Health Teaching, Health Literacy and Reflection Essay

Health Teaching, Health Literacy and Reflection Essay

Health Education empowers individuals and their families to make informed health decisions and achieve optimum health. Nurses can educate clients in various ways based on client’s knowledge and learning needs. They can teach a diabetic child on insulin administration techniques; adolescents on sexual health; factory workers on back safety procedures and a young mother on contraception and breast feeding techniques (McEwen & Pullis, 2009). The following essay is divided into three parts. Health Teaching, Health Literacy and Reflection Essay. The first part provides a definition and a brief discussion on health literacy. The second part demonstrates the key strategies to be used to advance the health literacy skills of clients with low health literacy skills. The final part gives a reflection of my learning experience on health literacy and how my knowledge can contribute to provide an effective nursing care in future practice that can empower clients to make informed health decisions.

Health Literacy

Health literacy can be defined as “The degree to which individuals can obtain, process, understand, and communicate about health-related information needed to make informed health decisions” (Berkman, Davis, & McCormack, 2010, p.13).

The Ministry of Health (2010) Ko¯rero Marama Health Literacy and Maori report clearly indicates that the majority of individuals in the overall New Zealand population have low health literacy skills and among them Maori are a higher proportion than Non- Maori. Therefore, those individuals with low health literacy skills have a limited ability to access, obtain, read, understand and communicate health information (Berkman et al., 2011). This results in less knowledge to use preventative measures such as screening programs and vaccinations; limited knowledge about their illness, treatment and medications; more work related injuries; therefore, leading to increased emergency services, hospitalizations and healthcare costs (Nursing Review, 2012).

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Health literacy is beneficial to individuals and their families in various ways to achieve optimum health. One of the ways the health literacy is beneficial to the individuals is that, it enables them to access to health clinics; fill out medical forms; communicate with health providers; interpret labels and health messages; understand about medications and their administration appropriately (Ministry of Health, 2010). In addition to that, health literacy helps people to be aware of prevention strategies such as breast and cervical screening programs (“Health Literacy,” 2013). Furthermore, health literacy enables individuals to make better health choices and self-manage their chronic condition, thereby, decreasing hospitalizations and health care costs (Ministry of Health, 2010). Health Teaching, Health Literacy and Reflection Essay.

Strategies for enhancing health literacy

In order to improve health literacy of clients, registered nurses have to implement the following strategies. First of all, make sure that the environment is shame-free, respectful, caring and supportive where clients can interact openly and productively with healthcare providers (New Zealand Nurses Organisation (NZNO) & College of Nurses Aotearoa, 2012). It is very important to assess the client’s level of knowledge to find out what they already know and what they need to know (Osborne, 2013).

Health Literacy is a shared responsibility, which means; health information is communicated in a way that both the healthcare provider and the receiver can understand (Osborne , 2013). While communicating with clients with limited English language, it is important to speak slowly and listen carefully and use common words like “cancer” instead of “oncology”. Moreover, avoid using medical jargon such as hyperglycemia, hypertension, etc; patients may not understand medical terms, abbreviations and acronyms that health professionals usually use. In addition to that, make the written language on documents simple, easy to read and understandable. For instance, using headings and sub headings can easily identify key concepts and clients can easily go through the information they needed (Osborne, 2013).

Moreover, it is important to breakdown the complex information into small chunks, organize information and convey the most important concepts that the client has to know regarding their health (U.S. Department of Health & Human Services, n.d.). In addition to that, identify different learning styles of individuals, for example, some people may prefer a visual learning, some other may prefer auditory or tactile learning styles (McEwen & Pullis, 2009).Health Teaching, Health Literacy and Reflection Essay.  Inclusion of decision aids and other teaching tools such as videos, quizzes, maps, booklets, images etc. would also be more effective (Osborne, 2013). Furthermore, communicating with non-English speakers can be addressed by appointing an appropriate medically trained interpreter.

It is very important for the health provider to address and acknowledge any cultural differences and provide health information appropriately. For example, they can make the clients feel welcomed by greeting them in their respective language, displaying multicultural artifacts and translated signs in the health settings (Osborne, 2013). Instead of making assumptions that the client understood the provided health information, it is important to pay attention to client’s non-verbal cues along with verbal statements (NZNO & College of Nurses Aotearoa, 2012).

