|Effective Communications for Nutrition in Primary Health Care (UNU, 1988, 208 pages)|
ROYAL D. COLLE
Cornell University, Ithaca, New York, USA
Primary health care and nutrition have been linked with communication in a variety of well-publicized projects. Nutrition workers in nine island nations in the South Pacific have used a communication satellite to carry out a maternal and infant nutrition programme; video-tape and television sets are being used in the Philippines to support nutrition workers; from Indonesia to Guatemala, audio cassettes are bringing health, nutrition, and agricultural information to rural families. The list could go on and on. We are witnessing a situation where communication technologies have taken their place alongside food supplements, oral rehydration salts, inoculations, rehabilitation centres, and home gardens as major ingredients in health and nutrition programmes.
The pattern that led to this partnership between communication and nutrition is familiar: expanded demand for services has been confronted by limited resources. Greater priority has been given to preventive approaches. Paraprofessionals such as community health workers or nutrition aides have become the front-line service providers. Meanwhile, the array of communication resources available for development purposes has expanded. There are high technology tools run by experts (for example, the communication satellites, computers, and colour television). And there are less sophisticated channels that can be effectively used by the non-technician: cassettes, puppets, and community workers. Recently, for example, modestly trained teams from Sri Lanka, Bangladesh, and Nepal won prizes in a Worldview International Foundation competition for producing video-tape programmes on development issues. These were not made by professional broadcasters, but by people associated with agriculture, health, and nutrition programmes.
IMPLICATIONS FOR HEALTH AND NUTRITION OFFICIALS
The success in using communication media to support nutrition projects does not mean that decision-makers should run out and buy a communication satellite or an audio cassette to solve the problems of providing effective health and nutrition services. But senior officials do have a substantial role to play in seeing that their programmes gain the full benefit of what an effective communication programme can offer. To do this they need to accept three responsibilities: (1) examine, at the planning stage of any programme, its implications for communication; (2) insist that communication or nutrition education people work within the framework of a communication strategy; and (3) provide communication resources. We will examine each of these in greater detail.
It is important to be specific about the word "communication" and about where a communication programme begins. In this paper, we consider communication to be the deliberate process of sharing information in a systematic way. We are concerned particularly with the use of mass media and interpersonal channels to achieve explicit communication goals. These goals are related to a broader policy and a comprehensive strategy that involves other sectors. (The word "sector" is used here to refer to an organized body of personnel, procedures and activities devoted to a specialized field or task, such as health, nutrition, agriculture, education, communication, research, training, etc.) It is at the policy level that the sequence of events leading to an effective communication programme begins (see figure 1).
A policy provides the political force that drives a programme. It usually includes an acknowledgment that a problem needs attention (for example, malnutrition in rural areas), that there is a goal to be reached, and a commitment to use resources to reach that goal. Policies are usually set by politicians or boards of directors, with details on implementation left to others. Some examples of policies in highly simplified form are: increase the nutritional well-being of the poor people of the country; provide primary health care to all the people; increase farmers' income; reduce the rate of population growth; change the nation from a rice-importer to a rice-exporter; achieve self-sufficiency in foods, etc.
Next, it is necessary to identify the sectors that will be involved in translating the policy into action. To do this, health and nutrition experts who are involved in planning may need to escape from their conventional thinking about service delivery and explore alternatives. An example could be the use of paraprofessionals. "Paraprofessionals" here refers to the kind of village health worker who generally has less than a year of professional training, and who has a large amount of day-to-day autonomy in providing health and nutrition services to rural low-income populations. This definition and some of the discussion that follows are elaborated in references 1 and 2. While there is a considerable acceptance of various kinds of village-level workers as an extension of the primary health-care system, there is somewhat less success with them than is usually expected. For example, at our workshop, Dr. Amorn Nondasuta indicated that about 60 per cent of village health volunteers are effective. That means a large proportion are not effective. The situation in Thailand is repeated throughout the world. There are various reasons, but the one that emerges prominently is the lack of adequate supervision for community workers.
Inevitably, when people think about supervision, they think of face-to-face contact. If, however, they were to break up "supervision" into its component parts, alternative approaches begin to emerge. What if, in planning a project using community nutrition volunteers, officials were to look at the tasks to be accomplished by supervision? From an analysis of programmes using paraprofessionals, we developed a list of some of the functions of supervision. In reading the list, an official should answer two key questions for each item: Is this important to my programme? What are the alternative ways this can be done ?
