Insights of literacy on preventive behaviors of non-communicable diseases in Bangladesh: descriptive types of cross-sectional study among female university students

Bilkis Banu, Sujana Haque Chowdhury, Nasrin Akter, Ulfat Ara, Kazi Rakibul Islam, M. Ruhul Amin, Sarder Mahmud Hossain


Background: Non-communicable diseases were the leading global causes of mortality, causing more deaths compare to all other causes combined, which strike hardest at world's low and middle-income countries. The aim of the study was to ascertain the health literacy and its practical application among the young generation to prevent major non communicable diseases.

Methods: This was a descriptive type of cross-sectional study with 400 participants drawn from female university students of Dhaka, Bangladesh. Data were gathered by pre-tested, self-administered, structured and anonymous online questionnaires. Analysis was performed by using multivariate techniques followed by regression modelling and the margin of error was considered as 0.05.

Results: Socio-demographic characteristics of the respondents showed that, majority of the female students belonged to age group <25 years. Study found that 63.5% of all university students had poor literacy on prevention of NCDs with female propensity. It was observed that highest level of poor literacy was about cancer (73.20%) and hypertension (75.20%) among all other NCDs. Statistically significant analysis observed that monthly lower family income <468 USD (AOR/p=1.73/0.01), respondents of businessman father (AOR=1.68/0.06) and residing in a family with >4 members (AOR/p=0.67/0.00) were the predictors for poor literacy about preventive health behavior on NCDs.

Conclusions: This study revealed that the status of literacy on preventive health behaviors of NCDs among female university students was not satisfactory and very few had overall good literacy. This study found several important predictors under socio-demographic consequence played a significant role regarding poor literacy.


NCD, Female university students, Diabetics, Cancer

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Bloomfield GS, Xavier D, Belis D, Alam D, Davis P, Dorairaj P, et al. Training and capacity building in lmic for research in heart and lung diseases: The NHLBI-UnitedHealth Global Health Centers of Excellence Program. Glob Heart. 2016;11(1):17-25.

Non-communicable diseases and their prevention: a global, regional and Bangladesh perspective. Available at: Accessed on 20 November 2021.

The World Bank. Cause of death, by non-communicable diseases (% of total) New York the world bank, 2016. Available at: Accessed on 20 November 2021.

Noncommunicable Diseases Progress Monitor 2017. Available at: Accessed on 20 November 2021.

Zaman MM, Bhuiyan MR, Karim N, et al. Erratum to: Clustering of non-communicable diseases risk factors in Bangladeshi adults: an analysis of STEPS survey 2013. BMC Public Health. 2015;15:892.

Rahim Z, Makkia FT, Haque ME, Robin TA, Debnath SC, Rouf MA, et al. Health literacy and behavior related to cancer and diabetes among Higher Secondary students. Asian J Med Biol Res. 2017;3(3): 341-6.

Oo W, Soe P, Lwin K. Status and determinants of Health Literacy: A study among adult population in selected areas of Myanmar. Int J Commu Med Public Health. 2015;5:318-22.

Kickbusch IS. Health literacy: Addressing the health and education divide. Health Promot Int. 2001;16(3): 289-97.

Almomani MH, Rababa M, Alzoubi F, Alnuaimi K, Alnatour A, Ali RA. Effects of a health education intervention on knowledge and attitudes towards chronic non-communicable diseases among undergraduate students in Jordan. Nurs Open. 2020; 8(1):333-342.

Banu B, Haque CS, Akter N, Rakibul IK, Mahmud HS, Ruhul AM. Preventive behaviors to mitigate COVID-19: Urban-rural disparities of densely populated country like Bangladesh. J Environ Sci Public Health. 2021;5(4):63-9.

Evans AY, Anthony E, Gabriel G. Comprehensive Health Literacy Among Undergraduates: A Ghanaian University-Based Cross-Sectional Study. Health Lit Res Pract. 2019;3(4):e227-37.

Bhusal S, Paudel R, Gaihre M, Paudel K, Adhikari TB, Pradhan PM. Health literacy and associated factors among undergraduates: A university-based cross-sectional study in Nepal. PLOS Global Public Health. 2021;1(11):e0000016.

Sørensen K, Pelikan JM, Röthlin F, Ganahl K, Slonska Z, Doyle G, et al. HLS-EU Consortium. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health. 2015;25(6):1053-8.

Svendsen MT, Bak CK, Sørensen K, Pelikan J, Riddersholm SJ, Skals RK, et al. Associations of health literacy with socioeconomic position, health risk behavior, and health status: a large national population-based survey among Danish adults. BMC Public Health. 2020;20(1):1-2.

Uysal N, Ceylan E, Koç A. Health literacy level and influencing factors in university students. Health Social Care Commu. 2020;28(2):505-11.

Yang J, Gao Y, Wang Z. Increasing health literacy in China to combat noncommunicable diseases. China CDC Week. 2020;2(51):987.

Zhang Y, Zhang F, Hu P, Huang W, Lu L, Bai R, et al. Exploring health literacy in medical university students of Chongqing, China: a cross-sectional study. PloS One. 2016;11(4):e0152547.

Wang W, Hou Y, Hu N, Zhang D, Tao J, Man Y, ET AL. A cross-sectional study on health-related knowledge and its predictors among Chinese vocational college students. BMJ. 2014;4(10): e005182.

Budhathoki SS, Pokharel PK, Jha N, Moselen E, Dixon R, Bhattachan M, et al. Health literacy of future healthcare professionals: a cross-sectional study among health sciences students in Nepal. Int Health. 2019;11(1):15-23.

Sarhan MB, Fujii Y, Kiriya J, Fujiya R, Giacaman R, Kitamura A, et al. Exploring health literacy and its associated factors among Palestinian university students: a cross-sectional study. Health Promot Int. 2021;36(3):854-65.

Luo YF, Yang SC, Chen AS, Chiang CH. Associations of eHealth literacy with health services utilization among college students: cross-sectional study. J Med Internet Res. 2018;20(10):e283.

Biswas T, Pervin S, Tanim MI, Niessen L, Islam A. Bangladesh policy on prevention and control of non-communicable diseases: a policy analysis. BMC Public Health. 2017;17(1):1.

Intarakamhang U, Macaskill A. Multi-group causal model of health literacy and behaviors on family wellbeing among thai adults at risk of non-communicable diseases (NCDs). J Res Health Sci. 2018;18(4):e00429.

Shah AR, Jindal RM, Subramanyam MA. A Randomized controlled trial enhancing non-communicable diseases health literacy of Indian youth. Res Squ. 2021.