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Insights from the first conference on Building Children’s Nursing For Africa, Cape Town 4/17-19, 2013

I conducted a pre-conference workshop  on engaging and  empowering mothers whose children are hospitalized with 15 nurse trainers and a whole class of nephrology students, we talked about the importance of basic literacy skills as the foundation for health literacy.  We reviewed screening questions that can be used to identify individuals who might benefit from adult literacy training.  One nurse said, “But using these questions, I would have to refer everyone who comes to my clinic.” Another said, “Yes,  that’s how it is.”
That’s how it is in some disadvantaged US communities, too.
This discussion, and others during my whirlwind week at Cape Town University and the Red Cross Children’s Hospital,  led to insights about the undeniable links between basic literacy skills (the 3Rs - reading, ‘riting, and ‘rithmatic), health and health literacy.
The 3Rs are  fundamental skills for acquiring knowledge. So it is not surprising that any way “health”  and “literacy” are defined, any way they are measured, they are inextricably linked. More literacy translates, directly and indirectly, to more health and more options and opportunities to regain, maintain and improve health, accomplish one’s goals and fulfill one’s potential. Basic literacy is the foundation for health literacy, computer literacy, science literacy, financial literacies and other “types” of literacy used to function in different social contexts. 
In addition, we now have hundreds of health literacy studies that show most people in most developed nations have difficulty understanding and using information to manage their health and illness and healthcare. 
Since health and literacy are so closely linked, healthcare organizations, especially hospitals and health plans, should consider their ethical duty and the compelling financial and practical benefits of taking the lead to improve adult literacy in their service areas. As primary prevention. As a way to increase the effectiveness of all other efforts. As the foundation for a healthy population, a pathway out of poverty and the key to the advancement of women and society.
Simple, inexpensive steps include collaborating with literacy enhancing services, and in their absence, establishing programs,  providing space for on-site classes, providing health content for literacy training, advocating for adequate funding, training personnel to understand and talk to patients about the role of literacy in their health, expanding Reach Out and Read.
Yes we rely on the schools to teach literacy. And yes, many, perhaps most schools need to do a better job. But we in Healthcare cannot reform Education; and we cannot wait for Education to reform.  To reduce the burden on healthcare systems, to improve outcomes, to increase people’s capacity to obtain the benefits of healthcare, address basic literacy in your service population.

Hamza, age 11, speaking to the conference about living with a "trachy". With him is his mother Farahna, and his nurse,  Jane Booth.
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