The list is as follows:
Some of these functions can be performed by other than face-to-face supervision. It should be evident that radio, video, and audio cassettes or television could play a major role in at least five of these. This would influence the planning for on-site visits by professional staff and for other logistics resources. It seems appropriate to propose that, in many ways, supervision is communication. Thus, in planning a village-level nutrition programme using field-workers, officials should not only think of conventional supervisors such as health personnel, but also consider the potential role of a communication sector. This is an example of the official's first responsibility in making communication effective: examining, at the planning stage, how and when communication fits into the overall programme.
Planning: Comprehensive Strategy
What programme planners or project leaders need to do at this stage is to develop a comprehensive strategy, indicating the major approach to be used, and the sectors needed to reach the policy goals. Inevitably communication will be one of those sectors, and that means that the health and nutrition decision-makers must themselves know more about communication than simply having a "bedside manner," or invite a communications person to participate in the planning.
The way this comprehensive strategy operates is dramatically portrayed by the Masagana 99 rice production effort in the Philippines. The policy was to make the nation a rice-exporter rather than a vice-importer. From among the approaches that might have been used, the planners decided to increase rice production. To translate the policy into action, the government concentrated on four sectors: a new rice technology, a new credit system for farmers, an enhanced agricultural extension system, and an ambitious communication and promotion programme. Like pieces of a puzzle, they fit together to make a comprehensive strategy for reaching a goal. (See P. Whit-more, in this volume, for a practical and systematic way of making a preliminary analysis of the various sectors that might be involved in an effort to change nutrition-related behaviour.)
One can also see the implications of different comprehensive strategies by looking at the official government plans for reducing the rate of population growth in two nations: Pakistan and Egypt. While the policy goals are the same, their approaches for reaching the goals are quite different. Pakistan emphasizes the health and welfare sectors; Egypt's nine-point plan includes agriculture, health, employment for women, industrialization, and social security. Both include a communication sector (see figures 2 and 3).
In summary, to develop effective communication in nutrition improvement and related programmes, the communication factor muct be built in at the beginning of the overall planning when major decisions are being made concerning the approaches to be used and resources to be allocated.
Working within a Communication Strategy: The Second Responsibility
Several years ago, the government of a Latin American country undertook a major nationwide nutrition programme. Quite properly, mass media and interpersonal communication components were included in the overall planning. However, these were carried out by two different agencies. The mass communication people launched an extensive media campaign that did not match the interpersonal communication being done in towns and villages by community nutrition and health workers. Nor had those front-line people been alerted to what was being done by the mass media. The nutrition communication phase of the project was a disaster. Resources were wasted, morale was destroyed, and the victims were not only the families who should have benefited from the programme, but professional people throughout the system, from senior nutrition officials to community health workers. There was no strategy.
All sectors in the comprehensive strategy have their own individual strategies, whether it is research, training, communication, distribution, or some other major activity. Programme leaders should insist that such strategies be made explicit. There are several major advantages in doing this with the communication sector. For example, a communication strategy:
What might senior persons in nutrition programmes expect of the communication sector in developing a strategy? First, they should expect those responsible for the communication sector to understand the policy and comprehensive strategy that govern the overall effort. With this background, the communication specialist should start a five step process, as show in figure 4.
The analysis (step 1) must clearly identify the communication "programmatic" problems. Supervision was an example discussed earlier. In the Masagana 99 case, the first step was gaining farmer acceptance and compliance with new agricultural programmes. In population programmes, it is often a problem of closing the gap between knowledge and practice of family planning.
Analysis of the problem(s) should include careful examination of the target group, the channels available and their capacities (see the summary chart in Appendix 1), and whatever additional background or "situational" information is available that will aid in making intelligent decisions. This includes demographic information on population involved, taboos, data on previous communication programmes, community social structure and typical life-styles, availability of resources, transportation, what the population needs to know, and what their priorities are. In many cases this step will include travelling to communities to talk to people and to observe conditions in the community; systematically gathering data (e.g. research); contacting specialists (such as those in agriculture or advertising); and reading reports and other documents available from ministries, international agencies, and libraries (see N. Rizvi's paper in this volume). From this array of material, a number of alternative approaches to the communication problems can be proposed, along with reasonable estimates of their advantages, disadvantages, and general consequences.
