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Blogpost on Navigational health literacy. Perspectives from Austria, Germany and Switzerland

By Diana Nemes

Theoretical and empirical studies show that patients find it challenging to navigate healthcare systems due to a lack of transparency and extreme complexity. This calls for navigational health literacy, or the ability to obtain, comprehend, evaluate, and apply knowledge about the healthcare system, its organisations, and its processes. In order to better understand navigational health literacy, which is poorly understood in part due to a lack of measurement tools, a new instrument was created as part of the Health Literacy Population Survey 2019–2021 (HLS19). It was used in national surveys on health literacy conducted in eight European countries, and also in the three German-speaking nations of Austria, Germany, and Switzerland.

The workshop on navigational health literacy* was designed to improve participants' comprehension of navigational health literacy and to suggest future scenarios and actionable strategies for creating and implementing better health literacy results. The workshop managed to 1) give an overview of the newly created instrument for assessing navigational health literacy in HLS19, as well as information on how it was developed and validated; 2) discuss the distribution of navigational health literacy among the Austrian, German, and Swiss population; and, finally, 3) highlight obstacles and challenges people face with regard to navigational health literacy.

Speakers and panellists of this workshop: Doris Schaeffer & Lennert Griese (Bielefeld University, Bielefeld, Germany), Saskia De Gani (Careum Center for Health Literacy, Zürich, Switzerland), Robert Griebler (Austrian National Public Health Institute, Vienna, Austria)

I dived deeper in the subject and discussed with Ms. Saskia De Gani, Head of Careum Center for Health Literacy, Zurich, Switzerland:

Q: What should the readers have as food for thought when it comes to navigational health literacy? Why should they know about that?

A: They must know that it is difficult for most European citizens to appropriately deal with information on navigating the health system. It is very difficult to use the information on navigating the health system effectively, so it is important to strengthen these issues.

Q: Please present a bit about the main causing difficulties of the population when navigating the healthcare system.

A: The main difficulty, at least for Switzerland, is to know about one's own rights as a patient. Also important is knowing about the right to receive a second opinion or know to whom to reach out when needed. The corona pandemic showed that people do not really know where to go and how to judge and apply all the information and resources. Better communication - this would be a good start - but it's not only about easy language, it is also about the support in the social context.

Q: To what extent would be ok to think that every patient that you are working with, as a doctor, has a low literacy level?

A: I think that is important, as some studies have shown that even higher-educated people profit from easy language in order to make sure that they understand the information correctly. Medical terminology is not very accessible to people. We need to also keep in mind that patients are suffering or are in distress, so the context already causes them to be a little less literate.

The key takeaway messages on the subject of navigational health literacy:

Navigating healthcare systems and related information is difficult for most of the general population.

There is a need of health literate healthcare systems and organizations reducing the demands placed on patients by providing guidance and support.

*Details of this workshop: Organised at the 15th European Public Health Conference 2022, held 9-12 November in Berlin, Germany. Workshop organised by Bielefeld University, School of Public Health and EUPHA Working Group on Health Literacy. Chair person of the workshop: Jürgen Pelikan (Austria). Workshop title: 2.K. Round table: Navigational health literacy. Perspectives from Austria, Germany and Switzerland. Abstract of this workshop is available in the European Journal of Public Health, Volume 32, Issue Supplement_3, October 2022, ckac129.098,

Written by Diana Nemes (interviewer), Research Technician at the Department of Public Health, Babes-Bolyai University from Cluj-Napoca, Romania, and
EUPHAnxt fellow at the 15th European Public Health Conference, held 9-12 November 2022 in Berlin, Germany.



Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or HaDEA. Neither the European Union nor the granting authority can be held responsible for them.