India and Visual Literacy
In India’s rural areas, literacy rates are still low, and people are highly dependent on visuals, rather than texts. India is a diverse country where every 50–100 Km language, literacy, food, apparel, lifestyle changes. So It’s crucial to ensure that every visual we create is culturally appropriate and resonates with the target audience.
Visual Testing & Noora Health
Visual testing is part of Noora Health’s design process and emphasizes exploration with visuals to understand whether the chosen visuals make sense to the thousands of families that consume this information without any text support.
Below is an overview of a visual literacy testing method that has been developed collaboratively with Noora Health and its local partners, and successfully deployed in 4 Indian states. Other organizations and individuals can adapt it to suit a variety of similar contexts.
- Finalize the medical content that will go into learning materials.
- Research and find the accurate Visual Reference, which will go along with the content and start the design process.
- Once the Design is ready, visuals are reviewed by In-house medical and content experts.
- Post-reviewed visuals that need more understanding are then chosen for Visual testing.
Visual Testing Tools
- A simple A4 sheet of paper
- Front Page: Only visuals, No Supporting text
- Back Page: space for user feedback
- Pen or pencil
Visual Testing Method
Distribute: Take the tool to your stakeholders and distribute one image per person. In this case, local partners take the tool to hospital wards and hand it over to patients and caregivers.
Patience: Let your users review the visuals for a while. Once the tools are shared among your users, move away to give them the time (about 5 minutes) and space to think freely.
Ask Why?: Next, please return to the first user you distributed the tool to and ask them what they understood from the image and why. Note down their feedback on the back of the image. Continue with the rest of the users.
Shuffle: You can continue to redistribute different images to different people if you have the time. We encourage our partners to shuffle the same tool among other patients to get varied feedback on the same visual.
Thanks: Thank them for their time spent with us.
Examples of instances where Visual Testing has proved Useful:
Varied Cost of Living: While developing materials on what to do after chemotherapy, local partners wished to emphasize that patients must not use arbitrary shampoos but use only the shampoos recommended by the doctor. After testing, it became apparent that most families and caregivers couldn’t understand the intended message. Several of them responded that they couldn’t afford shampoo bottles; they only used smaller shampoo sachets.
Unintentional Religious Associations: After chemotherapy, it is essential not to sit under direct sunlight. The sun and its rays were depicted, with a red “X” over them to understand ‘Don’t.’ However, some families and caretakers understood the image to contain the cross and sun as Jesus descended from the sky to save humankind. Later, the same visual was tested, but with the ‘X ’ repositioned. The majority of the audience understood the intended message.
Cultural Representation: In Punjab, local partners were working towards creating materials for an inpatient program. During the initial development, most imagery depicted the Sikh community. However, after testing these materials, it was found that although around 53% of Punjab’s population is Sikh, many families identified better with an individual who wasn’t depicted as Sikh.
Cultural Habits: While working on Pregnant Mothers Nutrition awareness in Karnataka, India, this visual was tested. The majority of the audience noticed the woman holding the plate in her hand, and eating is very inappropriate. They strongly believe in Hindu culture; you keep the plate on the surface and bow down and eat as a gesture of respect.
While it would be ideal to test every image with as many people as possible, it is essential to stop visual testing and commit to an idea at some point. There is always room to improve an image. Still, one must eventually finalize an image best understood by the majority, even if not by every individual.
Visual messaging is a crucial way to communicate with people, but knowing which are the most appropriate messages isn’t always clear. One of the core tenets adapted from Noora Health’s support is to always go back to users to understand and tell us whether the content works best for them. Visual testing is a great way to ensure we get families’ feedback. Additionally, given that literacy rates range and can be low for the families we want to empower, using and relying on visuals while communicating messages is important. We’ve outlined a few principles here that we hope could help someone maximize visual testing for their needs!