The communication specialist should be able to use this analysis to generate a strategy (step 2). That communication strategy should be laid out on paper so it can be reviewed by programme officials and representatives of related sectors. Putting it on paper should not imply that the strategy is fixed for the life of the project. A strategy must be dynamic for two major reasons: (1) formative evaluation may reveal flaws or suggest alternative actions, and (2) the situation on which the strategy was originally based is constantly changing - especially if the strategy is successful.
What follows are the kinds of elements that programme officials should insist be dealt with explicitly by the top managers in the communication sector. Anything less means that the overall programme could be jeopardized.
1. Principal Objectives
The strategy should begin with the principal communication objectives. Some may be quite general, others may be specific enough to be quantifiable. Those objectives that are quantifiable can be used in developing the summative evaluation. Table 1, taken from a health project, suggests the variety of objectives that might appear in a strategy.
2. Best Tentative Solutions
From among those potential approaches identified in the analysis, the communication expert must propose one or several that are most appropriate for the principal objectives. It might be stated, for example, that mass media will be used to build awareness and a climate of acceptance for a new food, while community health workers will concentrate on persuasion and demonstrations in meetings with small groups and families in villages. But the approaches will be integrated.
Table 1. Health project specific communication objectives
In all audiences, persons should be identified with an explicit statement as to why each is important to the strategy. Often these are clearly specified in the objectives; however, there may be intermediate persons who need to be reached in order to reach a specific target group. For example, to reach high-level officials, it may be necessary to enlist the support of persons working in the mass media. Children may be used as channels to reach parents, or local leaders to reach village men: The use of the word "audience" and "target groups" implies a top-down model for diffusing information. This is not to ignore the potential of indigenous knowledge in the fields of nutrition and health, but a nutrition agency may need to collect and validate that information and then diffuse it from the validating agency. Also, developing a strategy and identifying audiences or the public does not preclude an approach in which community participation is stressed. Some of our experience in India taught us that Indian farmers' resistance to planting new seed varieties could be traced to their wives, who favoured the texture of food prepared using traditional varieties.
In the analysis section, it was important to list systematically all the media available. To this should be added those that might be introduced, since innovative uses of media such as nutri-vans, as illustrated by Solon et al. elsewhere in this volume, and audio cassettes  are unlikely to be suggested by identifying only the media existing in a rural community. The task here is to use appropriate criteria for selecting from among those possibilities. Some of the criteria include: appropriateness for the audience, initial and continuing costs, technical support ("infrastructure") required, opportunities for participation, etc. Various media have characteristics that make them more appropriate than others for communication with audiences. Table 2 indicates some factors that influence media selection.
It is important to understand what the best media are for doing particular jobs. UNICEF's Project Support Communication Section in Bangkok has produced a Media Selection Wheel that matches media with communication ("learning") objectives. It also introduces various '' selection factors" such as flexibility of use, equipment required, degree of initial and continuing costs, etc., to help planners make more careful decisions.
Table 2. Media selection
Source: Adapted from H.E. Perret, Applied Communications Technology in Rural Development (Academy for Educational Development. Washington. D.C.. 1976).
A worksheet for media selection (fig. 5) provides a simple but systematic scheme for selecting different media. The communication specialist can list the criteria that are most important to the situation, taken into consideration the communication objectives, populations involved, the kinds of information to be communicated, and such factors as speed required and area to be covered. Numbers can be used to indicate how well each of the media listed meets the criteria. There is no absolute numerical total that will tell one which media to use, but this planning operation will assist in making a more rational decision.
The principal content for the communication programme must be identified, and it must be authenticated by the proper technical specialists (for example, agronomists, nutritionists, etc.). At this stage it is usually enough to indicate the major themes that will be used, keeping in mind that it may be important to distinguish between messages designed to inform or reinforce (cognitive), those intended to move a person to action (motivational), and those essential for carrying out actions (behavioural).
It is important to be specific about three dimensions of the content. These are: (1) What is the overall "inventory" of information that audiences need to have to do what is expected of them? (2) How much of this do most of them already have? (3) What is the balance (i.e. the gap between 1 and 2) ? This is the content that needs to be emphasized in laying out the strategy, remembering that even some of what is already known may need to be reviewed or used as an entry point for the newer material.
