Synthesis | THREE

Selecting Interventions

I decided to focus on the following interventions:

• AT THE GOVERNMENT DISPENSARY as I saw no media there and people wait for a considerable time for medicines, so they can view posters, etc.

• TAKE HOME MEDIA to help remind, recall and repeat to the patient to take the tabs regularly and properly.

Synthesis | TWO

Redefined Design Brief

To develop a set of printed materials that is standalone and primarily informational on the subject of Anaemia and specifically on the correct procedure of taking IFA (Iron and Folic Acid) tablets. This material can be used by either NGOs or the government while dispensing such tablets, as part of their Iron-supplementation schemes to avert the problem of incorrect usage and increase efficacy of the scheme.

Synthesis | ONE

Scenario Building

I read a lot of reports on Iron supplementation programmes and to my surprise, despite their introduction on a large scale, Anaemia is still very much widespread and the stats haven't changed. At the NGO community centre I had a long discussion with the NGO CHWs and the slum-dwellers about the inherent flaws of the system and why the government schemes often don't work.

Dispensing of tablets is quite a different matter from taking them. Getting people to take them properly, so that they work, and informing them of side-effects is just as vital but is missed out here. It is a huge waste of money when these free tablets are not taken properly. Also when they produce side-effects and people discontinue them, people lose faith in the tablets and the government scheme.

Later on, during my visit with Lakshmi Murthy we discussed this briefly and we both thought it was a good idea to focus on. I found this a great design opportunity so I outlined the problem and put down where I thought graphic design interventions could work.

Analysis | THREE

My decision to take the health issue of Anaemia

• After all the data had been collected I realised the major issues affecting this population of women were: menstrual hygiene, reproductive health, anaemia and sexual health.
• Having looked at a fair amount of case studies that were designed directly for this target audience, this seemed to be the most ignored issue (see below), and yet its repercussions were felt on basic well-being and reproductive health. Small simple changes in lifestyle to get rid of anaemia could bring an allover positive outcome on a slum-dwelling woman's life.

Inferences from data collected--

• Anaemia, in most of the case studies collected that deal directly with the target audience, is most often clubbed with another health concern like pregnancy, menarchy or nutrition (except in the case of Sanchetna). It does not stand out enough as a singular issue for women even though it affects them for a major portion of their lives, because they suffer blood loss throughout their reproductive life: during menarchy, pregnancy and menopause.
• Since symptoms of Anaemia are very generic and can often be misconstrued for general weakness, most women in this income bracket do the same and have practically no awareness on the issue (ignorance about Anaemia).
• The government has no means as yet, of promoting the free IFA tablets they provide to curb anaemia to those who cannot afford to pay for them.
• The government gives no information on side-effects, or on what foods aid/hamper absorption of iron so that the tablets work efficiently.
• Once the woman procures the free IFA tabs, she can forget to take them, or to take them properly and does not know how to check on her progress with them as she is unaware of her symptoms.

Analysis | TWO

A closer look at the Case Studies (Click to enlarge)

PAMPHLET ON ANAEMIA

• The colour red is consistent with the association of Iron-Deficiency Anaemia and blood. However it could have been used more efficiently. Perhaps a comparison of an anaemia sufferer and a normal person could have been brought out with the colour red (redness of lips and tongue, inner eye, nails, etc.). Instead the colour has been used for everything but that.
• The images are very small, few and not very descriptive. They could have been labeled and linked back with the text. However, the line drawings are the best representation for this type of audience.
• The text is too much, in my opinion, for an audience that is not fully literate. Though I do feel that the size of the text is appropriately large.
• The images could have been larger and supported by large, minimal text so that it is easy to follow.
• Contentwise, this contains almost all the information that is necessary: What Anaemia is, Symptoms, Diagnosis, Treatment, How to have the tablets properly to aid their absorption, Side-effects. During my research I looked at another simple method of fortifying food with iron: by using iron utensils in cooking, but this is not mentioned in any literature I have come across.
• It is not interactive in nature.

CHART ON ANAEMIA

I had first spotted this chart at a Manav Sadhana Anganwadi, and then later on found it at the Sanchetana clinic/centre, where I was informed that it was a chart Sanchetana had made several years ago.

• The interactive nature of this chart drew me to it. Looking at one's own face cannot be done, except in a mirror. The easiest way to detect anaemia by oneself is looking at the colour of the tongue or lips. The mirror offers a direct way of comparing the viewer's tongue to those pictured alongside.
• The pictures alongside offer a variety of stages of anaemia from normal (without anaemia), to mild, to severe, showing the viewer that its not a black or white situation (or should I say red and white?)
• This is a great way to detect Anaemia and raise awareness. The colour gradation and accompanying text help in diagnosis. The text at the bottom then immediately gives an overview of Anaemia and what can be done for it.
• The images are real photographs, so they are better for comparison.
• The format of a chart that can be hung like a calendar is one that is well accepted by this audience.

SURAKSHIT PRASAV

This manual by Chetna shows symptoms of Anaemia as it commonly affects women who are pregnant.

• Anaemia is not even mentioned, though its symptoms are shown, and though red ink is used in the book, it is not used in the pages of the book to offer a comparison between a normal and anaemic person.
• Pictures are not labeled, and the only text is that of the heading.
• The images are line drawings and are large which makes them easy to understand.

POSTERS ON ANAEMIA

These are two posters from a set of four on Anaemia, that were put up at Sanchetana's site, at Bombay Hotel, Behrampura. Yashodaben explained to me how the information was segregated and laid out on different posters.

• Most of the posters were only heavy text, though some were pleasantly broken up with largish images. I doubt how much low-literate people liked to read them. I myself have some difficulty reading Gujarati and did not feel like reading that much text on a poster.
• Some of the posters were in rather dull colours and could have been made far more dramatic and eye-catching for something that is such a serious issue. For e.g. if the poster had a red background with white text.
• In some posters, images were not consistent in visual style and seemed scattered. Also they were not in the right proportions to each other. Text keeps changing colour and the reader's eye is going all over the page. Visually there is a lot of scope for improvement.

Analysis | ONE

Sorting out the Data

I sorted out the data (click to enlarge) according to --

CONTENT: Iron-Deficiency Anaemia

END-USER: Poor Urban Women

MEDIUM: Print Media for Social Communication