Health literacy needs assessment among HIV-positive youth in Malawi: A qualitative approach A N D Prioritising Health Literacy enhancing action recommendations by HIV-positive youth in Malawi: A community participatory approach inspired by Concept Mapping

Start date: 19 August, 2015 End date: 26 November, 2015 Project type: Master's Thesis (prior to 2018) Project code: A27810 Countries: Malawi Institutions: Aarhus University (AU), Denmark Grant recipient: Nadege Sandrine Uwamahoro Total grant: 19,000 DKK

Description

Two Abstracts:

1. Health literacy needs assessment among HIV-positive youth in Malawi: A qualitative approach.

Background: Although not yet an integrated part of HIV and AIDS related health promotion research and practice in the low-and-middle income countries of Sub-Saharan Africa, literature from developed countries have indicated that health literacy is important for managing and coping with HIV.

 

Aim: The aim of this study was to assess health literacy related gaps and barriers affecting the health and wellbeing of young people living with HIV in Malawi.

 

Method: Focus group interviews were used to collect data from a sample of members of a national association of young people living with HIV. A total of 24 HIV-positive youth participated in three interviews which were held in each of the country’s three regions. Additionally, three one-to-one interviews were conducted with key informants (adults working with HIV-positive youth) to supplement data from the young people. Data collection tools were developed based on the theoretical concept which was supplemented by a review of existing health literacy measuring tools and contextual literature. The thematic framework approach was used to analyse data.

 

Results: Health literacy related gaps and barriers revealed by this study included information deficits in the HIV-positive youth and among the general public, contradictory information, lack of communication skills and skills to navigate the healthcare systems and lack of counselling to families and networks of HIV-positive youth. Additionally, the study revealed that there is need to promote clubs of HIV-positive youth and to advocate for youth friendly health services.

 

Conclusion: This study makes a contribution to understanding Health literacy related needs of HIV-positive youth in Malawi. The study found that barriers affecting HIV-positive youth’s health and wellbeing in Malawi were not only on the patient level. Gaps and barriers in the general public and in the social and public systems also affected the youth. Overall the study demonstrated that HIV-positive youth with low health literacy were unsupported by the unaccommodating public systems and social and cultural systems. It prevented the young people from seeking preventive and curative services.

 

2. Prioritising Health Literacy enhancing action recommendations by HIV-positive youth in Malawi: A community participatory approach inspired by Concept Mapping

 

Background: This study is characterised by the integration of two participatory approaches: qualitative needs assessment and concept mapping. It is embedded in a research project aimed of mapping health literacy needs of HIV-positive youth in Malawi within a health promotion perspective.

Aim: The study involved groups of HIV-positive youth in Malawi in a process of prioritising a list of 10 recommendations. The aim was to produce a list of prioritised recommendations that would form basis for further work towards addressing health literacy related gaps and barriers.

Methods: 25 HIV-positive youth from across Malawi were asked to rate ten statements describing actions that needed to be taken to address health literacy gaps and barriers. The recommendations were derived from a health literacy needs assessment involving the same groups of youth. Each statement was rated according to its importance in improving the health and wellbeing of HIV-positive youth and its feasibility. A 10-point Likert-type scale going from 1 for extremely unimportant/infeasible to 10 for extremely important/feasible was used to rate statements. A Go-zone- analysis was employed to show action statements rated above average on both importance and feasibility.

 

Results: From the ten statements, seven were rated above average on both importance and feasibility in a cumulative analysis while a separate analysis for each study site revealed differences in regional priorities. Of the seven statements, two were related to distributed health literacy, two to critical health literacy, two to interactive HL, and one to functional health literacy. No health literacy classification was dominatingly preferred over others based on feasibility ratings.

 

Conclusion: Although it was resource-intensive to involve HIV-positive youth not only in assessing challenges but also in prioritising actions to address them, this study has demonstrated that it is worth doing. The study produced a list of prioritised actions that can inform the development of an implementation roadmap and two ways of developing a road map were proposed based on the rating dimensions and on health literacy classifications. Furthermore, the study actively engaged the youth and thus fostered support and ownership of the research results.