Visual Health Literacy in Rural Nigeria
This research was conducted as part of my Master of Science in Biomedical Visualization at the University of Illinois at Chicago, in collaboration with Northwestern University's Access to Health Project.
Role:
Visual Communication Strategist & Medical Illustrator
Collaborators:
Justice & Empowerment Initiatives (JEI), Nigerian Slum/Informal Settlements Federation
Date:
2018-2019
CHALLENGE
In 2016, Northwestern University's Access to Health (ATH) Project began working in Lagos, Nigeria, in partnership with local organizations to address critical health needs in underserved communities. Despite creating a comprehensive health curriculum, significant barriers emerged:
Literacy Barriers: With over 62% of Nigeria's 170 million people living in extreme poverty and just under half of the population able to read and write, traditional text-based health education was ineffective.
Linguistic Complexity: Nigeria has over 250 ethnic groups speaking more than 520 languages and dialects, making consistent health communication extremely challenging.
Limited Resources: Community Health Educators (CHEs) operated in highly variable teaching environments with minimal materials and infrastructure.
Cultural Disconnection: External health education often failed to resonate with local communities due to cultural insensitivity or inappropriate visual language.
The fundamental question became: How could visual aids be designed to effectively engage members of a low health-literate community and augment long-term retention of health information?
APPROACH
Key Research Components:
Literature Review: Examined health literacy, Nigerian educational systems, visual learning principles, and long-term memory retention strategies.
Cultural Analysis: Investigated traditional Nigerian art forms, textile patterns (Ankara, Adire, Akwete), color associations, and community values.
Focus Group Discussions: Conducted interviews with Chicago-area Nigerian volunteers to gain insights into cultural attitudes toward art, health, and visual communication.
Curriculum Analysis: Systematically broke down the ATH health curriculum to identify key concepts suitable for visual translation.
Cultural Insights That Shaped the Approach:
Nigerians generally prefer straightforward visual communication rather than abstract or overly clever imagery
Color has significant cultural meaning (e.g., fun fun, pupa, and du du color categories in Yoruba culture)
Traditional textile patterns carry embedded meanings that could be leveraged for health communication
Community elders' involvement and approval is crucial for successful implementation
VISUAL DESIGNS
& RATIONALE
The design process resulted in a series of visual motifs that transformed complex health concepts around three core topics (germs, water, sanitation) into culturally appropriate imagery; incorporating traditional Nigerian patterns, colors, and visual language to ensure cultural relevance and resonance. These designs were created to be flexible—functioning as both standalone educational pieces and components of larger narrative murals.
Germs & Disease Prevention
A WiFi signal, which is recognizable in the region, illustrates the transmission of germs. Different "germs" (viruses, parasites, bacteria, fungi) lead to illness symptoms, shown in culturally appropriate red (danger) and black (illness/death) colors. Nurses represent trusted community health leaders.
"Germs & Disease" Final Composite
Water Safety
Elderly woman (considered wise and respected in Nigeria) presides over covered water containers to prevent against contamination and malaria. "Water wagon" used in the community to acquire drinking water. Black germs and white raindrops show the health affects of water purity.
"Water Safety" Final Composite
Sanitation Practices
Mother washing her child's hands in clean water incorporates the Nsubra Ankara pattern in the background, which traditionally symbolizes water ripples or deep wells. Color choices are deliberate: green (health), blue (purity), and yellow (fertility and preciousness).
"Sanitation" Final Composite
IMPLEMENTATION
STRATEGY
The murals were designed to be implemented through community participation, reinforcing the health lessons through active engagement:
Community Health Lessons: CHEs would first conduct their standard lesson on a health topic from the curriculum.
Collaborative Creation: Community members would then participate in painting the related murals in public spaces, physically engaging with the health concepts.
Ongoing Visual Reinforcement: The completed murals would remain as persistent visual reminders of health information in community spaces.
Community Ownership: By participating in creation, community members develop a sense of ownership over both the murals and the health knowledge they represent.
"Knowledge is Health" Final Composite
REFLECTION &
FUTURE ITERATION
While full field implementation was beyond the scope of this initial research, the project created a foundation for an innovative approach to health education in low-literacy settings. By drawing on both scientific understanding of visual learning and deep cultural knowledge, the murals offer a promising approach to health education that respects local traditions while effectively communicating modern health concepts.
Future development could include:
Field testing in Lagos communities to measure impact on health knowledge retention
Expansion of the visual system to cover additional health topics
Development of training protocols for local artists to continue creating health-focused public art
Adaptation of the methodology for other cultural contexts and global regions