Discipline of Social Science and Administrative Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, 11800, Penang, Malaysia.
Pharmacy Enforcement Department, Penang, 10400, Jalan Anson, Penang, Malaysia.
Public Health. 2019 Feb;167:8-15. doi: 10.1016/j.puhe.2018.09.028. Epub 2018 Dec 10.
Health literacy is increasingly recognized as a public health concern. Most of the literature on health literacy concentrate in the Western countries. Therefore, this study aimed to systematically review and examine the available studies on health literacy in Southeast Asian countries and estimate its prevalence in this region.
Systematic review.
A search for relevant articles was carried out using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE (via EBSCOhost), Scopus, Science Direct, PubMed and Google Scholar with multiple search terms. Inclusion criteria comprised articles published in English language and assessing general health literacy. Risk of bias reduced with the involvement of two independent reviewers in the screening of the literature and the quality assessment process.
A total of 11 studies were included, which only consist of studies from five countries out of 11 making up the Southeast Asian region. The overall prevalence of limited health literacy varied considerably, 1.6%-99.5% with a mean of 55.3% (95% confidence interval [CI]: 35.1%-75.6%). A much higher prevalence was noted in studies conducted in healthcare settings, 67.5% (95% CI: 48.6%-86.3%). The most common factors associated with limited health literacy were education attainment, age, income and socio-economic background. Other factors identified were gender and health behaviours.
In summary, despite the little evidence available and existences of high heterogeneity among studies, limited health literacy is still prevalent in Southeast Asian countries. Urgent strategies to improve and promote health literacy in the region are highly warranted. Besides, more studies on health literacy with better quality on the methodology aspect are needed.
健康素养越来越被认为是一个公共卫生关注点。大多数关于健康素养的文献都集中在西方国家。因此，本研究旨在系统地回顾和检查东南亚国家健康素养的现有研究，并估计该地区的流行率。
系统回顾。
使用 Cumulative Index to Nursing and Allied Health Literature (CINAHL) 和 MEDLINE（通过 EBSCOhost）、Scopus、Science Direct、PubMed 和 Google Scholar 进行了相关文章的搜索，使用了多个搜索词。纳入标准包括以英语发表且评估一般健康素养的文章。通过两名独立评审员参与文献筛选和质量评估过程，降低了偏倚风险。
共纳入 11 项研究，这些研究仅来自于构成东南亚地区的 11 个国家中的 5 个国家。有限健康素养的总体流行率差异很大，为 1.6%-99.5%，平均值为 55.3%（95%置信区间[CI]：35.1%-75.6%）。在医疗机构进行的研究中，患病率更高，为 67.5%（95% CI：48.6%-86.3%）。与有限健康素养相关的最常见因素是教育程度、年龄、收入和社会经济背景。其他确定的因素包括性别和健康行为。
总的来说，尽管现有证据很少，而且研究之间存在很大的异质性，但有限的健康素养在东南亚国家仍然很普遍。急需在该地区制定和实施提高和促进健康素养的策略。此外，还需要更多在方法学方面质量更高的健康素养研究。
