Health Literacy Profiles and Disparities Among Adolescents and Implications in Ethiopia

Health literacy (HL) among adolescents is a crucial public health and health equity issue. Currently, research on HL among adolescents is expanding to support effective, evidence-based interventions. However, in Ethiopia, it remains under-researched. Thus, this study focuses on HL among adolescents in Ethiopia. It examines adolescents' HL profiles, identifies and analyzes existing HL inequalities, and ascertains the implications for developing targeted public health strategies and educational programs aimed at improving HL among adolescents. This study employed a school-based, cross-sectional survey design. Data collection took place in January and February 2024. Data analysis comprised both descriptive and inferential statistics, using SPSS version 27.0. Descriptive statistics summarized sociodemographics and HL scores and statuses. Chi-square tests examined disparities in HL across these sociodemographics. Binary logistic regression analyses identified significant predictors of HL among adolescents. A total of 722 adolescents participated in this study, and only about one-quarter of them had adequate HL, with extreme disparities observed across sociodemographic and related factors. Chi-square tests revealed significant associations between HL and school type, parents' education, household income, Internet access, academic performance, interest in health matters, and outlooks on life/futurity. Logistic regression analyses further indicated that respondents having fathers with high education (AOR=1.824, 95% CI=1.126, 2.954), mothers with high education (AOR=1.942, 95% CI=1.154, 3.268), middle household income (AOR=3.819, 95% CI=2.197, 6.636), high household income (AOR=4.583, 95% CI=2.582, 8.137), high academic performance (AOR=3.275, 95% CI=1.472, 7.285), and positive outlooks on life/futurity (AOR=1.948, CI=1.060, 3.582) were more likely to have adequate HL. Respondents lacking Internet access (AOR=0.146, 95% CI=0.069, 0.309) and having low interest in health matters (AOR=0.196, 95% CI=0.096, 0.401) were less likely to have adequate HL. This study investigates HL among adolescents in Ethiopia, revealing a high prevalence of inadequate HL and disparities that contribute to broader health inequalities in society. To address this, the study calls for targeted policies and interventions, including formal HL education in schools.