When Dr Mariam* fled her home and crossed the border into Armenia, she brought with her over a decade of medical experience. What neither the system nor her medical training had given her was a way to bridge the gap between her own experience of displacement and the expectations of a new healthcare environment, as well as between her patients’ needs and their ability to navigate care.

Like many refugee healthcare professionals, Mariam found herself caught between two worlds: trained to practice medicine, but unfamiliar with a different system and unsure how to help patients do the same. Mariam is far from alone. Across Europe, nearly half of people, especially the most vulnerable, struggle to find, understand, and use basic health information, which widens inequalities and increases societal costs.

What is health literacy

It is used as the term to describe the ability of individuals to find, understand, and use health information. But to achieve that, we need to build more fair, resilient, and rights-based health systems. Because health literacy is often framed as a patients’ “problem” where people need to change and understand the system better. But what if institutions and the system are the ones who need to change?

The missing link is communication

That shift in thinking is at the heart of a Council of Europe initiative that took part in Gyumri. Recently, Mariam joined dozens of other healthcare professionals for an intensive, two-day capacity-building workshop, not to learn more medicine, but to learn how to empower patients to participate in the decisions about their health, how to communicate the decisions taken and reduce stigma and discrimination in the field of healthcare. By supporting refugee medical professionals to become bridges between public institutions and displaced communities, the Council of Europe ensures that the right to health belongs to everyone. This initiative promoted better access to health information and services and responds to the needs of vulnerable groups, including migrants and refugees.

Through role-play,  guided debates and real-case scenarios, participants practiced skills that rarely appear in medical trainings: how to make patients feel safe, respected, and understood from the moment they walk in; how to explain a diagnosis so it can actually be understood; how to support a patient in making an informed decision about their own care; and how to ensure that services, including digital, are accessible to all, including vulnerable groups.

A system that speaks to people

The results are beginning to show. Participants left not only with new tools, but with a different understanding of their role. “We learned that health literacy is a two-way street,” says Mariam. “Institutions usually expect the public to understand them. But we are the ones who should help them understand the system. When a patient leaves the clinic truly understanding their care, they don't just get healthier, they start to trust the system again.”

Armenia is working to strengthen the relationship between health institutions and the people they serve and to ensure that access to healthcare is not determined by where someone was born, what language they speak, or what their journey to Armenia looked like.

The Council of Europe work in this area is guided by the European Social Charter and the Convention on Human Rights and Biomedicine (Oviedo Convention), and builds on the Council of Europe Guide to health literacy and Report on Promoting health literacy and human rights to reduce stigma and discrimination.

As Secretary General Alain Berset highlighted on World Health Day: “Through strengthening equitable access to care, promoting health literacy, and safeguarding human dignity, we reinforce the foundations of resilient, inclusive, and stable communities. Protecting health protects the democratic values that unite us.”

The event was organised by the Council of Europe as part of its Project “Protection of Human Rights in Biomedicine III”, implemented within the Council of Europe Action Plan for Armenia 2023-2026. 

*Name changed for privacy