Introduction <p>Like caregivers across diverse geographical scales in general, informal caregivers in slum communities actively engage in health decision-making, such as supervising self-management and treatment adherence of their care recipients. However, studies on the factors influencing health literacy among informal caregivers of older adults in slum communities are limited in Ghana. This study aimed to examine determinants of health literacy among informal caregivers of older adults in slum communities in Ghana.</p> Methods <p>Data for this study were obtained from a cross-sectional survey of the healthcare needs of 458 informal caregivers of older adults aged 60 years or older living in slum communities in the Greater Kumasi Metropolitan Area of Ghana. Health literacy was measured using a standardized 12-item scale with a Cronbach’s alpha coefficient of 0.96. A multivariable binary logistic regression was used to estimate the demographic, socio-economic and health-related factors associated with health literacy. Odds ratios (OR) and 95% confidence intervals (CI) were reported, with a significance level set at a probability value of 0.05 or less.</p> Results <p>The results indicated that 76.2% of the participants had excellent/sufficient health literacy, while 23.8% had problematic/inadequate health literacy. The findings revealed that non-Akan participants (OR: 4.027; 95% CI: 1.292–12.552), those with a secondary education level or higher (OR: 3.741; 95% CI: 1.599–8.751), individuals who frequently experienced illness (OR: 2.868; 95% CI: 1.603–5.131), those who rated their health as excellent (OR: 2.160; 95% CI: 1.015–4.595), and individuals with chronic non-communicable diseases (NCDs) (OR: 3.463; 95% CI: 1.548–7.751) were significantly more likely to have a sufficient/excellent level of health literacy compared to their counterparts.</p> Conclusion <p>Findings from this study indicate that demographic, socio-economic and health-related factors are significantly associated with health literacy. We suggest that policy initiatives and interventions by health professionals and services aimed at promoting health literacy, especially among informal caregivers, should also consider the demographic, socio-economic and health-related factors influencing health literacy. We recommend that future research with larger samples, especially longitudinal designs, is necessary to explore changes in caregivers’ health literacy over time and to establish the mechanisms linking notable observations, such as frequent illness and chronic NCDs, to higher levels of health literacy among this population group.</p>