Strengthening Health Literacy Through Structured Sessions for Non-Communicable Diseases in Low-Resource Settings: The Learning Nest Model.

Health literate self-management education is at stake for the prevention and management of non-communicable diseases in low resources settings and countries. Here we describe the Learning Nest in Ordinary Context (NA-CO in French, aiming at the structuring of health education programs at the micro- (education sessions) and the meso-levels (adapted to context). The Learning Nest model was designed based on a combination on health literacy principles and on studies conducted with vulnerable people with non-communicable diseases. Observation of NA-CO active-learning sessions found them to be operational and relevant as they center on access, understanding, and use of health information while integrating the ordinary context of learners. The Learning Nest packages (including several adapted thematic sessions, training of trainers and development in context) were shown to be feasible and realistic in diverse locations (Reunion, Mali, Mayotte, Mauritius, Burundi). Qualitative and intervention studies have documented the potential usefulness of the Learning Nest model for context- and setting-specific health literacy interventions.