Abstract
Background/Objectives: Health literacy has an impact on students' reproductive health. Therefore, the objective of our study is to systematically examine, identify, and summarize all research on the role of health literacy in fertility awareness and reproductive health among university students in order to understand how health literacy influences reproductive health outcomes in this population. Methods: Using the PRISMA guidelines, a comprehensive systematic search was conducted using electronic databases, such as PubMed, EMBASE, CINAHL, Scopus, and Google Scholar. The protocol was registered in the Prospective Register for Systematic Reviews (PROSPERO, CRD 42024566268). All studies were imported into EndNote software and screened using a two-level title/abstract screening process. The included studies were narratively summarized. Results: The database search identified 1360 articles; 116 duplicates were removed, and thus, 1244 were initially screened, leading to 1133 exclusions. A total of 111 articles underwent full screening, and 94 were then excluded. A total of 14 articles were included for data extraction. Health literacy impacts university students' behaviour, fertility awareness, and reproductive health knowledge. Students with higher health literacy show more understanding of critical topics such as fertility and emergency contraception. Socioeconomic factors play a crucial role in shaping health literacy and reproductive choices, while gender disparities highlight the need for targeted educational interventions, particularly for male students. Effective educational programs have been shown to enhance health literacy. Additionally, technology integration serves as a valuable tool for disseminating reproductive health information. Cultural context also plays a vital role in influencing health literacy. Conclusions: The findings of this study emphasize the importance of comprehensive strategies to enhance health literacy among university students, and future research should focus on developing and evaluating targeted educational programs that address gender disparities and socioeconomic factors influencing health literacy.