Tropentag, September 10 - 12, 2025, Bonn "Reconciling land system changes with planetary health"

Lost in transition? health literacy as a key to combat malnutrition in Tanzania

¹University of Dar es Salaam, Dept. of Physical Education and Sport Sciences
²German Sport University Cologne, Dept. of Physical Activity in Public Health
³German Sport University Cologne, Dept. of Physical Activity in Public Health
⁴German Sport University Cologne, Dept. of Physical Activity in Public Health
⁵Humboldt-Universität zu Berlin, Thaer-Institute - Div. Urban Plant Ecophysiology
⁶University of Dar es Salaam, Dept. of Physical Education and Sport Sciences
⁷German Sport University Cologne, Dept. of Physical Activity in Public Health

Abstract

Background:
Food systems transformation is rapidly occurring in Tanzania, fostering challenges to planetary health, including public health, especially malnutrition. In the past decade, food environments have shifted into more processed and western-orientated foods, losing traditional knowledge and practices, including changes in dietary behaviours. Understanding health information is crucial for individuals to adopt healthy lifestyles. The FoCo-Active project assessed food choices, physical activity (PA) levels, and general health literacy (HL) to address malnutrition. Based on these baseline findings, a context-adapted Health Literacy Program (HLP) was developed to strengthen individuals’ competencies in making informed dietary and PA choices.

Methods:
A cross-sectional survey was conducted with 713 adults (n=487 females) from rural (n=194) and urban Tanzania. HL was assessed via a modified version of the HLS-EU-Q47 questionnaire. Prevalence rates of insufficient HL were analysed by gender and location. Additional data on food choices and PA were collected to contextualize HL findings.

Results:
Overall, 63.6% of participants demonstrated insufficient HL. Women showed a higher prevalence (68.4%) compared to men (53.6%; p<0.001). Furthermore, 74.5% of rural participants had insufficient HL versus 59.9% in urban areas (p<0.001).

Conclusion:
The results highlight a critical HL in the Tanzanian population, particularly among rural populations and women. The FoCo-Active project responds with a context-adapted HLP that integrates culturally appropriate education. The HLP goes beyond classical education by integrating additional lifestyle-related factors such as PA, sedentary behaviour, hygiene, and self-organisation. It aims to develop transferable, practical solutions for everyday health-related decision-making - co-designed with local stakeholders - the programme aims to empower individuals and communities.

Keywords: Health literacy, malnutrition, physical activity

Contact Address: Msabila Damian Charles, University of Dar es Salaam, Dept. of Physical Education and Sport Sciences, Dar es Salaam, Tanzania, e-mail: msabila.charlesyahoo.com