Executive Summary: National Health Literacy Surveys in Thailand (2019 & 2023) 1. Context and Conceptual Framework Health Literacy (HL) in Thailand is defined as the personal knowledge and cognitive/social skills that enable individuals to access, understand, inquiry, and use health information to make appropriate decisions for their well-being . Thailand conducted its first national survey in 2019 (reported in 2019/2020) and its second in 2023 to monitor health equity and provide evidence for public health policy . While the 2019 survey used a framework based on the European HLS-EU-Q47 model, the 2023 survey utilized the HLS-TH-Q17, a localized 17-item short-form instrument . 2. Key Findings and Trends The 2023 national survey revealed that 80.9% of the Thai population aged 15 and above possessed adequate health literacy . This suggests a significant improvement from the 2019 survey, which found that 55.3% of the population had adequate HL when recalculated using 2023 criteria . However, significant disparities remain across the 13 health regions, with proficiency levels ranging from 59.4% in Region 12 to 96.8% in Region 6 . 3. Competency Gaps and Health System Topics The surveys identify specific areas where Thais face the greatest challenges: Weakest Skills: The skill of "using information for decision-making" received the lowest scores (3.03 out of 4) among Thais in 2023 . In 2019, the process of "Inquiry" (asking questions) was also identified as a significant hurdle, particularly for the youngest age groups . Challenging Topics: The health system topics receiving the lowest proficiency scores were pharmaceutical and health products (2.95), emergency care (2.97), and oral health (2.99) . 4. High-Risk Demographics Both surveys consistently identify specific groups at high risk for inadequate health literacy: The Elderly (60+): This group is 3.2 times more likely to have inadequate HL than younger students . Education and Literacy: Individuals with no formal education or those who cannot read fluently face the highest barriers, with illiterate individuals being significantly more likely to score in the inadequate range . Economic Factors: Those with insufficient income (destitute) or who are unemployed are at higher risk . Digital Divide: A strong correlation exists between internet usage and HL; individuals who do not use the internet or social media (Line, Facebook) for health news are significantly more likely to have limited HL . 5. Strategic Policy Recommendations To address these gaps, 13 regional policy briefs were developed focusing on multidisciplinary collaboration and community-based interventions . Key strategies include: Targeted Programs: Designing specific HL interventions for the elderly and low-income groups, utilizing Health Volunteers and simplified, visual-based media . System Simplification: Reducing the complexity of the health system and medicinal product information to make them more "HL-friendly" . Skill Development: Strengthening the capacity of health personnel to act as "Health Coaches" who use simple language and encourage patient inquiry