Building a national health literacy network in Portugal: early lessons from its implementation

Issue

Around 30% of people in Portugal report problematic or inadequate health literacy, particularly in navigating the health system, undermining equitable access, informed decision-making and efficient use of health services. Despite initiatives across institutions, academia, professional bodies and communities, action is often fragmented, weakly embedded in practice and lacks shared governance or evaluation.

Description

To operationalize the Portuguese National Plan for Health Literacy and Behavioral Sciences (2023–2030) across the National Health Service, the Directorate-General of Health designed a National Health Literacy Network linking Local Health Units and Portuguese Oncology Institutes. It combines national steering with local focal points who support multidisciplinary teams and local action plans. Quarterly meetings, thematic working groups and a repository of validated tools are being set up. A national advisory group is also being created to involve health literacy associations, patient representatives and other stakeholders.

Results

Early deliverables include an agreed governance and role framework. In April 2025, 38 of 42 local focal points were endorsed by local administrations. Local teams are drafting institutional action plans aligned with national priorities and standardized domains. These outputs provide shared governance and measurement infrastructure to reduce duplication and scale locally adapted interventions. The Network will support the M-POHL organizational health literacy (OHL) survey in 2026 and 2027.

Lessons

Clear roles help align institutions while preserving autonomy. Local services show readiness to act but require common standards, indicators and shared tools to translate motivation into measurable implementation. By treating health literacy as a coordinated implementation process, this governance package becames adaptable to other countries seeking coordinated health literacy implementation.

Key messages

• Portugal’s Health Literacy Network identified 38/42 local health literacy focal points in 1 month, creating a governance backbone to scale validated, equity-focused actions across services.

• Standard roles, shared indicators and a common repository reduce duplication, support local implementation and enable organizational health literacy measurement (OHL) to guide improvement.