Institutional readiness to promote digital health literacy: insights from national strategies

Background

Within the Joint Action PreventNCD, the Health Literacy Task aims to reduce health inequalities by strengthening health literacy in Europe, with a focus on equitable access to health information and services. Digital health literacy (DHL) is essential for enabling individuals to use digital health services, yet evidence on its implementation at policy and system levels remains limited. This study aims to map and compare national policies and strategies addressing DHL in five European countries - France, Hungary, Italy, Norway, and Ukraine - and to examine how DHL is defined, prioritized, and implemented at the system level.

Methods

National policy documents and strategic frameworks were identified through official governmental sources. A qualitative content analysis examined DHL-related objectives, implementation measures, workforce training, monitoring, and governance structures. This mapping was complemented by semi-structured interviews with policymakers and public health experts, exploring system-level understandings, implementation processes, and key barriers and facilitators. An inductive thematic analysis ensured cross-country comparability.

Results

DHL integration varied across countries, from explicit strategic focus to fragmented or implicit approaches. Policy analysis showed limited references to workforce training and monitoring in most countries. Preliminary interview findings revealed common system-level barriers, including insufficient intersectoral coordination, limited workforce capacity, and lack of resources. Several countries reported emerging local initiatives supporting DHL implementation.

Conclusions

This study identifies key gaps and opportunities for strengthening DHL integration at policy and system levels. Findings support more coordinated strategies, including workforce training, governance, and resource allocation. The proposed approach can inform policy development and be applied to other health system contexts.

Key messages

• Digital health literacy is unevenly integrated into national strategies, with gaps in coordination, workforce training, and resources.

• Strengthening institutional readiness is essential to improve DHL implementation and reduce health inequalities across health systems.