While teaching elderly people, it is very important to assess their physical readiness to learn new information. For example, some elderly people may have hearing, seeing and alertness problems that make their learning difficult (Lowenstein, Foord-May, & Romano, 2009). To overcome this, always speak in ways that elderly people can hear and always make sure that the written information is readable. Moreover, encourage elderly people to bring a support person or a trusted friend to reinforce and clarify the informed health information (Osborne, 2013).

Furthermore, use a teach-back technique to assess and confirm whether the health information provided is clear to the client. This technique will help to know to what extent the client can recall the comprehensive message and whether the client interpreted it correctly (Osborne , 2013). For example, instead of asking the client “ Do you understand?” it will be better stating that “ I just want to make sure I explained things well, tell me how you take these medications?” .

Reflection

On reflection, I have realized that a thorough assessment of client’s learning needs based on their age groups and developmental stages given me an insight on how their physical, cognitive, psychosocial learning abilities change in each developmental stage; and what teaching methods and strategies would be more effective and appropriate for that particular target group. For example, preschool children cannot think abstractly and they learn by watching and interacting with others. Whereas, adolescents can think abstractly and they can effectively learn through web and computer based resources, books, pamphlets, games, movies and through interacting with peers (McEwen & Pullis, 2009).  Health Teaching, Health Literacy and Reflection Essay.

Evaluation at the end of the teaching session in my practicum helped me to analyze the effectiveness of the teaching session. This given me an insight of what teaching strategies were more effective and what other strategies I need to implement to improve my future teaching session. I realized that some teaching tools such as videos, quizzes and games reinforced the target group to interact and co-operate well with our teaching session. In addition to that, I also realized that I have to use simple language and avoiding medical terms while stating objectives to the adolescents. Furthermore, I realized that it is very important to document the evaluation on teaching session. This will be a base for our team when we plan another teaching session in future for that particular age group.

In my future practice, I will definitely prepare a lesson plan based on thorough assessment of client’s learning’s needs. I will also use effective communication strategies that can reinforce the target group during lesson delivery. At the end of the teaching session I will also document the evaluation for future references.

Conclusion

In conclusion, Health Literacy skills are very important for the health and wellbeing of individuals. Health literacy skills empower individuals to take informed health decisions. Thorough assessment of client’s knowledge levels and learning needs are essential to develop a good lesson plan for a particular target group. Following effective communication strategies and teaching methods during lesson delivery will reinforce clients to participate effectively and make informed health choices for better health outcomes.

Health literacy is defined as “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Healthy People, 2010 cited in Paasche-Orlow et al., 2005, p. 175). The word Health literacy was first appeared in 1974 in a paper which calls for “education standards for all grade school levels in USA” (Peerson and Saunders, 2009, p. 285). Health literacy not only addresses the literacy aspects of an individual, it is also linked with the overall health status of an individual, in the recent decades researchers identified the relation between health literacy and the health outcome (Speros, 2005). According to an estimation, around ninety million people in USA have poor literacy and have problems in understanding health related information (Hawkins, Kantayya and Sharkey-Asner, 2010). Health Teaching, Health Literacy and Reflection Essay. Health literacy is a newly emerged concept in health promotion research and some recent works suggest that there is a relation between literacy, low health and premature deaths (Zarcadoolas, Pleasant and Greer, 2005). This essay will explore these issues. It will begin by considering awareness of health literacy, it will then discuss on the influence of health literacy on the health.

Literacy and health

Low literacy is common among the people all over the world, even developed countries have low literacy levels and in developing countries these figure are much higher (Nutbeam, 2006). (Hemming and Langille, 2006) stated that literacy is the essential basic for health literacy and individual’s life reflects the relationship with health and literacy. Education plays a key role in addressing the health of an individual, improving the literacy among the people will tackle one of the major inequalities of health because it indirectly indicates an individual’s capacity to make healthy choices (Nutbeam and Kickbusch, 2000). Literacy have more influence on health than all other demographic variables and other factors like age, ethnicity and race (Manganello, 2008). People with low literacy may have difficulties in understanding the information related to health matters like medical prescriptions, instructions and recommendations by their health care provider (Hahn and Cella, 2003). Ivnik and Jett (2008) also explains that the discriminations in individuals ability to read and to interpret the information available related to personal care and health care services also contribute to the disparities of health. In an study by (Dewalt et al., 2004) found that people with poor literacy are misusing the preventive measures like taking the vaccinations and they are never gone to take the screening tests like cancer smear tests and mammography. According to an estimation in United States of America about 75 percent of people with chronic diseases are having limited literacy levels (Ivnik and Jett, 2008).

