Pregnant Women’s Health Literacy in the South of Iran

  • Sakineh Dadipoor Mother and Child Welfare Research Center, School of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
  • Ali Ramezankhani Department of Public Health, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Azin Alavi Fertility and Infertility Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
  • Teamur Aghamolaei Social Determinants on Health Promotion Research Center, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
  • Ali Safari-Moradabadi Mail Student Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Health Literacy, Pregnancy, Test of Functional Health Literacy in Adults, Iran


Objective: Investigate the health literacy of pregnant women in the south of Iran.Materials and methods: The present descriptive-analytical study was conducted on 775 pregnant women in the south of Iran (including Boushehr, Ahvaz, Zahedan and Bandar Abbas cities) through the clustering sample selection method. The data were collected through the Test of Functional Health Literacy in Adults: TOFHLA, and were analyzed statistically via SPSS 16 through independent-sample t-test and ANOVA.Results: The average age of the subjects was 31.89 ± 7.54 years. The results indicated that 15.5% of the subjects had an inadequate level of health literacy; 41.7% had a border-line level of health literacy, and 42.8% had an adequate level of literacy. Significant correlations were found between each of these variables and the subjects’ level of health literacy: education, age, occupation and care provision during pregnancy (p ˂ 0.05). The highest mean score of health literacy belonged to Ahvaz while the lowest belonged to Boushehr.Conclusion: According to the results, the health literacy level of pregnant women in the target geographical areas showed to be inadequate or on a border-line. Moreover, subjects’ education, age and occupation showed to be significantly correlated with health literacy. Therefore, promoting pregnant women’s health literacy through simplifying health-related information, use of audio-visual media, improving communicative skills among the health staff and mothers can be effective.


Lupattelli A, Picinardi M, Einarson A, Nordeng H. Health literacy and its association with perception of teratogenic risks and health behavior during pregnancy. Patient educ couns 2014;96: 171-8.

Ohnishi M, Nakamura K, Takano T. Improvement in maternal health literacy among pregnant women who did not complete compulsory education: policy implications for community care services. Health Policy 2005;72:157-64.

Kandula NR, Nsiah-Kumi PA, Makoul G, Sager J, Zei CP, Glass S, et al. The relationship between health literacy and knowledge improvement after a multimedia type 2 diabetes education program. Patient education and counseling 2009; 75: 321-7.

Nutbeam D, Kickbusch I. Advancing health literacy: a global challenge for the 21st century. Health promotion international 2000; 15: 183-4.

Shieh C, Halstead JA. Understanding the impact of health literacy on women's health. J Obstet Gynecol Neonatal Nurs 2009; 38:601-10.

Ferguson B. Health literacy and health disparities: The role they play in maternal and child health. Nurs Womens Health 2008; 12: 286-98.

Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 2011;155:97-107.

Endres LK, Sharp LK, Haney E, Dooley SL. Health literacy and pregnancy preparedness in pregestational diabetes. Diabetes Care 2004; 27: 331-4.

Ghanbari S, Majlessi F, Ghaffari M, Mahmoodi Majdabadi M. Evaluation of health literacy of pregnant women in urban health centers of Shahid Beheshti Medical University. Daneshvar Medicine 2012;19: 1-12. (Persian)

Hoseinpour N, Sajadi H, Mahmoudi Z, Sharifian SM.( 2014). Health Literacy And Nutrition Status In Rural Pregnant Women Of Izeh, Iran. Nutrition And Food Sciences Research, 1(1), 132-33. (Persian)

Peyman N, Abdollahi M. The relationship between health literacy and self-efficacy physical activity in postpartum women. Journal of Health Literacy 2016; 1: 5-12. (Persian)

Banihashemi S-AT, Amirkhani MA. Health literacy and the influencing factors: a study in five provinces of Iran. Strides in Development of Medical Education 2007; 4: 1-9. (Persian)

Von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. J Epidemiol Community Health 2007; 61: 1086-90.

Delanoë A, Lépine J, Portocarrero MEL, Robitaille H, Turcotte S, Lévesque I, et al. Health literacy in pregnant women facing prenatal screening may explain their intention to use a patient decision aid: a short report. BMC Res Notes 2016; 9: 339.

