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Empowering healthy behaviors in the Philippines

Results from Year 1 of the Health Promotion and Literacy Longitudinal Study.

 

©Jilson Tiu/IDinsight

The Health Promotion and Literacy Study (HPLS) is a five-year collaboration with the Philippines Department of Health (DOH) that tracks nationally representative data on health literacy and healthy behaviors across seven critical pillars: diet and physical activity, environmental health, immunization, substance use, mental health, sexual and reproductive health, and violence and injury prevention. The goal of the study is to fill data and evidence gaps for frequent data on health literacy and healthy behaviors that DOH can use to adapt programs and policies towards 2030 health targets.

Following the first year of data collection in 2023 (comprising two separate rounds), the results present an informative picture of Filipinos’ knowledge, attitudes, and behaviors around key health topics. These insights are being used to inform evidence-based policies and interventions by the Department of Health’s Health Promotion Bureau (DOH-HPB). 

This blog post provides an overview of the study and what we’ve learned so far about health promotion and healthy behaviors in the Philippines.

Measuring Health Literacy

Health literacy refers to an individual’s ability to access, understand, appraise, and use information and services in ways that promote and maintain good health and well-being (WHO, 2024). Measuring health literacy across populations is crucial for addressing public health needs and guiding effective interventions. Regular assessments of health literacy can be used to inform health promotion policies, improve health education programs, and enhance healthcare provider training to better address community needs.

HPLS includes two measurement approaches for measuring health literacy and has identified key gaps needing attention:

  • Many report difficulties in accessing and applying health information. Only half of Filipinos (52%) state that it’s easy or very easy to find information to treat an illness concerning them, and nearly two-thirds (63%) state that it’s difficult to choose treatment options for different health issues. 
  • Health literacy can also vary across topics. For example, only one-third of Filipinos (35%) state that it’s easy or very easy to find information on how to manage mental health problems like stress or depression.
  • Underpinning these issues are also issues with basic literacy and numeracy. When presented with an image of a childhood vaccination schedule, only 34% were able to correctly count how many doctor visits were needed for a child to be fully immunized.

Health Knowledge, Attitudes, and Behaviors

HPLS collects key data points related to health knowledge, attitudes, and behaviors of Filipino adults, providing vital information on how, on average, people think and act across health topics. Below is a summary of the key findings for each survey pillar.

Health Pillar Key Knowledge (K), Attitude (A), and Practice (P) Findings
Diet and Physical Activity Many Filipinos know what foods and physical activity levels contribute to healthy living, but many consume unhealthy food and few meet recommended exercise levels.

  • K: 65% of Filipinos agree that regularly consuming fruits and vegetables can help prevent disease (98% mentioned at least one), and 4 out of 5 are knowledgeable of the WHO-recommended 150 minutes of exercise per week.
  • A: Despite high consumption of unhealthy food groups, 3 in 4 Filipinos think that their current diet is nutritious. Additionally, most are satisfied with their current exercise levels, despite being aware that they don’t meet the recommended levels.
  • P: Many Filipinos have consumed high-sugar (85%) and high-fat (56%) foods within the last two days, particularly younger Filipinos. Additionally, only 23% meet the recommended physical activity levels, with cited barriers to physical activity including lack of time, motivation, company, and money.

For more information, see our policy briefs here and here

Environmental Health Awareness of proper handwashing remains low among Filipinos, while concerns of climate change and emergency preparedness are high, yet still lack ideal practices.

  • K: Only 24% of Filipinos could identify more than 3 critical times for handwashing. In regards to emergency preparedness, 76% know ​​they should prepare basic necessities and emergency supplies.
  • A: 45% of Filipinos believe handwashing is only needed if dirt is visible. Additionally, 77% are worried about climate change and 76% want to do more for the environment.
  • P: 46% of Filipinos lack a “go bag” for emergencies as part of their emergency preparedness.
Immunization Vaccine confidence is high, but knowledge gaps persist in child and adult vaccine requirements.

  • K: Around 1 in 4 Filipino adults could not name any vaccine for adults, 3 in 10 could not name any for children, and many struggle to understand the DOH childhood vaccine schedule.
  • A: Vaccine confidence among Filipinos is high, with over 90% agreeing that vaccines are safe and effective.
  • P: 88% of Filipinos received at least 1 COVID-19 shot in Round 1 of data collection, slightly increased to 90% in Round 2. However, only 35% received both COVID-19 shots and 1 booster, which is lower among lower-income groups.

For more information, see our policy brief here

Substance Use Majority of Filipinos know the risks of smoking yet still not able to quit, while many see moderate alcohol consumption as beneficial.

  • K: Most Filipinos know smoking and secondhand smoke cause illness, but some specific risk factors are less known, with only 14% mentioning risk of heart disease.
  • A: Over half of Filipinos think small alcohol consumption carries no health risk, with 44% believing moderate alcohol consumption is beneficial (more common among men).
  • P: 2 in 3 smokers in the Philippines tried to quit, but only 13% succeeded. 31% of smokers smoke indoors and 26% non-smokers are exposed to secondhand smoke, mainly at home. In addition, 51% of Filipinos drink alcohol, with men drinking more frequently and in larger amounts.
Mental Health Filipinos’ knowledge of mental health conditions and health-seeking behavior remain limited.

  • K: Only 3 in 10 Filipinos could correctly recognize symptoms of depression when prompted with a hypothetical scenario.
  • A: 1 in 4 Filipinos think mental health is not a real medical condition.
  • P: Over half of Filipinos practice some form of self-care. However, while 2 in 5 have previously suspected having a mental health issue, very few have ever sought treatment.
Sexual and Reproductive Health Many Filipinos understand risky sexual behaviors and value testing, but half lack awareness of what STD is and practice unsafe sex.

  • K: 5 in 10 Filipinos know what an STD is and can name at least one, and a majority also know some risky behaviors that can lead to STDs, yet many (33%) don’t know where to get an HIV test.
  • A: Attitudes towards STD testing are generally positive among Filipinos.
  • P: Over half of sexually active individuals (54%) had unprotected sex in the last 3 months, with men being more likely to engage in risky behaviors than women.
Violence and Injury Prevention Filipinos can identify and are willing to report violence cases, but many often engage in risky driving behaviors like drinking or phone use.

  • K: Over 98% of Filipinos correctly identify violence against women/children and know at least 1 reporting channel. Additionally, only 39% of those who drive know the meaning of yellow traffic lights.
  • A: Hesitancy to report violence cases stems from fears of intervening or harm to the reporter/victim.
  • P: 41% of Filipino drivers admit to drinking and driving (more common among men), with 1 in 5 drivers use their phone while driving.

For more information, see our policy brief here

What’s next for HPLS?

In the remaining four years of HPLS (Year 2-5), our surveys will regularly track many of these data points to assess changes over time, as well as conduct several deep dives on specific pillars to inform time-sensitive and decision-relevant policy discussions. With ongoing rounds of data collection and capacity-building efforts for local health officials, the study is supporting evidence-based policymaking and laying the foundation for a healthier Philippines.

Updates and results from the next phases of the HPLS project will be published periodically.

For more information on how our data is being used, see here.

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HPLS is powered by IDinsight’s DataDelta. DataDelta deploys sampling innovations, highly-trained data collection teams, and custom-built software to provide decision-makers with top-quality survey data at scale when they need it.