Exploring the development of a household cholera-focused health literacy scale in James Town, Accra
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Background: Food borne diseases are significant reasons for in-patient and out-patient morbidity in Ghana.
Of the food borne illnesses reported in the country, cholera incidence and outbreaks have resulted in food related
mortality since the disease was first reported in the 1970s. Cholera is now endemic in the country.
This study attempts to develop and pilot a tool to measure household health literacy among the urban
poor in James Town, a cholera endemic neighborhood.
Methods: A survey questionnaire was developed based on four of the World Health Organization’s (WHO)
recommendations on issues for measurement of health literacy in low- and middle-income countries.
The instrument was administered to 401 households in the community. We undertook reliability and
validity analyses. T-test, Kruskal Wallis test, and Mann–Whitney test were used to examine the association
between the health literacy scores of the scale and subscales and the demographic characteristics
of households.
Results: The reliability analyses showed that the instrument was internally consistent (Cronbach
alpha = 0.762). All the subscales were reliable except the beliefs about health and healthcare subscale.
Based on content and construct validity analyses, 13 items were used for further examination of health
literacy. We found that majority of households know about the information, education, and communication
materials and 52% of households indicated that these materials remind them about the dangers of
cholera. About 39% of the households decide together as a unit on steps to avoid getting cholera during
an outbreak. Overall health literacy scores and the subscales were significantly associated with sex, age,
marital status, and educational level of household head. Specifically, females, being married, increasing
age and higher household income had a significant association with higher health literacy scores.
Conclusion: Household units in James Town impacts individual health literacy through: family discussions;
access to information, education, and communication materials on cholera; and intentional efforts
made to get information on cholera risk factors.
Description
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Keywords
Health literacy, Household health, Foodborne diseases, Infections