Awareness on Health literacy

The concept of health literacy was first originated in early years and it was recognised as an autonomous research field in 1990s (Pleasant and Kuruvilla, 2008). Mika et al. (2005) suggests that finding more information on health literacy and the problems associated with it in population with health disparities is very important. But proper preference is not given to the health literacy which is a key problem which acts as a barrier between the health care systems and people seeking health services (Speros, 2005). Health Teaching, Health Literacy and Reflection Essay. Moreover Zahnd, Scaife and Francis (2009) explains that health literacy is focused on three domains they are, clinical understanding which is the ability to understand the directions on the prescriptions, prevention by recognising the signs and symptoms of a disease and using health care systems by understanding the services provided by it. The awareness on the health and the literacy is increasing, and several governments are implementing various national programmes to raise literacy levels and health standards. Some organisations are implementing health awareness programmes in the community, and they promote them through media, social marketing and printed materials. However, people who can read pamphlets and printed text can only know the information in it. So accessibility to health information is a key factor among every individual in community, which can be achieved by health literacy(Hemming and Langille, 2006). Moreover ishikawa and Yano (2008) explains that the studies on health literacy up to present are only concentrated on the communication between individual seeking health care and health care providers in an medical setting, it might be expanded to address the more broader aspects of health literacy in population rather than individual level.

Estimation of Health literacy and its outcome

As the awareness on the health literacy is rapidly growing various assessment scales are developed to estimate the impact of health literacy on health outcomes. Currently ‘Rapid Estimate of Adult Literacy in Medicine’ (REALM) and the ‘Test of Functional Literacy in Adults’ (TOFHLA) is the widely used scales in clinical setting to measure the reading ability of patients (Hixon, 2004). Nutbeam (2009) also argues that these tools only measure the selective knowledge of overall capacity of an individual but not in particular aspects of health literacy. In addition Pleasant and Kuruvilla (2008), argue that none of these make sense of an appropriate measurement of health literacy. There is a continuing debate on what should be measured health literacy in an individual perspective or a relation between health systems and individual skills (Jordan, Buchbinder and Osborne, 2010). The Test of Functional literacy in adults measures the adult literacy rates in health care field and only concentrates on individual capacity to read the medical information on some medical slips and labels, Rapid Estimate of adult literacy is a short screening tool made to measure adult literacy in medical settings but no tool is made till now to access the broader aspects of health literacy (Mika et al., 2005).Health Teaching, Health Literacy and Reflection Essay.  Baker (2006) claims that it is important to show a difference between general literacy and reading ability of health material, because the capacity to perceive the health information is more likely related to health outcomes than general reading ability. United States of America developed a national assessment scale called National Adult Literacy Scale to measure the health literacy among the adults, this scale consists of twenty six health related questions in it to access the prevalence of health literacy (Hawkins, Kantayya and Sharkey-Asner, 2010). According to the reports by NALS in the year 1993 about fifty million of population in America are having inadequate health literacy (Speros, 2005).

All these screening tools only measure the reading abilities of an individual in health field they failed to access the other forms of information seeking and health knowledge gained through the oral communications (Nutbeam, 2008). literacy means not only the ability to read the text it is the capacity to understand and use the text or information available in the form of passages, figures or any other forms (Zahnd, Scaife and Francis, 2009).

Health Literacy and its impact on individual health

The researchers recently came to know the problems associated with the health literacy, they came to know the role played by it in the medical as well as the individual self care by the comprehension of information related to health and the outcomes related to it (Speros, 2005).The people with poor literacy levels may be prone to have bad health status and show more unhealthy behaviours like excessive alcohol intake and smoking (San Diego, Calif 2004).The People having low health literacy may possess weak communication skills on health related issues may lead to improper diagnosis of their health condition and inappropriate usage of medication and using of health care services.  Health Teaching, Health Literacy and Reflection Essay.Nutbeam (2008) have proposed three critical points where the health literacy shows its impact on community, they are as follows reaching to the health care services, Communication between the health care staff and patients, and personal care. Paasche-Orlow and Wolf (2007) claims that, distinguishing the independent effects of health literacy is quite difficult due to the complex issues like demographic variables and social determinants are interrelated to it.

