Exploring health literacy amongst the general population and healthcare providers in Nigeria: a mixed methods study

Health literacy in Nigeria was investigated by examining the relationship between healthcare users and providers, the healthcare system, and health information. Also, the intersection between health literacy and COVID-19 knowledge was explored. A mixed methods approach was adopted, using a nine-dimensional health literacy questionnaire among the general population and interviews with healthcare providers in Nigeria. A self-created questionnaire was also used to investigate the association between health literacy and COVID-19 knowledge. Participants (ages 18-65) from three of Nigeria’s six geopolitical zones, along with 16 healthcare professionals, were recruited. The acquired data were evaluated using multiple regression and thematic analysis and weighted equally in relationship tests. The association between health literacy and COVID-19 knowledge was also analysed using Spearman’s rank correlation. Result: Age, ’needing help to fill out the survey’, and employment are all important factors in the relationship between healthcare users and providers; the healthcare system; and health information. Education improves health literacy but does not always determine it. A positive correlation between COVID-19 knowledge and health literacy was observed, specifically for "actively engaging the Healthcare providers", "navigating the healthcare system", "ability to find good health information" and "understanding health information well enough to know what to do". Conclusion: The factors contributing to health literacy in Nigeria require further investigation. To reduce inequities, healthcare providers should be enlightened on health literacy. Better health literacy, involving understanding of the healthcare system and health information, and active engagement with healthcare providers, can prepare the general public for future pandemics.