<![CDATA[Digital health systems have been increasingly integrated into primary care globally. In Indonesia, Surabaya’s municipal e-health programme has operated since 2013. Despite prolonged availability, face-to-face care remains dominant at community health centres (Puskesmas), suggesting that service availability alone may not ensure functional user engagement. This study described overall and domain-specific digital health literacy among primary care users and explored its associations with sociodemographic factors. A cross-sectional study was conducted among 100 adult users with prior e-health experience at an urban Puskesmas in Surabaya, using the eHealth Literacy Questionnaire (eHLQ). Descriptive statistics and Kendall’s tau-b correlation were used to examine overall and domain-level literacy and associations with age, educational attainment, and income. Overall digital health literacy was generally moderate to high, with 39% high, 36% moderate, and 25% low. Domain-specific analysis showed that the ability to actively engage with digital services had the highest proportion of low literacy (41%), followed by the ability to use technology to process health information (37%). Understanding of health concepts and language had the highest mean score, with most respondents falling into the moderate or high categories. Age showed a weak negative association, education a weak positive association, and income was not statistically significant. The findings suggest that functional engagement with e-health services is domain-specific and shaped by factors beyond access alone, underscoring the need for usability-focused design, integrated user support, and inclusive primary care strategies.]]>
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