The communication activities to be undertaken should be put into a general timetable. Scheduling of themes is influenced by various factors: the logical development of the overall message, e.g. awareness-motivation-behaviour; circumstances of related sectors, e.g. the agricultural calendar, or distribution of health materials, or the deployment of community workers; and so on. This timetable should be developed co-operatively with other sectors.
|Accessibility to ministry|
|Accessibility to population segment|
|Control over final message|
|Appropriate for population segment|
|Appropriate for message content|
Fig. 5. Worksheet for media selection.
RS = Radio spots
P = Posters
C = Cinema advertisement
R = Radio programme
FW = Field-workers
IM = Indigenous media
AC = Audio cassette
Fig. 6. Scheduling: messages/media.
Figure 6 is a worksheet for planning themes and media according to different periods in the overall programme. Using the worksheet, the communication people can schedule particular themes for particular periods or phases of the programme.
There are two "facilitating" strategies that need to be included with the overall communicating strategy. These include (1) a plan for mobilizing resources and (2) a plan for doing formative evaluation (research). First, as regards resources, if radio broadcasts (or other media) are to be used, these questions need to be asked: Who will do it? How will it be done? The attempt to answer these questions may suggest some resource needs: a script-writer, performers, recording facilities, money to purchase time, listening group leaders, or persuasive efforts applied to broadcast station officials, etc. These should be carefully calculated and provision made for obtaining the resources before going into the implementation activities that require them. Anticipation of needed resources - from spare parts to training staff will increase the chances of effective communication.
The formative evaluation plan must indicate how information on the communication efforts will be collected, processed, and fed back into the strategy or implementation phases. (See D. Foote's paper on evaluation models in this volume.)
The Remaining Steps
We have moved through the first two steps of the process suggested earlier (fig. 4). The third step, implementation, is the most visible part of the communication sector's activities. This is where messages are designed, posters printed, cassettes distributed, etc. These details are vitally important, but of less concern to high-level programme officials than the more macrolevel planning and strategy process discussed earlier. (See J.E. Andersen's paper in this volume for useful ideas on some aspects of implementation. )
Obviously, the programme official will have an interest in both the implementation and summative evaluation phases, expecially that they be carried out in a manner faithful to the strategy. The results of the summative evaluation (step 4) - if they are to be useful at all - need to be followed by an explicit statement as to future action to be taken (step 5). How, for example, do the results influence the initiation or completion of another strategy, or a decision to restate the communication problem?
Dealing with audiences and channels and messages may seem quite distant from issues such as nutrient deficiencies, diarrhoea, and the weight-for-height charts that nutritionists may be more comfortable with, but it bears repeating that effective communication methods may be as vital to improving the nutritional status of a population as a sanitary water supply or special formula supplements. That is why leaders of community or national nutrition programmes must demand the kind of detailed planning for the communication sector that is outlined above. This leads us to the third responsibility that nutrition officials have.
It is a rare agency that has all the resources it needs or wants to carry out its mission. The communication sector in a nutrition programme is quite likely to suffer in resource allocations because microphones or cassette tapes or projectors seem less vital than vaccines, vitamins, and medicines. In addition, the health and medical items are more visible symbols of health-care services offered by the health establishment. If, however, nutrition programme leaders have accepted and committed themselves to the first two responsibilities outlined above, it is imperative that they give higher priority to providing reasonable resources for communication activities.
Examination of budget allocations for nutrition and health education communication suggests that these kinds of activities tend to get token amounts of money, or what is left over after other needs have been met. One reason is that, in planning and budgeting activities, there are seldom advocates speaking as forcefully for the communication sector as those speaking for the medical, health, and nutrition sectors and the conventional resources they require. If there is to be effective communication for nutrition in primary health programmes the medical doctors and nutrition experts who are most influential in allocation of resources will need to lobby for additional resources for communication, or increase the priority of communication resources in the competition for what overall support is available.
In addition, more attention needs to be paid to the development of human communication resources within the nutrition establishment. It is a sad state of affairs when persons whose principal activity is based largely on communication have little professional training to do that kind of work. What is the balance between technical training and communication training for those persons who work directly with the public? Too frequently we assume that communication is "natural," and that to have effective extension agents and nutrition aides it is only necessary to provide them with technical information.
What can be done? Nutrition and health officials need to initiate or support efforts to examine the job responsibilities of the people working on their programmes to discover if and where communication plays a significant role in their activities. Does their successful performance depend on effective communication? This was done in Thailand, where the Ministry of Health now uses the phrase "village health communicator" to describe one of the two kinds of health volunteers working at the community level. The re-examination of job tasks should lead to a systematic effort, through in-service training, to upgrade health-care workers' skills for communicating about nutrition and related topics. This should be a priority issue.
