Abstract
Health literacy refers to the skills and abilities individuals require to access,
understand, and apply health-related information to make informed decisions about
their health and well-being. However, healthcare professionals are not always aware
of their patients’ health literacy levels, which may result in health education and
instructions being delivered in ways that patients cannot fully understand. In addition,
such instructions are often not delivered in the patient’s native language, which may
further hinder comprehension and potentially contribute to poor health outcomes.
The purpose of this study was to develop and evaluate strategies to enhance health
literacy awareness among primary healthcare nurses in Gauteng.
In Phase 1, a quantitative, descriptive, non-experimental, and contextual research
design was used. Ethical approval was obtained from the University of Johannesburg
Ethics Committee, the Gauteng Health Districts, and the supervisors of the selected
primary healthcare clinics. In Phase 1, data were collected from twelve primary
healthcare clinics across the five health districts in Gauteng. A total of 401
respondents participated, with a minimum of 31 respondents recruited per clinic.
Health literacy levels were measured using the Rapid Estimate of Adult Literacy
Measure–Revised (REALM-R (SA) (South Africa), a multilingual tool available in
English and nine South African languages (Afrikaans, isiZulu, isiXhosa, Sesotho,
Sepedi, Setswana, siSwati, Tshivenda, and Xitsonga). The tool was administered
through Google Forms in both English and each respondent’s preferred native
language. Health literacy levels were scored based on the correct reading and
pronunciation of eight medical terms. A score of five or fewer indicated low health
literacy, six to seven indicated moderate health literacy, and a full score of eight
reflected adequate health literacy. The data were analysed quantitatively to describe
and compare the health literacy levels of respondents in English and in their native
language. The main findings showed that respondents demonstrated low health
literacy when assessed in English, but their scores improved significantly when
assessed in their native languages...