A study from Austria highlights how organisational health literacy self-assessment can help primary care teams identify barriers, improve communication and navigation, and support more equitable care.
Health literacy is often understood as something individuals have or lack. But people’s ability to find, understand and use health information also depends on the systems and services around them.
A new scientific publication produced as part of JA PreventNCD highlights this important shift. Published in Frontiers in Public Health, the article Organizational health literacy in Austria: Policy developments and results from a pilot assessment in primary care explores how healthcare organisations can make information, services and care pathways easier to access, understand and use.
The article is authored by Christina Dietscher, Christa Straßmayr, Lisa Gugglberger, Julia Eder and Denise Schütze. It focuses on organisational health literacy in Austria, where work in this area began in the 2010s and has since become part of the national health literacy strategy and the Austrian Health Literacy Alliance.
“Health literacy is not only an individual responsibility. Healthcare organisations also need to make information and services easier to access, understand and use. The Austrian pilot showed that self-assessment can help primary care teams reflect on their own structures, identify barriers and turn health literacy into concrete improvements, such as clearer communication, better navigation and more accessible information. This is important for quality of care and for equity, especially for people who face additional barriers when using health services,” says Christa Straßmayr.
From individual responsibility to organisational change
Organisational health literacy looks beyond what individuals know and focuses on how healthcare services are designed and delivered. This includes how easy it is to contact a service, find the right place, understand written and oral information, communicate with staff, use digital tools and participate in decisions about care.
Primary care is especially important in this context. It is often the first point of contact with the healthcare system and plays a central role in basic healthcare provision. In Austria, supporting patient health literacy is legally defined as an organisational responsibility of primary care units.
Within JA PreventNCD, Austria coordinates work to further develop and disseminate organisational health literacy in the European Union, with the aim of reducing health inequalities. The pilot assessments were conducted as part of this JA PreventNCD work and were co-funded by the European Union.
What the Austrian pilot found
The study presents results from a pilot assessment in ten Austrian primary care units. The pilot used the International Self-Assessment Tool for Organizational Health Literacy in Primary Health Care Services (OHL-PHC), developed by the WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL). The tool comprises seven standards, 15 sub-standards and 70 measurable indicators. The process involved a broad mix of professionals, including general practitioners, nurses, reception staff, social workers, physiotherapists, psychologists, dietitians and other staff members.
The participating primary care units performed relatively well in user-oriented areas such as ease of access, navigation and oral and written communication. At the same time, the study identified areas requiring further attention, including organisational anchoring, staff development, digital health literacy, user involvement and participatory feedback mechanisms.
Coordinators involved in the pilot found the self-assessment process valuable for identifying strengths and improvement areas. They also reported that the process helped increase staff understanding of organisational health literacy and generated concrete ideas for improvement, such as enhancing website accessibility, improving signage, expanding multilingual resources and providing staff training.
The article underlines that self-assessment can be more than a measurement exercise. It can provide a structured starting point for reflection, prioritisation and continuous quality improvement. By making structural barriers more visible, healthcare organisations can better understand where patients may struggle and what changes are needed to make services more accessible and equitable.
While the study focuses on Austria, several insights may be relevant across health systems. Structured, team-based self-assessment can help primary care organisations translate health literacy concepts into practical action. However, implementation needs to be adapted to local governance, funding arrangements and policy conditions.
For JA PreventNCD, the publication offers a practical example of how health literacy can be strengthened through organisational change. By improving communication, navigation, digital inclusion and user involvement, primary care services can become more responsive to the needs of the people and communities they serve.
Read the full paper in Frontiers in Public Health: https://doi.org/10.3389/fpubh.2026.1802212
