IDinsight is partnering with the Philippines Department of Health to conduct the Health Promotion and Literacy Longitudinal Study (HPLS), a 5-year study to monitor the health literacy of Filipino adults and key knowledge, attitudes, and health-seeking behaviors over time.

Decision-maker’s challenge

The Philippines Department of Health (DOH) envisions a country where health-seeking and health-literate individuals are empowered to make healthy decisions for themselves and their families, backed by health-enabling environments and health-supportive governance. To achieve this, the DOH Health Promotion Bureau (HPB) developed the Health Promotion Framework Strategy (HPFS) as the roadmap for all health promotion policies, programs, and activities at the national, regional, and local levels. 

Successful implementation of the HPFS will rely on data-driven insights to guide crucial decisions in these activities. However, the DOH currently lacks nationally representative data that regularly assess health literacy and key knowledge, attitudes, and practices (KAP) among Filipino adults to inform national health promotion efforts.

Impact opportunity

Past research on health literacy in the Philippines has found that less than half of Filipinos (48.5%) have sufficient or excellent comprehensive health literacy, and that many still face challenges in accessing, understanding, and utilizing health information (HPFS 2030). In addition to health literacy, understanding general knowledge, attitudes, and practices (KAP) is crucial, as they significantly influence healthy behaviors. However, data on KAP—such as attitudes towards vaccinations or Filipino dietary habits—are often scattered across different surveys or deprioritized as key indicators. By having improved access to nationally representative data on health literacy and KAP, DOH can leverage data-driven insights to inform the creation or engagement of public health policies, design programs, and develop messaging campaigns to improve health literacy and KAP for all Filipinos.

As the HPFS targets double-digit improvements in KAP, using more frequent and high-quality data to inform these policy and programmatic decisions can help millions of Filipinos better utilize health information and achieve improved health outcomes.

Our approach

The Health Promotion and Literacy Longitudinal Study (HPLS) provides regular data to track trends in health literacy and knowledge, attitudes, practices (KAP) for a nationally representative sample of Filipino adults across seven priority health behaviors (the seven core HPFS pillars). The study collects data twice a year around respondents’ health literacy, as well as key KAP questions within the core HPFS pillars: 1) diet and physical activity, 2) environmental health, 3) vaccinations, 4) substance use, 5) mental health, 6) sexual and reproductive health, and 7) violence and injury prevention.

As of November 2024, IDinsight has conducted four rounds of nationally-representative data collection, surveying between 1,600 to 2,000 respondents per round across all 17 regions of the Philippines.

In addition to the longitudinal survey, the project will also include conducting qualitative studies and capacity-building initiatives. The qualitative studies will further investigate KAP across various public health topics such as diet, vaccinations, or road safety. Capacity building initiatives will be targeted to government health officials at the national and local-level to translate the wealth of data from both quantitative and qualitative studies towards refining local health policies and supporting the conduct of local health literacy assessments.

HPLS is powered by IDinsight’s DataDelta team. 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.

The results

The first two rounds of HPLS have revealed key insights on health literacy and KAP. Below, we share a snapshot of select study results.¹

• Diet and nutrition: While a vast majority are aware of the importance of eating fruits and vegetables, there is lower knowledge around what food groups to limit (e.g. high-sugar, high-salt, and high-fat foods). Additionally, most Filipino adults had consumed high-sugar or high-salt foods in the 2 days prior to the survey, with higher rates among younger age groups. For barriers to healthy eating, 1 in 5 cited access to affordable, healthy food as a challenge. These findings underscore the importance of improving access to nutritious options while increasing awareness of the risks of excess consumption of salt, sugar, and fat.
• Smoking: A vast majority of Filipinos (98%) are aware of the risks of smoking tobacco, yet results show that 1 in 5 Filipino adults have recently smoked. While 7 in 10 tried to quit, of those, only 10% successfully stopped smoking. This highlights the importance of improving support and resources for smoking cessation.
• Alcohol: Most (92%) Filipino adults understand that there are health risks associated with drinking alcohol, but a significant percentage underestimates these risks. Among people who consume alcohol, 60% believe that they can drink a small amount without risk, and 40% believe that a moderate amount of alcohol can be beneficial. We also found that men are significantly more likely to drink any amount of alcohol, and are more likely to be binge/excessive drinkers. This highlights the need to shift attitudes towards alcohol consumption, highlighting that any amount of alcohol poses health risks, and to specifically target men who consume alcohol in higher promotion to women.

DOH has used the results from HPLS to inform various policies and strategies for both health promotion and healthcare delivery.

1. Barangay health workers (BHWs) are now a key part of the national health promotion and literacy strategy after HPLS found that BHWs are common and preferred² sources of health information among Filipinos, especially in rural areas.
2. A measles outbreak in the Bangsamoro Autonomous Region of Muslim Mindanao (BARMM) was rapidly addressed guided by data from the HPLS. Based on the results from Rounds 1 and 2, vaccine confidence among Filipinos has bounced back to >90% following a previous national vaccine scare that saw vaccine confidence plummet to 20-30% in 2018³. This saved time by allowing DOH to focus on the delivery of vaccines rather than spending time and resources educating Filipinos on the safety and effectiveness of vaccines.
3. The DOH-HPB have also reported that results are being used as inputs for various health policies across the HPFS pillars (diet and physical activity, sexual and reproductive health, substance abuse, etc.).
4. These results have also been disseminated to local government units (LGUs) to inform community-level policies and programs.

As of December 2024, the capacity building and qualitative study are still ongoing workstreams, and results will be updated periodically.