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Global health systems and policy development: implications for health literacy research, theory and practice

Lookup NU author(s): Professor Gill Rowlands



This is the authors' accepted manuscript of a book chapter that has been published in its final definitive form by IOS Press, 2017.

For re-use rights please refer to the publisher's terms and conditions.


Accessible and responsive health systems are critical to population health and human development. While progress has been made toward global health and development targets, significant inequities remain within and between countries. Expanding health inequities suggest a widespread and systemic neglect of vulnerable citizens, and a failure to enshrine within policies a responsibility to tailor care to the variable capabilities of citizens. Implementation of health and social policies that drive the design of accessible health systems, services, products and infrastructure represents the next frontier for health reform. Within this chapter we argue the need to consider health and health literacy across policy domains, to operationalize the intent to address inequities in health in meaningful and pragmatic ways, and to actively monitor progress and impact within the context of the Sustainable Development Goals (SDGs). We contend that viewing and developing policies and systems within a health literacy framework will assist in placing citizens and equity considerations at the center of development efforts. In this chapter, we explore the relationship between health literacy and equitable access to health care, and the role of health system and policy reform. We first explore international policies, health literacy, and the SDGs. We then explore national policies and the role that national and local services and systems play in building health literacy, and responding to the health literacy challenges of citizens. We discuss the World Health Organization’s (WHO) Framework for Integrated People-Centered Health Services and the way in which health services are being encouraged to understand and respond to citizen health literacy needs. Each section of the chapter ends with a summary and a review of health literacy research and practice. Throughout, we illustrate our points through ‘vignettes’ from around the world.

Publication metadata

Author(s): Rowlands G, Dodson S, Leung A, Levin-Zamir D

Editor(s): Robert A. Logan, Elliot R. Siegel

Publication type: Book Chapter

Publication status: Published

Book Title: Health literacy: new directions in research, theory, and practice

Year: 2017

Volume: 240

Pages: 359-391

Print publication date: 17/10/2017

Acceptance date: 30/06/2017

Series Title: Studies in Health Technology and Informatics

Publisher: IOS Press

Place Published: Amsterdam


DOI: 10.3233/978-1-61499-790-0-359

Library holdings: Search Newcastle University Library for this item

ISBN: 9781614997894