Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 860 874 Elham CHAROGHCHIAN KHORASANI Department of Health Education and Health Promotion, Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Seyedeh Belin TAVAKOLY SANY Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Arezoo OROOJI Department of Epidemiology and Biostatistics, Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Gordon FERNS Department of Medical Education, Brighton and Sussex Medical School, University of Brighton Falmer Campus, BN1 9PH, UK Nooshin PEYMAN Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran 2019 03 18 2019 06 24 Background: Inadequate health literacy (HL) is associated with poorer health outcomes and worse health care. Up to one-half of Iranian women have difficulty in interpreting medical information, and national HL assessment has been limited in Iran. We have undertaken a systematic review of the literature and used a meta-analysis to examine the situation of HL status in Iranian women, and determine the relationship between HL and self-efficacy, and self-care behaviors. Methods: Six databases (PubMed, Web of Science, Scopus, Google Scholar, Scientific Information Database) and other non-indexed citations were searched using a variety of keywords regarding HL and Iranian women. The bias risk was decreased by the involvement of two independent reviewers assessing study quality and eligibility of included articles. Results: The average HL scores were in the range of marginal or limited (63.08; 95% CI, 59.83–66.32) in the Iranian women. The HL score was significantly higher among pregnant women (67.55; 95% CI, 32.54– 82.57) and was lower in women with chronic disease (57.79; CI, 48.34-67.24). There was a significant association between HL and self-efficacy and self-care behaviors. Conclusion: The average level of HL in the period of the review was marginal among Iranian women. The relationship of HL with self-efficacy and self-care behaviors was statistically significant but moderate. https://ijph.tums.ac.ir/index.php/ijph/article/view/16605 https://ijph.tums.ac.ir/index.php/ijph/article/download/16605/6908