Pour une communication basée sur la culture en santé (health literacy) des populations

Résumé

Le concept de « health literacy » est très utilisé dans les pays anglophones, où il sert de cadre théorique à des approches de l’éducation en santé, mais encore peu connu dans les pays francophones et, semble-t-il, ignoré en Afrique francophone. Nous proposons de l’appliquer à la communication en santé en le traduisant par « culture en santé », expression très large qui englobe les connaissances et les représentations, non seulement sur des questions de santé mais aussi sur les autorités sanitaires et les promoteurs des messages de santé publique. L’approche de culture en santé permet de fonder des stratégies, messages et outils de communication sur les représentations de la population ciblée, pour l’amener à adhérer aux changements de comportement promus par cette communication. Nous montrons quelques exemples de son application dans des programmes de santé publique en Afrique.

For a communication addressing populations’ health literacy

The concept of “health literacy” has been widely used in English-speaking countries for about 20 years. However, its meaning has evolved since its first definition as “cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health”, to be most often centered on the narrower meaning of “functional health literacy”, which is the ability to read and understand written medical documents. This narrow definition excludes illiterate populations and don’t take into consideration the social skills. Moreover, it doesn’t take into consideration the barriers erected by the culture. Working in the field of health communication, we propose the broadest concept of “health culture”, which encompasses health literacy as well as all the representations that influence people decisions about their health. The health culture approach makes it possible to base strategies, messages and communication tools on the representations of the target populations, in order to sensitize them to the behavioral changes promoted by this communication. We show some examples of its application in public health programs in sub-Saharan Africa: breastfeeding, pregnancy support, Ebola virus disease, HIV testing, tuberculosis, and COVID-19.