despite having a high level of functional literacy, you are unable to access necessary medical care.

This is quite similar to what people with inadequate or low health literacy experience at hospitals. They struggle to understand the signs, instructions and recommendations in a clinical setting. They find the language of healthcare providers to be alien to them.

Today, health issues are more complex than ever, and even individuals with a decent level of traditional literacy may face difficulty in dealing with their bodies, serious illnesses, unfamiliar medical terms and information, navigating healthcare facilities, and conducting self-care.

It is high time to adopt national policies and programmes to improve health literacy among the common people of Bangladesh. Educational programmes should be made available through schools, colleges, universities and mass media. Hospitals and clinics should design and use carefully crafted communication materials, targeting the needs of different groups.

But the issue of poor health literacy is not merely at the individual level. Rather, it has social, political, economic, and environmental dimensions. The high prevalence of inadequate health literacy causes health disparity in terms of access to and use of healthcare services. Several studies indicate that inadequate health literacy levels cause a severe economic burden on the national healthcare system, organisations' outputs, and individual pockets.

In our current complex informational, socio-political and environmental ecology, traditional literacy is not enough. What we need now is public health literacy. Recent studies and empirical experiences indicate that limited health literacy is a public health challenge in many countries around the world. An individual with limited health literacy often fails to benefit from available resources as they have a poor understanding of their health, illness and treatment, resulting in an increased risk of being hospitalised and high medical costs. Scientists also argue that the tendency to adhere to medical and public health recommendations is very low among people without adequate health literacy.

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Our low health literacy needs urgent fixing

During the recent Covid-19 pandemic and the ongoing dengue crisis, we have seen how people tend not to adhere to public health recommendations. The cost of such ignorance has been very high in terms of national interest and disease prevention and control.

Along with investing resources in traditional literacy, it is high time to adopt national policies and programmes to improve health literacy among the common people of Bangladesh. Educational programmes should be made available through schools, colleges, universities and mass media. Hospitals and clinics should design and use carefully crafted communication materials, targeting the needs of different groups. In partnership with the government, private hospitals and donor agencies, a dedicated organisation can be established to improve health literacy in the country. Moreover, mobile apps and patient portals may be created to improve the availability of healthcare information and resources. We must recognise limited health literacy as a public health problem and treat it as such.

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When health(care) comes at a high price

Mohammad Aminul Islam is senior lecturer of media studies and journalism at University of Liberal Arts Bangladesh (ULAB).

Views expressed in this article are the author's own.

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