The people with low health knowledge may be more likely to lead an unhealthy lifestyle due to the lack of minimum health consciousness on the prevention of several infectious diseases, proper using of the vaccinations and poor management of various illnesses, and there is a more chance of acquiring diseases because health outcome often depends on self management of the patient (Gazmararian et al., 2005). The people with low literacy skills are spending four times more expenditure on their health care, according to some estimates in United States more than 75% of people having chronic mental or physical illness comes under poor literacy category (Ivnik and Jett, 2008). A person with the ability to read and understand the basic level health issues have the capacity to make use of health care services, and they can manage their health by lifestyle modification and by increasing their living standards at an individual and community level (Nutbeam, 2008). Health literacy improves the public to access available information of health and the ability to give appropriate feedback on his own health status, decision making on health and can lead a disease free lifestyle which lessens the frequent visits to hospitals (Speros, 2005).

Different ways to promote Health Literacy

Various awareness programmes conducted by government such as national eradication programmes in prevention of Poliomyelitis, Malaria, Tuberculosis, etc., and some awareness programmes on maternal health, paediatric health, etc. are promoting health literacy by educating the people on diseases and its preventive method. Health literacy may be promoted through visual media, printed material, and internet sources (Bastian, 2008). However, these sources sometimes don’t show satisfactory outcomes. The people who are illiterates are misusing the services available because they cannot understand the basic printed information available and complex issues like using internet sources is quite complicated to those people. Health information is more complex these days the information can only be understood by experts (Gazmararian et al., 2005). Patients with less minimum health literacy may feel shame to communicate with their health care providers and they feel shy in asking help from their physician and leave with incomplete information and they may not know how to use the medications and when is their next appointment for their follow up of health condition and they just ignore their medical care (Hahn and Cella, 2003). Safeer and Keenan (2005) suggest that the information provided by the physicians to the patients should be in a simple manner so that the condition and the medical treatment should be clearly understood by the patient. Alternatively Egbert and Nanna (2009), suggests that the health information should be made in a user friendly manner which is in an easily accessible manner which explicit information with visual links(Ivnik and Jett, 2008). The best way to promote health literacy is through the direct interaction by health care providers with the people who cannot read (Shaw et al., 2009).Health Teaching, Health Literacy and Reflection Essay.  Tanya and Al-Assaf (2006) suggests that, Nurses and other health care persons should act as Health volunteers and create a convenient environment so that the people can interact with health educators and discuss on health issues, efforts are made to increase patient and physician interaction . In addition it is advised to the patients to develop the communication with their physician and health care providers regarding their health status, treatment procedures, follow up and effective self care for a healthy life style (Mika et al., 2005).

Conclusion

This essay had considered a range of issues to do with health literacy including an estimation of the extent of the problem and strategies to address the issue. Health literacy plays a key role on the overall health and wellbeing. Multiple factors like proper usage of health care services, communication of health issues with health care providers, leading healthy lifestyle, good hygienic conditions, taking preventive measures like immunisation, which might show to impact an individual’s physical and mental wellbeing are directly or indirectly associated with health literacy. So it is suggested that promoting health literacy will make a healthy community, and it should be considered as a primary public health goal.

Health literacy is defined as “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Healthy People, 2010 cited in Paasche-Orlow et al., 2005, p. 175). The word Health literacy was first appeared in 1974 in a paper which calls for “education standards for all grade school levels in USA” (Peerson and Saunders, 2009, p. 285). Health literacy not only addresses the literacy aspects of an individual, it is also linked with the overall health status of an individual, in the recent decades researchers identified the relation between health literacy and the health outcome (Speros, 2005). According to an estimation, around ninety million people in USA have poor literacy and have problems in understanding health related information (Hawkins, Kantayya and Sharkey-Asner, 2010).Health Teaching, Health Literacy and Reflection Essay.  Health literacy is a newly emerged concept in health promotion research and some recent works suggest that there is a relation between literacy, low health and premature deaths (Zarcadoolas, Pleasant and Greer, 2005). This essay will explore these issues. It will begin by considering awareness of health literacy, it will then discuss on the influence of health literacy on the health.

