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Despite growing evidence of the significance of health literacy in managing and coping with acquired immune deficiency syndrome (HIV), it is not yet an integrated part of HIV/AIDS-related health promotion research and practice in Africa. This article contributes to addressing the gap in research on health literacy and HIV in Sub-Saharan Africa. We aimed to assess health literacy-related needs of young people living with HIV (YPLHIV) and adapt existing health literacy frameworks to the context of HIV/AIDS in Malawi. We used focus group discussions to collect data from a sample of the membership of the national association of YPLHIV. Twenty-four HIV-positive youth (18–29 years) participated in focus group discussions. Participants came from three regions of Malawi. Additionally, we conducted three in-depth interviews with key informants. We used a thematic framework approach to analyse data in MAXQDA. We contextualized definitions of four dimensions of health literacy: functional, interactive, critical and distributed health literacy, which we used as an a priori analytical framework. To further contextualize the framework, we revised it iteratively throughout the analysis process. We identified the need for comprehensive information about HIV and sexual reproductive health, skills to interact with healthcare providers and navigate the health system, and skills to appraise information from different sources, among others. The identified needs were translated into nine action recommendations for the national association of YPLHIV, and with relevance within the wider HIV sector in Malawi and beyond. We found that the dimensions in our analytical framework operate on the individual, system and public policy levels.

Aims A key issue in public health is how to approach ethnic inequities. Despite an increased focus on the health of people from ethnic minorities in the last 15 years, significant ethnic health inequities still exist in Denmark. These arise during pregnancy and are exacerbated by higher rates of exposure to health risks during the life course. This study aimed to formulate recommendations on both structural and organisational levels to reduce ethnic health inequities. Methods Nine decision-makers – representing municipalities, regions, the private sector and voluntary organisations in Denmark – participated in the formulation of recommendations inspired by the Delphi method. The consensus process was conducted in three rounds during spring 2020, resulting in eight overall recommendations, including suggestions for action. Results The recommendations address both structural and organisational levels. They aim to strengthen: 1) health policies and strategies related to the needs of people from ethnic minorities, including health literacy, linguistic, cultural and social differences; 2) health-promoting local initiatives developed in co-creation with people from ethnic minorities; 3) health promotion and prevention from a life course perspective with a focus on early intervention; 4) cross-sectoral and interdisciplinary collaborations that facilitate transitions and coordination; 5) competencies of professionals in terms of cultural knowledge, awareness, reflexivity and skills; 6) access to healthcare services by increasing information and resources; 7) interpreting assistance for, and linguistic accessibility to, healthcare services; 8) documentation and intervention research. Conclusions To reduce ethnic health inequities, it is crucial that Danish welfare institutions, including their strategies, approaches and skills of employees, are adapted to serve an increasingly heterogeneous population.

Background Health literacy (HL) as an enabler of health equity and health promotion. HL is closely linked to other social determinants of health such as age, sex, education, social status and ethnicity. HL responsiveness is the degree to which systems or organizations make it easier for people to navigate, understand, and use information and services. HL can be enhanced through individual support, by targeting the responsiveness of the health professional workforce, or by taking a structural or organizational HL perspective. Methods In Denmark, the HL Network, which is part of Danish Society for Public Health, developed a position paper for approaching HL from a structural level. In 2018-2019 a rapid literature review was conducted followed by three different methodologies: (i) stakeholder meetings, (ii) expert interviews (policy, practice, research) and (iii) thematic meeting focusing on different dimension of the initial recommendation for the position paper, which was published at the National Conference for Public Health. Results In the position paper eight recommendations were developed to improve HL in Denmark from a structural perspective. The recommendations overall aim to prevent low HL and its consequences by targeting health services at the organizational level. The recommendations are: Integrate HL into Danish health policies and strategiesDevelop HL throughout the life courseInclude HL in health education curriculaIntegrate HL at organizational levelsIntegrate HL into partnership and co-creation processesMeasure and monitor HL using local and national dataDevelop, test and evaluate HL interventionsConsider HL in all forms of health communication Conclusions The recommendations can support the integration of a health literate thinking into current national health strategies, including the ongoing efforts to achieve the 17 UN Global SDGs, and thereby contribute to the equitable distribution of health in the Danish population.