Assessment of health literacy and its determinants among undergraduate students in a Nigerian Federal University

Abstract

Background: Health literacy is increasingly recognized as an integral part of public health strategy and fundamental to the quality of decisions on personal health, recognition of disease symptoms, treatment choices, and participation in disease management. The rise in infectious and non-communicable diseases among the younger population has increased awareness of the need to promote health literacy among students, as this will lead to better prevention and control of diseases. Objective: This study aimed to assess the level of health literacy among undergraduate students and its demographic determinants. Methods: This was a cross-sectional survey carried out among undergraduate students selected from twelve faculties of the University of Maiduguri, Borno State, Nigeria. The “health literacy questionnaire” used is a 39–item instrument on a five-point Likert scale (strongly agree to strongly disagree with neutral in the middle) subdivided into nine domains. A total of 1800 questionnaires were self-administered on respondents selected using a convenience sampling method. The questionnaires were retrieved, and 1500 were found suitable for inclusion in the final analysis, which represents an 83.3% return rate. Satisfaction with the level of health literacy is based on a total score of 80% or above, while scores below this figure represent dissatisfaction. The data was entered into Microsoft Excel, cleaned, and loaded into SPSS version 21 and analysed using descriptive and inferential statistics. Chi-square test was used to determine the association between health literacy and demographic variables. P values < 0.05 are statistically significant. Results: Demographic data showed that the majority of respondents were male (54%) and were within the age bracket of 18 – 25 years of age. Health literacy score was between 48 – 70.1% which is below the 80% satisfaction benchmark. For instance, Social health support (D4) recorded the highest domain score (70.1%) while other domains, such as actively managing my health (D3) (68.9% and ability to actively engage with healthcare providers (D6) (67.8%) recorded lower satisfaction scores. There was a statistically significant association between health literacy and gender (p=0.002), level of study (p<0.001), course of study (p<0.001), and study of health science courses (p<0.0001). The low level of health literacy among undergraduate students presents an opportunity for University authorities to improve and strengthen existing health information services provided to students. Conclusion: The low health literacy among students may lead to poor health choices, risky lifestyles, and inability to appraise healthcare choices, all of which have long-term consequences.