More Links in Health Programs

Trachoma Health Education Materials Library: Flip Charts

  • A health worker in Ghana leads a discussion about trachoma in a primary school. He uses the flip chart "Let's Be Trachoma Free" to encourage student participation.

  • Above, community health workers carry educational materials in northern Sudan.

  • A community-based health educator in Ethiopia uses a flip chart to facilitate health education.


Community-based health educators use flip charts to facilitate health education in rural areas. Health educators use these charts to stimulate community discussion about health and sanitation issues during village meetings, school-based health education, and during other program activities such as antibiotic distribution and trichiasis surgery campaigns.

Considered one of the most widely produced forms of health education material for trachoma control, flip charts consist of large photographs or drawings that depict a story or message about trachoma control. Program managers develop flip charts using images that non-literate populations will understand. Health messages are printed on the backside of the images to prompt health educators as they conduct rural education activities. The large size of these images and their ease in portability allow health workers to conduct health education activities with a large group of people.

Interpretation of visual aids can vary between cultural and linguistic groups. An effective flip chart design incorporates the cultural context of its audience such as colors, clothing styles, household architecture, and religious symbols. An effective health educator can use these cultural elements in flip charts to create more elaborate, involved stories that engage the community audience. In Niger, a popular flip chart tells the story of two characters, Aicha and Mariama, who have opposite experiences with nutrition and family planning. The story is so popular that village women discuss their stories long after the village health worker holds her meeting.

Designing a Flip Chart

The cost of producing flip charts can be considerable. Costs can increase due to design and printing factors such as page size, multiple colors, lamination, binding, and number of pages. It is a good idea to talk to a few printers before designing a flip chart. This will help you decide how big it should be and how many pages to include.

Flip chart images should be organized in a logical progression. Most flip charts are coil or wire bound to keep pages in order since the order of the pages will affect the order of the health messages presented. This can impact the level of discussion and participation by the audience. If the pages are well organized, health workers will be able to use them as an effective tool while leading a meeting on health education.

When designing a flip chart be sure to use culturally appropriate and relevant images. Details such as clothing, headscarves, and depictions of everyday life (cook-stove placement, latrine design, etc.) may seem unimportant compared to the central health messages, but your audience will react to them.

The printed text on the back of the images should be clear and simple. Write messages in both the official language and local dialects to widen the pool of health educators able to teach the material.

  • Sample prompt questions and responses are helpful to get a facilitator started, for example: "What is this woman doing here? She is washing the face of her child with soap and clean water. This prevents trachoma."

Pre-Testing Flip Charts

Flip charts should be pre-tested with the target audience, either with individuals or in small groups. Test each page individually for content, clarity, and cultural appropriateness to measure how well the illustration represents actions and real-life situations.

For example, if testing an illustration of women at home ask questions such as:

  • Does her kitchen look like yours?
  • Does her home look like yours?
  • Is her headscarf tied correctly?
  • What do you think she is doing?
  • Is anything missing from this picture?

Once each page is analyzed, ask the testers to discuss the chart as a whole.

  • Are the pages in the correct order?
  • What were the main messages conveyed by this chart?
  • What did you understand from the content?
  • How could the flip chart be improved?
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