In reviewing these three responsibilities for bringing about more effective communication for nutrition in primary health care, it should be clear that senior-level health and nutrition professionals need not change the nature of their careers and become communication experts. But they do need to understand enough about what can be done with communication so that, in their influential positions, they can demand systematic, quality planning and performance from the communication sector, and, given the expectation that it is forthcoming, support resource allocations for both vitamins and video cassettes.
The author wishes to acknowledge the contributions of Njoku E. Awa, Ronald E. Ostman, Donald F. Schwartz, and J. Paul Yarbrough to this paper.
1. R.D. Colle, "Tasks Required for Technical Management and Supervision in Rural Health and Development Programs," in The Training and Support of Primary Health Care Workers (National Council for International Health, Washington, D.C., 1981).
2. M.J. Esman, R.D. Colle, N.T. Uphoff, et al., Paraprofessionals in Rural Development, A Stateof-the-Art (Center for International Studies, Cornell University, Ithaca, N.Y., 1980).
3. P. Winichagoon et al., "A Cassette-tape Recorder Technique as an Approach to Nutrition
Education of Rural Mothers in Northeast Thailand," mimeo (Institute of Nutrition, Mahidol
University, Bangkok, 1983).
4. Shawki M. Barghouti, Reaching Rural Families in East Africa (PBFL/FAO, Nairobi, 1973).
APPENDIX 1. Summary Chart of Communication and Education Techniques
|Method||Main advantages||Main disadvantages||Comments|
|1. Public meetings
|Easy to arrange. Reach many people. Can have more than one speaker. Create public interest and awareness. Stimulate follow-up discussions.||Audience is usually passive. Speakers may not understand audience's needs. Difficult to assess success. Audience might not learn the main points.||Handouts should be used. Presentation should be clear. Use visual aids when possible. Audience should be encouraged to raise questions and to participate. Speaker should establish two way communication.|
|2. Group discussions||Build group consciousness. Individual members of the group can understand where each member stands in regard to the discussed issue: provide chances for exchanging opinions and increase tolerance and understanding.||Some members may dominate. Sometimes difficult to control or to keep focusing on the main issue.||Should be used with an interested audience to discuss a definite problem. Procedure should be fexible and informal. Summary of discussion should be presented at the end of discussion. Decision should be made by group members regarding its stand on the issue discussed. Requires the selection of good chairman.|
|3. Role-playing||Facts and opinion can be presented from different viewpoints, especially in controversial issues. Can encourage people to re-evaluate their stand on issues and can invite audience participation. Deepens group insight into personal relations.||Cannot be used in community meetings. Some role-players may feel upset by playing a role they do not agree with. Requires careful preparation for the selection of the issue and actors. Careful preparation is essential.||Can only be used in training courses. Follow-up discussion should focus on the issue rather than on actors performances. Source material about the issue should be provided to the actors to prepare their arguments.|
|4. Drama||Groups can be active, "learning by doing." Can attract attention and stimulate thinking if situations are effectively dramatized.||Actors require attention in training and preparing script. Preparations might be too difficult for the field-worker. Difficult to organize because it requires considerable skills and careful guidance by the field worker.||Should be restricted to one issue. Can only be used during training courses. Can be used as entertainment if well prepared before a public meeting.|
|5. Case study||Can illustrate a situation where audience can provide suggestions. Can elicit local initiative if the case corresponds to local problems.||Difficult to organize. Rewording of events and personalities might reduce the effectiveness of the case. Some audiences may not identify themselves with the case.||Should be clearly prepared. Can be used in training course. Questions and discussions should lead to recommendations for audience action. Audience should be encouraged to prepare case studies relevant to its experience.|
|6. Home visit||Establish good personal relationships between field-workers and families. Can provice information about rural families that cannot be collected otherwise. Encourages families to participate in public functions, demonstrations and group work.||Field-worker cannot visit every family in the community. Only families in accessible localities can be visited.||Records should be kept for families visited. Schedule of home visits should be developed to assure allocation of time for field-work activities. Handouts should be given to the families visited.|
|7. Demonstration||Participants can be active and learn by doing. Convinces the audience that things can easily be done. Establishes confidence in field-worker's ability.||Requires preparation and careful selection of demonstration topic and place. Outside factors can affect demonstration results and consequently might affect confidence in field-worker.||Demonstration processes should be rehearsed in advance. Audience should participate in the doing. Educational materials should be distributed to the participants at the end of the demonstration. Time and place of demonstration should be suitable for people to attend.|
|8. Radio, newspapers and television||Radio can be used to teach illiterates and literates. Newspapers can provide information within a short time for those who can read. Mass media can create awareness of issues and announce activities in this regard.||No visual aids can be used on radio. They can be used in newspapers and television. Media programmes are always short. Regular mass media programmes are one-way communication. Difficult to assess effects. Programmes are usually prepared for national audience, which reduces their relevance to local problems.||Mass media programmes should be relevant to the problems of the local people. They are better utilized if combined with group discussion.|
Mass media group
|Combines mass media
and personal channels. Can be prepared and used for many audiences over a period
of time. Encourages group participation.
