Health literacy needs and community-based solutions for African Australians in NSW and Victoria at the point of care

Health literacy, the ability to access, understand, appraise, and use health information, is critical for active healthcare engagement, yet little is known about African Australians' needs at the point of care. We conducted a qualitative descriptive study involving six focus groups with 22 community members and nine community intermediaries in NSW and Victoria, to explore African Australians' health literacy needs, including the current organizational health literacy environment and strategies to improve their health literacy at the point of care. We identified five themes: health literacy is complex and context dependent, experiences determine and shape health literacy, social determinants impact access to and active engagement with healthcare services, experiences of feeling misunderstood and unsupported at the point of care, and a whole-of-systems approach is needed across individual, provider, system, and policy levels to enhance the health literacy of African Australians. Our findings highlight how social determinants, such as culture and identity, and organizational contexts intersect, underscoring the need for a systems-wide, intersectional approach to address health literacy gaps at the point of care.