02186nas a2200217   4500000000100000008004100001260003400042653005700076653002700133653002000160100001800180700001300198700001700211700001500228700001300243245007900256300001200335490000700347520160000354022001401954       2019                            d  bOxford University Press (OUP)10aPublic Health, Environmental and Occupational Health10aHealth(social science)10aHealth Literacy1 aMcClintock HF1 aAlber JM1 aSchrauben SJ1 aMazzola CM1 aWiebe DJ00aConstructing a measure of health literacy in Sub-Saharan African countries  a907-9150 v353 a<jats:title>Abstract</jats:title>
               <jats:p>We sought to develop and evaluate a health literacy measure in a multi-national study and to examine demographic characteristics associated with health literacy. Data were obtained from Demographic Health Surveys conducted between 2006–15 in 14 countries in Sub-Saharan Africa. Surveys were the same in all countries but translated to local languages as appropriate. We identified eight questions that corresponded to the National Academy of Medicine (NAM) definition of health literacy. Factor analysis was used to extract one measure of health literacy. Logistic regression was employed to examine the relationship between demographic characteristics and health literacy. A total of 224 751 individuals between the ages of 15 and 49 years were included. The derived health literacy measure demonstrated good internal consistency (Cronbach’s α = 0.72) and good content validity. The prevalence of high health literacy overall was 35.77%; females 34.08% and males 39.17%; less than or equal to primary education 8.93%, some secondary education 69.40% and ≥complete secondary 84.35%. High health literacy varied across nations, from 8.51% in Niger to 63.89% in Namibia. This is the first known study to evaluate a measure of health literacy relying on the NAM definition utilizing a large sample from 14 countries in Sub-Saharan Africa. Our study derived a robust indicator of NAM-defined health literacy. This indicator could be used to examine determinants and outcomes of health literacy in additional countries.</jats:p>  a1460-2245