Promoting health literacy: a case study in the prevention of diarrhoeal disease from Bangladesh

The relationship between health education and health literacy is examined through a case study of a project to prevent diarrhea in rural Bangladesh by CARE-Bangladesh in 1993. Health professionals in Bangladesh typically define health education as a one-way approach of information dissemination. Achieving health literacy implies that health education not only relays information but also enhances a persons ability to think about healthy behaviors seek and use information and motivates people to take action to improve health. This paper illustrates how a traditional health education program failed to bring expected changes in the community to improve health. It then describes the development and implementation of the Sanitation and Family Education (SAFE) project by CARE-Bangladesh. SAFE is a diarrhea prevention program which illustrates the concept of health literacy as a step to improved health outcomes. Emphasis is given on the dynamic process of communication community needs and participation identification of problems related to socioeconomic and environmental factors and role of the field workers. It argues that health promotion interventions must respond to the local context and needs to be continually reviewed and revised as necessary. Lessons learned and achievements of SAFE are highlighted. The paper suggests that readers review whether their existing programs are doing enough to raise health literacy and improve health outcomes or if they are merely increasing awareness of related issues. (authors)