Critical Health Literacy for Maternal and Child Health

Reported by Eunice Kua


In the fourth dialogue of the CIE Spring Speaker series on April 20, 2018, Elena Carbone (left), associate professor in the nutrition department of the School of Public Health, and Cristine Smith (right), associate professor in the College of Education and international education faculty member, introduced a new initiative for improving health literacy among women globally.


In introducing the speakers, the CIE interim director Melinda Novak noted that the collaboration between the two professors is a good example of thinking about international education in a broad perspective—including nutrition, sustainable agriculture, and other potential cross-campus collaborations. 


The session covered why mothers’ health literacy is important, some examples and definitions of health literacy, a proposed initiative for work with mothers and children, as well as discussion of the process. 


Elena provided a clear and succinct overview of health literacy, defined as how we deal with health information—how we access, understand, judge and use this information. She noted that most of the current literature deals with “functional” health literacy skills of individuals, e.g. the ability to fill out forms, find doctors, manage a chronic disease, etc.


A second category is known as “interactive” health literacy, e.g. knowing how to share health history with providers and asking doctors questions about treatment options.


However, Elena and Cris are most interested in health literacy not just as an individual characteristic, but as part of a system. This is where “critical” health literacy is pertinent—being able to judge the validity of different, and perhaps contradictory, pieces of information; understanding the social determinants of health, and using skills to take action at both the individual and at a community level.


Thus, they are interested not just in individual skills, but in empowering communities to take action to improve their health. 


As Elena noted, “There are not a lot of us” who are involved in critical health literacy globally. With a grant from the Research Trust Fund, they are trying to bring together professionals in a global network to create a process supporting mothers’ critical health literacy that is replicable for global use and would be adaptable to a wide range of languages, cultures and contexts. Their network currently includes researchers in Ghana, England, Australia and the United States.


Cris outlined the proposed process thus far, which consists of women’s groups coming together to identify and discuss four major items: 1) Health care issues and needs that are important to them, 2) Supports and barriers to getting those needs met, 3) Actions to take to address the barriers and get more support, 4) Help and support they need to take action. 


Following the presentation, faculty and graduate students raised questions and discussed considerations and challenges in applying the framework. Cris and Elena noted that this is not a new process, but it has not often been applied specifically to maternal health literacy. They are hoping to engage with practitioners and researchers working with existing women’s groups who would be able to apply and refine it in their own contexts.


Cris Smith has been involved in health and women’s literacy projects in Nepal and other countries. Elena Carbone’s research focuses on maternal health literacy in low income, culturally diverse populations.