Literacy and health

Low literacy is common among the people all over the world, even developed countries have low literacy levels and in developing countries these figure are much higher (Nutbeam, 2006). (Hemming and Langille, 2006) stated that literacy is the essential basic for health literacy and individual’s life reflects the relationship with health and literacy. Education plays a key role in addressing the health of an individual, improving the literacy among the people will tackle one of the major inequalities of health because it indirectly indicates an individual’s capacity to make healthy choices (Nutbeam and Kickbusch, 2000). Literacy have more influence on health than all other demographic variables and other factors like age, ethnicity and race (Manganello, 2008). People with low literacy may have difficulties in understanding the information related to health matters like medical prescriptions, instructions and recommendations by their health care provider (Hahn and Cella, 2003). Ivnik and Jett (2008) also explains that the discriminations in individuals ability to read and to interpret the information available related to personal care and health care services also contribute to the disparities of health. In an study by (Dewalt et al., 2004) found that people with poor literacy are misusing the preventive measures like taking the vaccinations and they are never gone to take the screening tests like cancer smear tests and mammography. Health Teaching, Health Literacy and Reflection Essay. According to an estimation in United States of America about 75 percent of people with chronic diseases are having limited literacy levels (Ivnik and Jett, 2008).

Awareness on Health literacy

The concept of health literacy was first originated in early years and it was recognised as an autonomous research field in 1990s (Pleasant and Kuruvilla, 2008). Mika et al. (2005) suggests that finding more information on health literacy and the problems associated with it in population with health disparities is very important. But proper preference is not given to the health literacy which is a key problem which acts as a barrier between the health care systems and people seeking health services (Speros, 2005). Moreover Zahnd, Scaife and Francis (2009) explains that health literacy is focused on three domains they are, clinical understanding which is the ability to understand the directions on the prescriptions, prevention by recognising the signs and symptoms of a disease and using health care systems by understanding the services provided by it. The awareness on the health and the literacy is increasing, and several governments are implementing various national programmes to raise literacy levels and health standards. Some organisations are implementing health awareness programmes in the community, and they promote them through media, social marketing and printed materials. However, people who can read pamphlets and printed text can only know the information in it. So accessibility to health information is a key factor among every individual in community, which can be achieved by health literacy(Hemming and Langille, 2006). Moreover ishikawa and Yano (2008) explains that the studies on health literacy up to present are only concentrated on the communication between individual seeking health care and health care providers in an medical setting, it might be expanded to address the more broader aspects of health literacy in population rather than individual level.

Estimation of Health literacy and its outcome

As the awareness on the health literacy is rapidly growing various assessment scales are developed to estimate the impact of health literacy on health outcomes. Currently ‘Rapid Estimate of Adult Literacy in Medicine’ (REALM) and the ‘Test of Functional Literacy in Adults’ (TOFHLA) is the widely used scales in clinical setting to measure the reading ability of patients (Hixon, 2004). Nutbeam (2009) also argues that these tools only measure the selective knowledge of overall capacity of an individual but not in particular aspects of health literacy. In addition Pleasant and Kuruvilla (2008), argue that none of these make sense of an appropriate measurement of health literacy. There is a continuing debate on what should be measured health literacy in an individual perspective or a relation between health systems and individual skills (Jordan, Buchbinder and Osborne, 2010). The Test of Functional literacy in adults measures the adult literacy rates in health care field and only concentrates on individual capacity to read the medical information on some medical slips and labels, Rapid Estimate of adult literacy is a short screening tool made to measure adult literacy in medical settings but no tool is made till now to access the broader aspects of health literacy (Mika et al., 2005).Health Teaching, Health Literacy and Reflection Essay.  Baker (2006) claims that it is important to show a difference between general literacy and reading ability of health material, because the capacity to perceive the health information is more likely related to health outcomes than general reading ability. United States of America developed a national assessment scale called National Adult Literacy Scale to measure the health literacy among the adults, this scale consists of twenty six health related questions in it to access the prevalence of health literacy (Hawkins, Kantayya and Sharkey-Asner, 2010). According to the reports by NALS in the year 1993 about fifty million of population in America are having inadequate health literacy (Speros, 2005).

