Background

This study aimed to evaluate health literacy and general health status among school principals and vice principals in Pakistan, (1) to identify work-related factors associated with them, and (2) to determine their association with physical and mental health, particularly in the context of the COVID-19 pandemic.
Methods

An online-based cross-sectional survey was conducted among 350 school principals and vice principals in Punjab province, Pakistan. The study was conducted under the COVID Global Health Literacy Network. Data related to socio-demographic characteristics, health literacy, general health status, chronic illnesses and impairment, well-being, psychosomatic complaints, and emotional exhaustion were collected. We applied bivariate analyses as well as binary and multivariable logistic regression analyses.
Results

Over half of the respondents (66.6%) had sufficient levels of health literacy. A good general health status was reported by 80.3%. One of the strongest predictors of health literacy and general health status was school position (principals vs. vice principals). Additionally, those with sufficient health literacy were less likely to have frequent emotional exhaustion; while those having good general health status were less likely to report low well-being, frequent emotional exhaustion, and psychosomatic complaints. The study also found that females were less likely to have a good general health status (OR  0.45) and were more likely to have frequent emotional exhaustion (OR  1.75) as well as psychosomatic complaints (OR  1.94) than males.
Conclusions

Limited health literacy in school leaders requires interventions for better decision-making on health matters, emphasizing the need for targeted training programs.