Development of Pictorial Materials to Support Health Education (Case Study: ORT, Baluchestan)

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Development of Pictorial Materials to Support
Health Education(Case Study ORT,
Baluchestan)
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ORT The Case for Consensus

• In any health programme, it is important that all
  agencies active in the area agree to support a
  common intervention or consumers will become
  confused as to which method to follow. In this
  case study, all Government, UN, INGO and local
  NGOs were presented with the problem and agreed
  to support the same system of home solution (ORT).

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Define the Technical Problem

• IMR/CMR unacceptably high
• Diarrhoeal mortality major contributor
• What rôle malnutrition/micronutrients ?
• What rôle measles ?
• Who/what will be the target audience ?
• How will we reach that audience ?
• What reach radio, TV, newspapers ?

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Define the Audience

• Population to be reached
• Gender, age, occupation, etc
• Literacy rate (thus discard all text)
• Culture and especially taboos
• Problem area (diarr. mortality) and whether there
  are special health characteristics to be noted

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Define the Essential Messages

• Technical content to be by MoH
• Women must identify diarr. dehydration
• They must realise the urgency
• They should be able to prepare ORT
• They should continue breastfeeding
• Should give a healthy diet on recovery

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Define the medium to be used

• Pictures on a poster was selected
• Should they be colour or B W ?
• Line drawing or artistic or photos ?
• If writing required, how detailed ?
• What technical terms should be used ?
• Should this have application beyond Baluchestan
  and if so, where ?

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Drawing the First Pictures

• For a flyer or a poster ?
• How many pictures for the whole message
• Content of each picture ?
• Message of each picture ?
• Relationship between successive pictures
• The office test

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The Field Test

• Identify a typical consumer group
• Meet them, explain what you are doing
• Ask individuals what they see in the pix
• Record their comments
• Ask a focus group the same
• Record their comments
• Return to office, write trip report

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Office Discussions re Field Test

• Estimate comprehension rates
• What was not understood ? Why ?
• Was the meaning clear ?
• Is a complete re-draft required ?
• Can the pictures be improved ? How ?
• Can the pictures be simplified ?

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Modifying Pictures (and text)

• Based on field test discussions, re-draft the
  pictures (and text)
• Avoid identifying a single group/tribe
• If text is used, ensure terms are those used by
  the consumers
• Check that the modified pictures (and text)
  reflect exactly what was intended originally
  unless there is good reason why not

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Breastfeeding Picture

• Continuation of breastfeeding during diarrhoea is
  essential
• Breastfeeding pictures can cause offence if badly
  presented
• Field test must be handled with great care but
• If done well, young mothers confident to
  breastfeed when most needed

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The Breastfeeding Picture
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Comprehension Rates

• If the picture is 100 understood, keep
• If less than 100, try to raise comprehension
  rate
• What to do if repeated redrafting and field
  testing cannot improve the rate ?
• Does field test allow for a stand-alone poster,
  or must there be training as well?

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What Training is Required ?

• Poster could not stand-alone. So, what ?
• Who to train mothers and where ?
• How many trainers who to train them ?
• What support materials for trainers ?
• Remember to field test the trainers materials as
  well. . . . . .

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Instructions for FHWs on back of flipchart
Trainers Flipchart
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The Print Run How Many ?

• Do not overestimate the need
• Clinics need posters and schools as well
• Standardise in adjacent areas as well
• To conform with policy, mention ORS
• Keep the masters for reprints
• Ensure that all posters for use in Pakistan carry
  the MoH logo for credibility

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Feedback for Future Materials

• All records MUST be kept available
• Any feedback must be kept on file
• Trainers should be encouraged to provide comments
  (also to be filed)
• Try to use common themes (same logos, same
  artist, etc)
• Use common themes on radio TV if they are used
  later

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Important Lessons

• Focus material on real health problems
• Define audience with care
• Have simple, focussed message(s)
• Develop material with consumers
• Field test materials keep records
• Aim for hi compr. rates common themes
• Print only what you can use keep masters
• Keep feedback for future use

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The Final Poster