All these screening tools only measure the reading abilities of an individual in health field they failed to access the other forms of information seeking and health knowledge gained through the oral communications (Nutbeam, 2008). literacy means not only the ability to read the text it is the capacity to understand and use the text or information available in the form of passages, figures or any other forms (Zahnd, Scaife and Francis, 2009).

Health Literacy and its impact on individual health

The researchers recently came to know the problems associated with the health literacy, they came to know the role played by it in the medical as well as the individual self care by the comprehension of information related to health and the outcomes related to it (Speros, 2005).The people with poor literacy levels may be prone to have bad health status and show more unhealthy behaviours like excessive alcohol intake and smoking (San Diego, Calif 2004).The People having low health literacy may possess weak communication skills on health related issues may lead to improper diagnosis of their health condition and inappropriate usage of medication and using of health care services. Nutbeam (2008) have proposed three critical points where the health literacy shows its impact on community, they are as follows reaching to the health care services, Communication between the health care staff and patients, and personal care. Paasche-Orlow and Wolf (2007) claims that, distinguishing the independent effects of health literacy is quite difficult due to the complex issues like demographic variables and social determinants are interrelated to it.

The people with low health knowledge may be more likely to lead an unhealthy lifestyle due to the lack of minimum health consciousness on the prevention of several infectious diseases, proper using of the vaccinations and poor management of various illnesses, and there is a more chance of acquiring diseases because health outcome often depends on self management of the patient (Gazmararian et al., 2005). Health Teaching, Health Literacy and Reflection Essay. The people with low literacy skills are spending four times more expenditure on their health care, according to some estimates in United States more than 75% of people having chronic mental or physical illness comes under poor literacy category (Ivnik and Jett, 2008). A person with the ability to read and understand the basic level health issues have the capacity to make use of health care services, and they can manage their health by lifestyle modification and by increasing their living standards at an individual and community level (Nutbeam, 2008). Health literacy improves the public to access available information of health and the ability to give appropriate feedback on his own health status, decision making on health and can lead a disease free lifestyle which lessens the frequent visits to hospitals (Speros, 2005).

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Different ways to promote Health Literacy

Various awareness programmes conducted by government such as national eradication programmes in prevention of Poliomyelitis, Malaria, Tuberculosis, etc., and some awareness programmes on maternal health, paediatric health, etc. are promoting health literacy by educating the people on diseases and its preventive method. Health literacy may be promoted through visual media, printed material, and internet sources (Bastian, 2008). However, these sources sometimes don’t show satisfactory outcomes. The people who are illiterates are misusing the services available because they cannot understand the basic printed information available and complex issues like using internet sources is quite complicated to those people. Health information is more complex these days the information can only be understood by experts (Gazmararian et al., 2005). Patients with less minimum health literacy may feel shame to communicate with their health care providers and they feel shy in asking help from their physician and leave with incomplete information and they may not know how to use the medications and when is their next appointment for their follow up of health condition and they just ignore their medical care (Hahn and Cella, 2003). Safeer and Keenan (2005) suggest that the information provided by the physicians to the patients should be in a simple manner so that the condition and the medical treatment should be clearly understood by the patient. Alternatively Egbert and Nanna (2009), suggests that the health information should be made in a user friendly manner which is in an easily accessible manner which explicit information with visual links(Ivnik and Jett, 2008). The best way to promote health literacy is through the direct interaction by health care providers with the people who cannot read (Shaw et al., 2009). Health Teaching, Health Literacy and Reflection Essay. Tanya and Al-Assaf (2006) suggests that, Nurses and other health care persons should act as Health volunteers and create a convenient environment so that the people can interact with health educators and discuss on health issues, efforts are made to increase patient and physician interaction . In addition it is advised to the patients to develop the communication with their physician and health care providers regarding their health status, treatment procedures, follow up and effective self care for a healthy life style (Mika et al., 2005).

Conclusion

This essay had considered a range of issues to do with health literacy including an estimation of the extent of the problem and strategies to address the issue. Health literacy plays a key role on the overall health and wellbeing. Multiple factors like proper usage of health care services, communication of health issues with health care providers, leading healthy lifestyle, good hygienic conditions, taking preventive measures like immunisation, which might show to impact an individual’s physical and mental wellbeing are directly or indirectly associated with health literacy. So it is suggested that promoting health literacy will make a healthy community, and it should be considered as a primary public health goal. Health Teaching, Health Literacy and Reflection Essay.