Health literacy levels and correlates among refugees in Mount Lebanon

Abstract

Objectives The study aimed to assess the levels and correlates of health literacy among refugees.

Study design This is a cross-sectional study design.

Methods Health literacy was assessed through face-to-face interviews in eight primary healthcare centers (PHCs) in Mount Lebanon. The questionnaire consisted of the Arabic Functional Health literacy scale, the short version of the European Health Literacy Survey (HLS-EU-Q16), socio-economic questions (sex, age, nationality, marital status, educational level, and ability to pay for medical fees at PHCs), and health-related questions (self-perceived health, long-term illness, recent visit to health care, and freedom to make health decisions). Statistical analyses were performed to evaluate the association between functional health literacy (FHL), comprehensive health literacy (CHL), and potential explanatory variables.

Results Of 263 participants (61.6% females), mean age 38.49 ± 12.80 years, 52.1% had inadequate FHL and 35.7% had inadequate CHL. The likelihood of having inadequate CHL was higher in refugees who were ever married (odds ratio [OR] = 2.794; 95% confidence interval [CI]: 1.187–6.576) or had average ability to pay for medical expenses at PHC (OR = 4.562; 95% CI: 1.554–13.393). The odds of having inadequate FHL was lower in refugees with some level of education (OR = 0.211; 95% CI: 0.077–0.580). Furthermore, their perceived lack of freedom to make personal health decisions was associated with inadequate levels of CHL (OR = 5.195; 95% CI: 2.693–10.022) and FHL (OR = 4.676; 95% CI: 2.610–8.376).

Conclusions Health messages and delivery should be tailored to refugee health literacy levels. Initiatives should seek to improve refugee interaction with the health system, promote uptake of available health services and facilitate health-related decision-making in daily life.