Universal health information is essential for universal health coverage

Universal access to health information is a human right and is essential to achieving universal health coverage (UHC) and the other health-related targets of the sustainable development goals (SDGs).1 2 The COVID-19 pandemic has further demonstrated the importance of access to relevant and trustworthy health information to enable people to make decisions that protect their health and well-being.3

In the digital age, hundreds of thousands of websites exist that are publicly available, providing health information, advice and opinion. It is access to trustworthy, understandable and actionable information that remains the challenge. The same digital technologies that make it possible to find quality and easy to understand health information also provide unfiltered access to information and opinion that is inaccurate, sometimes deliberately misleading, and often driven by special interests. This challenge has become more obvious throughout the COVID-19 pandemic.

WHO Director-General Tedros Adhanom Ghebreyesus’ declaration that ‘we’re not just fighting an epidemic; we’re fighting an infodemic’ was recognised by the World Health Assembly in May 2020, when WHO Member States passed a Resolution calling on Member States and international organisations to take measures to counter misinformation and disinformation.4 WHO has since developed a competency framework for health authorities and institutions to manage infodemics,5 recognising that messages have to be relevant to people according to local context, requiring ‘the creation and dissemination of trusted information so that it is not excessive, overwhelming or confusing’.6

Such a call is not new; in 2020, the BMJ and the Healthcare Information for All (HIFA) movement called for improved access to timely and accurate healthcare information that met the health literacy levels, language and/or cultural preferences of the intended recipients.7 Credible, trustworthy providers of health information, including and especially the WHO and government health agencies, have a mandate to provide health information for the public good, and need to establish themselves in a very crowded and competitive information environment.

This has not always resulted in the intended outcomes. Even when information is provided from a trustworthy source there is a significant body of research indicating that the majority of information from these sources does not meet established standards for health literacy and the public communication of science and risk.8 Health information is routinely hard to understand—written at a level of comprehension beyond what is recommended for the majority of people, and too often fails to provide advice in a form that is actionable for the public.

To address this gap, and building on experience gained through the COVID-19 pandemic, WHO has for the first time developed an integrated digital resource providing information on health and well-being for the public. WHO’s Your life, your health: Tips and information on health and wellbeing9 is intended for use by the public (referring here to the general public as lay users rather than to health technical or policy specialists), anywhere in the world who are engaged in managing their own health and/or that of their families and communities. The resource is based on established WHO technical guidance and reflects WHO’s commitment to using digital technologies to enable all people to access vital health information for their health and well-being throughout the life course.10 It is also aligned with SDG monitoring indicators related to public access to information, learning and skills development, such as SDG target 4.7 that by 2030 all learners will acquire knowledge and skills needed to promote sustainable development, including sustainable lifestyles, human rights and gender equality.11

Your life, your health was developed using a structured method, summarised in figure 1: (1) synthesising existing WHO technical guidance, prioritising public-oriented guidance within global strategies, and related points in national health and health literacy plans and international human rights frameworks; (2) developing messages and graphics to be accessible, understandable and actionable for the public through the application of health literacy principles; (3) engaging with experts and other stakeholders to refine messages and message delivery; (4) building a website and testing content to obtain feedback from a range of potential users and (5) adapting and co-developing the resource based on feedback and new evidence going forward.

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Figure 1

Five-step process to develop Your life, your health: Tips and information for health and well-being.

Your life, your health not only provides essential health information ‘By Life Phase’, but has also been been developed to help people build more critical health literacy skills by promoting awareness of the broader determinants of health, including rights related to health.12 The section on ‘Finding and using information’ includes advice on how to ask questions of health workers and the critical use of digital media to obtain information. The section ‘A Healthy World’ section reflects the ambitions of the SDGs, and the different roles that individuals, frontline workers, governments, businesses, the media and others play in promoting and protecting health. A section on ‘Know your rights’ includes advice on human rights as they relate across life phases, as well as people’s rights to health, to information, and to be heard. In bringing this information together in a integrated resource, Your life, your health enables individuals to better understand the expectations they might reasonably have of their government in protecting health. In this way, the resource seeks to support people to move beyond simply obtaining and following health information, to gaining a greater sense of control over their health.

Your life, your health was developed using health literacy principles to make WHO’s technical advice more accessible, understandable and actionable. It is based on a ‘universal precautions’ approach that assumes that all patients, consumers and caregivers will have some difficulties in comprehending health information.13 Health information that is universally accessible is presented first and then further detail can be obtained by following a link to WHO infographics and factsheets. This reflects the ‘progressive disclosure’ technique used more widely in information and communication technologies to make applications easier to learn and less error-prone.14 Related research has shown that those capable of understanding complex information prefer more straightforward health information15 and then have the option to access more detailed technical information as needed.

Similar to other information resources on the WHO website, our goal now is for the resource to be locally adapted for use in different communication contexts and campaigns as a form of co-development to meet the social and cultural preferences of different audiences, including preferred communication channels and spoken language. As part of the iterative co-development, we intend to test its use both with the general public and health workers who may also use the resource as a aid to communication across various settings. including low and high resource and urban and rural.