A Systematic Review of Health Literacy Status Among Local Community in Protected Area
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Abstract
Introduction: Protected areas (PAs) play a vital role in conservation but often impose restrictions that limit economic and educational opportunities for local communities. These constraints can negatively affect health literacy (HL), particularly in rural populations exposed to zoonotic diseases and environmental health risks. This systematic review aims to explore how living in protected areas influences health literacy status, with a focus on knowledge, attitudes, and practices (KAP) related to health risks. Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science for studies published between 2014 and 2024. Articles were screened based on the PEO framework, and eligible studies were appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. A thematic synthesis was performed to identify common factors influencing HL among adults living in or near protected areas. Results: Nine studies met the inclusion criteria. Most studies assessed HL indirectly through KAP related to zoonotic diseases. Findings revealed that residents in PAs often demonstrated low awareness of disease transmission, poor preventive practices, and limited access to health information. Key influencing factors included low education levels, poverty, occupation (e.g., hunting, farming), and poor access to healthcare. Only communities exposed to prior outbreaks or targeted health programs showed improved HL. Conclusion: Communities in PAs exhibit generally low health literacy, shaped by structural inequalities and ecological constraints. Interventions should prioritize community-based health education, cross-sector collaboration, and culturally tailored messaging. Addressing HL in PAs is critical to reducing health disparities and achieving sustainable development goals (SDGs).
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