Evidence map›Paper›PMID 40665282›Full record

ArticleBMC public health2025

Health literacy in five districts in Sri Lanka: a baseline assessment of health literacy levels among 18-49-year-olds and associated factors.

Millawage Supun Dilara Wijesinghe, Nathasha Hithaishi Obeyesekera, Balangoda Muhamdiramlage Indika Gunawardana, Weerasinghe Mudiyanselage Prasad Chathuranga Weerasinghe, Upeksha Gayani Karawita, Nissanka Achchi Kankanamalage Ayoma Iroshanee Nissanka, Vithanage Chandima Nayani Vithana, Singappuli Arachchilage Sanjeewanie Champika Karunaratne, Praveen Nagendran, Gayani Sandeepika Dissanayake and 3 more

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Millawage Supun Dilara WijesingheHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Nathasha Hithaishi ObeyesekeraHealth Promotion Bureau, Colombo, 08, Sri Lanka. n.h.obeyesekera@gmail.com.
Balangoda Muhamdiramlage Indika GunawardanaHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Weerasinghe Mudiyanselage Prasad Chathuranga WeerasingheHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Upeksha Gayani KarawitaHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Nissanka Achchi Kankanamalage Ayoma Iroshanee NissankaHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Vithanage Chandima Nayani VithanaHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Singappuli Arachchilage Sanjeewanie Champika KarunaratneHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Praveen NagendranHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Gayani Sandeepika DissanayakeHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Ranjith BatuwanthudaweHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Maap AlagiyawannaHealth Promotion Bureau, Colombo, 08, Sri Lanka.
Palitha KarunapemaHealth Information Unit, Ministry of Health, Colombo, 10, Sri Lanka.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite Sri Lanka's high general literacy rate, disparities persist in health literacy (HL), which is a critical determinant of healthcare outcomes. This study assessed HL levels among adults aged 18-49 years in five districts and identified the associated sociodemographic and behavioral factors.

methodsA cross-sectional study was conducted (October 2022 - March 2023) via multistage cluster sampling across five districts (Colombo, Hambantota, Kurunegala, Monaragala, and Mullaitivu). Participants (n = 532) were recruited. The validated HLS-EU-Q16 (European Health Literacy Survey- 16-item version) tool was used, and HL was categorized as "limited" (0-12) or "sufficient" (13-16). Multivariable logistic regression was used to analyze the predictors of limited HL. The analysis was conducted via SPSS software (version 23.0).

resultsOverall, 84.6% of the participants demonstrated sufficient HL, whereas 15.4% had limited HL. Regular interaction with public health midwives, the use of television or the internet for health information, and the absence of language barriers significantly reduced the odds of limited HL. Socioeconomic disparities were evident, with 27% lacking access to health information and 17% reporting language-related comprehension challenges.

conclusionWhile Sri Lanka's primary healthcare infrastructure supports relatively high HL, systemic gaps persist, particularly among linguistically diverse and socioeconomically disadvantaged groups in Sri Lanka. Prioritizing multilingual health communication, digital platforms, and community-based education through frontline health workers can help bridge these gaps. Integrating critical HL competencies into national education and health policies is vital to address the disconnect between general literacy and health empowerment.

Indexed as

Health LiteracyAdolescentAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedSocioeconomic FactorsSri LankaSurveys and QuestionnairesYoung AdultHealth communicationHealth literacyLanguage barriersSocioeconomic factorsSri Lanka

Identifiers

PMID40665282
PMCPMC12261826

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.