An Exploration of Health Literacy and Attitudes to Contraceptive Use in Tongan Women

Abstract

Health literacy has been identified as an important health determinant. However, there has not been any publication to date of health literacy research conducted in New Zealand. This study aimed to evaluate the health literacy of Tongan women aged 16 to 55 attending two General Practice (GP) clinics in Auckland and explore the links between their health literacy and their attitudes to, and use of, contraception. This study employed an anonymous survey including the Health Literacy Questionnaire (HLQ), a comprehensive tool that measures level of health literacy across nine distinct areas, together with a questionnaire on contraceptive use and attitudes. Face to face interviews were used to further explore contraceptive use and attitudes. Fifty six women participated in the survey and five in the interviews. This study found no significant relationship between health literacy and factors such as age, education level, country of birth or use of English language at home. The lack of significance could possibly be attributed to the size of the sample and/or response bias. However, the questionnaire items did reveal three domains of health literacy which participants found difficult. These were: “Navigating the healthcare system”, “Ability to find health information” and “Understanding health information”. The wider economic and health benefits of contraceptives were not well understood by this study group. Attitudes of women to contraceptive use were contradictory. The majority did not want any more children or wanted to delay having children yet they did not use contraception. Cultural and religious beliefs were the two main barriers identified that influenced women’s attitudes to contraceptive use. This study was a first of its kind for Tongan women in Auckland and its findings could be used for further research. These findings also help inform healthcare providers’ strategies to deliver contraceptive information effectively to women and women with low health literacy. More concerted efforts are also required to educate Tongan women on the wider benefits of contraceptive use.