|Requires preparation for recruiting groups, training group leaders, and preparation of educational material. Can be expensive.||Should he regularly held. Participants should be provided with educational material. Can be effective in enforcing literacy and adult education. Programmes selected should be about local problems. Tape recorders can he used. They are flexible. Can be used to tape role-playing, group discussion and interviews with local personalities.|
|10. Blackboard||A flexible tool. Easy to make and to use. Can be very attractive if used properly. Use of coloured chalks can add to its visual appeal. Can be portable .||Requires some manipulation skill (though quickly acquired). Requires teaching skills to make best use.||Should he essential in every group. Very useful for schematic summaries of talk or discussion. Audience can participate. Small blackboards can be portable. Writing should be clear and organized.|
|11. Flannelboard||Can be portable and mobile. Can be prepared by expert in advance: little skill required in actual operation. Could be used to make presentation more dynamic.||Can only be used for what it is prepared for. Cannot adapt to changing interest of group. More elaborate equipment than ordinary blackboard. Difficult to keep up to date.||Very useful but only for the prepared talks. Audience can participate. It should be used step-by-step. Flannel materials should be stored properly for future use. Flannel graphs should be numbered according to their order in the presentation.|
|12. Bulletin board||Striking, graphic, informative, flexible, replaces local newspapers. Keeps community up to date with information.||Requires preparation and attention to community needs.||Should be combined with maps, talks and photographs. Very suitable for posting articles, announce meets and news of development in the community.|
|13. Flip charts (turn-over charts)||Cheap and simple. Can be stopped at will for analysis. Can be prepared locally. Ideas could be illustrated in sequence. Illustrations on flip chart could be used many times for different audiences in different sessions.||Soon torn. Can only be seen by a few at a time. Can be difficult to illustrate complicated ideas.||Should not be over looked for illustration of simple sequences - especially with small groups. Lectures should be prepared in advance for use on several occasions.|
|14. Films||Because of sight and sound can attract audience's attention. Can make great emotional appeal to large audiences.||Good films are rare. Equipment costly to buy and maintain. One-way communication unless properly used. Requires skill in running film projectors.||Best if combined with discussion groups. Much work to be done in getting good films made. Attention should be given to encouraging audience to evaluate the film. Films should be used for stimulating discussion rather than for teaching alone.|
|15. Filmstrips||Much cheaper and easier to work than films. Easily made from local photographs. Encourage discussion.||Usually sight only. Not so dramatic as motion pictures. Could be expensive.||Can have recorded commentary. Strip can be cut up and individual pictures mounted as 2-inch slides; then can be selected and rearranged.|
|16. Slides||Have all the advantages of filmstrips plus more flexibility and can be more topical.||Could be expensive. Difficult to have them on all subjects of teaching. They can be used in a series to illustrate a concept.||They should be used after careful preparation of logical sequence and a good commentary.|
|17. Models, exhibitions, and displays||Appeal to several senses. Can be used on various occasions and situations. Can illustrate ideas in detail.||Not many workers can build or use them properly.||Useful models and exhibitions could be built up locally. Should be used in familiar places/ centres.|
|18. Maps, charts, diagrams||Visual appeal. Should simplify details. Permit leisurely study: can develop sequence on display boards.||May mislead by over-simplicity. Create transport and storage problems.||Should be made especially for groups. May need careful explanation at first. Could be used as summary of in formation. Symbols and layout should be familiar to the audience.|
Source: Reference 4.