The IROHLA project (Intervention Research into Health Literacy of the Ageing population) has produced policy recommendations on how to improve health literacy across Europe. The recommendations and the policy brief are targeted at the decision makers at the national and local level. But what does it take to transform the policy into practice? What needs to happen to avoid IROHLA’s recommendations and work simply sitting on the shelves at ministries and health institutes, gathering dust and being forgotten? What will generate action for real change in the countries of the European Union?
By Karolina Mackiewicz
There is no universal way, but there are universal tools
Europe today is diverse and pluralistic. Countries’ health systems, healthcare culture and experience in the area of health literacy differ markedly. For this reason there is no universal or standardised way for all European countries and cities to improve health literacy. However, there are some common preconditions that need to be met in order to transform policy into practice and guarantee that IROHLA’s work contributes to improved quality of life and care in Europe.
First of all, because health literacy is a complex issue, a multi-dimensional approach must be adopted. This means that the action should take place simultaneously in many sectors and at many levels. The health sector must take action to remove literacy-related barriers to information, services and care, while the education sector needs to work to improve the level of literacy in the population.
Involve the local level
National governments must involve municipalities in order to implement the national health literacy strategy. The local level is the closest one to citizens, and often responsible for the organisation of health, social and educational services. To reach target populations, initiatives to improve health literacy are best grounded in settings of everyday life. This is why special focus must be placed on upgrading the skills of local decision makers and administrators. Based on previous work by the WHO, and corroborated by experience within IROHLA the following tools appear to be appreciated by the local implementers of national and regional programmes:
- A toolbox for practical implementation with evidence, steps to be taken and concrete examples of actions;
Workshops and seminars for local politicians and administrators; - Thematic and local support groups, to help find means of implementation adapted to local conditions;
Support of centres of excellence; - Mechanisms to monitor progress.
Coordinate national actions
At the national level, the respective ministers and agencies should:
- Establish structures and processes that enhance the wide involvement of stakeholders (relevant institutes, organizations, relevant networks and NGOs);
- Broaden access to policy guidance by organising seminars and training sessions for local governments and stakeholders;
- Support learning exchange by developing health literacy networks;
- Support European centres of excellence that will help drive the momentum for health literacy further;
- Provide better monitoring and comparative data about health literacy at all levels.
Strategic integration aiming to improve health literacy policy with other programmes supports its understanding and implementation. Policy should provide guidance and tools but at the same time leave space for adaptation to the local context. Support and assistance needs to be available at every step on the path of putting policy into practice. Such a comprehensive approach will contribute to the improvement of health literacy and will result in better health status of the population.
IROHLA organised the launch of evidence-based guidelines to promote health literacy among older people. The conference, entitled “Sustainable Health Systems through Evidence-based Guidelines on Improving Health Literacy”, took place in Brussels on the 17th November 2015 .
The Consortium presented the guidelines to the European Commission and to representatives of other European and national-level institutions and organisations. Discussion focused on how improving health literacy among older people can contribute to the development of more sustainable health systems in Europe.
Karolina Mackiewicz
Karolina has over 6 years of experience in cross-sectoral and strategic work with local, regional and national authorities in the Baltic Sea Region, including Russian Federation. Since 2009, she has been working with the World Health Organization’s European Healthy Cities Network, taking care for project management in the area of public health and health promotion and capacity building of local governments (leadership for heath, community diagnosis, management of change, evidence-based policy interventions, community participation). Since 2011 Karolina has been involved in the Expert Group on Non-Communicable Diseases of Northern Dimension Partnership in Public Health and Social Well-being. As a Development Manager responsible for projects and communication, Karolina initiates, develops and conducts the health projects with partners and stakeholders and takes care for its complex communication.