Javadzade SH, Sharifirad G, Reisi M, Tavassoli E, Rajati F . Health Literacy among Adults in Isfahan, Iran. Health Serv Res J 2013;9: 540-9. (Persian)

Tavousi M, Haeri MA, Rafiefar S, Solimanian A, Sarbandi F, Ardestani M, et al. Health Literacy In Iran: Findings From A National Study. Payesh 2016;15: 95-102. (Persian)

Afshari M, Khazaei S, Bahrami M, Merati H. Investigating Adult Health Literacy in Tuyserkan City. Journal of Education And Community Health 2014; 1: 48-55. (Persian)

Haerian A, Moghaddam MHB, Ehrampoush MH, Bazm S, Bahsoun MH. Health literacy among adults in Yazd, Iran. J Educ Health Promot 2015; 4: 91.

Paasche‐Orlow MK, Parker RM, Gazmararian JA, Nielsen Bohlman LT, Rudd RR. The prevalence of limited health literacy. J Gen Intern Med 2005; 20:175-84.

Williams MV, Parker RM, Baker DW, Parikh NS, Pitkin K, Coates WC, et al. Inadequate functional health literacy among patients at two public hospitals. JAMA 1995;274: 1677-82.

Tol A, Pourreza A, Tavasoli E, Rahimi Foroshani A. Determination of knowledge and health literacy among women with type 2 diabetes in teaching hospitals of TUMS. Journal of Hospital 2012; 11: 45-52. (Persian)

Amiresmaili M, Nekoei MM, Saberi anari S, Sadeghi A, Saber M, Taheri G, et al. Study of health literacy level of women referring to health centers-2010. Journal of North Khorasan University of Medical Sciences 2013; 5:1071-8. (Persian)

Carthery-Goulart MT, Anghinah R, Areza-Fegyveres R, Bahia VS, Brucki SMD, Damin A, et al. Performance of a Brazilian population on the test of functional health literacy in adults. Rev Saude Publica 2009; 43: 631-8.

La Vonne AD, Zun LS. Assessing adult health literacy in urban healthcare settings. J Natl Med Assoc 2008;100: 1304-8.

Berkman ND, DeWalt DA, Pignone MP, Sheridan SL, Lohr KN, Lux L, et al. Literacy and health outcomes:summary. AHRQ Evidence Report Summaries 2004.

Javadzade SH, Sharifirad G, Radjati F, Mostafavi F, Reisi M, Hasanzade A. Relationship between health literacy, health status, and healthy behaviors among older adults in Isfahan, Iran. J Educ Health Promot 2012;1:31.

Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults. J Gen Intern Med 1995;10: 537-41.

Noblin AM, Wan TT, Fottler M. The impact of health literacy on a patient's decision to adopt a personal health record. Perspect Health Inf Manag 2012;9:1-13.

Muir KW, Lee PP. Health literacy and ophthalmic patient education. Surv Ophthalmol 2010;55: 454-9.

Cho YI, Lee S-YD, Arozullah AM, Crittenden KS. Effects of health literacy on health status and health service utilization amongst the elderly. Soc Sci Med 2008; 66: 1809-16.

Sudore RL, Mehta KM, Simonsick EM, Harris TB, Newman AB, Satterfield S, et al. Limited literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc 2006;54: 770-6.

Jovic-Vranes A, Bjegovic-Mikanovic V, Marinkovic J. Functional health literacy among primary health-care patients: data from the Belgrade pilot study. J Public Health (Oxf) 2009;31:490-5.

Artinian NT, Lange MP, Templin T, Stallwood LG, Hermann CE. Functional health literacy in an urban primary care clinic. The Internet Journal of Advanced Nursing Practice 2003; 5.

McLaughlin, Rosemary Ann. Associations among Health Literacy Levels and Health Outcomes in Pregnant Women with Pregestational and Gestational Diabetes in an Urban Setting. Theses and Dissertations (ETD) 2009.

How to Cite
Dadipoor S, Ramezankhani A, Alavi A, Aghamolaei T, Safari-Moradabadi A. Pregnant Women’s Health Literacy in the South of Iran. J Fam Reprod Health. 11(4):211-218.
Original Articles