What are Information, Education and Communication materials?
Information, Education and Communication (IEC) materials are used to convey public health messaging in order to support the overarching behaviour change strategy developed to respond to a public health problem. IEC materials include a range of products like:
social media posts
audio spots for radio
billboards or murals
It is important to remember that most IEC materials are not powerful enough by themselves to change behaviour. The materials should be incorporated in an activity or activities in such a way that they form a behaviour change package. The packages should complement each other in addressing a range of behavioural barriers in the target setting. A range of communication channels should be used, including some which allow for a dialogue to be created with community members. For more information on choosing the correct communication channel, see our resource here.
What should be considered when designing IEC materials?
1. Design your overall planned response
Develop an overarching social and behaviour change strategy tailored to the needs of the specific target groups you want to reach. Conduct formative assessments to understand the determinants of preventive behaviours among your target audiences and identify potential knowledge gaps. The formative research insights should be used to design IEC materials which will not stand alone, but rather will support specific activities within the overall behaviour change strategy.
2. Design with illiteracy in mind
Think about how posters or graphical materials would look if you had difficulty reading the text. This is important to consider not just for adults who are illiterate, but also for children or people with visual impairments. Take time to learn about illiteracy rates in your setting and consider how images alone could convey the target message. An easy way of doing this might be to depict a process of actions or to compare the ‘right’ behaviour with the ‘wrong’ behaviour by using simple ticks and crosses against these. Always ask yourself whether it is possible that your images could be misinterpreted without the text that accompanies them and where possible, minimise written messages. If text is included, make sure the words being used are simple and in the local language. Make sure your materials are also available in all languages spoken by your target population, including minority languages. For more tips on improving the accessibility of disease response programmes, read this article on inclusive programming.
The video below is an example of an IEC material that is able to convey a clear message without relying on written or verbal explanations.
Source: Stanford Medicine
The graphic below focuses on conveying one behavioural message (physical distancing) and does so with minimal writing and clear visuals.
3. Make IEC materials motivating and informative
Sharing information about important behaviours to prevent disease transmission and information that dispels harmful myths is important. However, knowledge alone does not change behaviour. This is a common challenge for behaviour change programmes – people know the right thing to do, but rarely put it into practice. To change behaviour, it is useful to play to people’s hearts as well as their minds. To do this, design messages that link behaviours with responsibility towards those more vulnerable, or with solidarity in combating the disease together. Examples of this include messages like ‘We are all in this together’ or ‘I’m wearing this to protect you’ type branding.
Promoting collective action, cooperation, and appealing to a sense of community through catchy messages and slogans is key to information retention.
For example, in Edo State in Nigeria, staff wore branded t-shirts and hats that said ‘Protect our Elders’ when working in communities during the COVID-19 crisis.
Source: Edo in Action
In 2014, the global #IsurvivedEbola campaign was launched to “to inform, protect, and spread hope”, as well as addressing stigma and discrimination towards individuals who had been infected.
Source: Brian Lightbody
4. Borrow good ideas, but adapt them
Take time to look at examples of effective IEC materials from other countries and consider whether similar ideas could be effective in your context. Take time to think about how you could adapt ideas that have worked in other settings and make them relevant to your context and aligned with national guidelines. Use the checklist below as a starting point:
Is the message aligned with national guidelines in my setting?
Is the message aligned with the planned response/behaviour change strategy that we have developed?
Does the message address gaps in knowledge that are common in my setting?
Does the message say what behaviour to do?
Does the message link the behaviour with an appropriate motivation?
How could visual graphics be adjusted to look more similar to my setting? This may include thinking about how houses should be depicted to be similar to your setting, what clothes should characters wear to be similar to your target population and even making sure that handwashing facilities, soap and water points look similar to what is found in the areas where you are working.
What language/s should be used in the IEC materials so that it can be easily understood?
Are there any parts of the IEC material that would not make sense in my context or that could be misunderstood? How should they be adjusted?
Does the format of the IEC materials need to be adapted so that it can be shared through appropriate and safe delivery channels?
What other details could be added so that the IEC materials feel more like the experiences of your target population? For example, could local music be added to an audio spot to make it feel more typical of the area where you are working?
5. Design materials that people will want to keep and use
In responding to crises, organisations often give out leaflets to communities that are quickly thrown out and create waste. If you want people to keep IEC materials or put them on their wall, then create attractive and interesting materials. This could include a pledge that people can sign and commit to; a space for children to draw a picture of their family staying healthy; or you could even try adding a basic sticker-type mirror in the middle of the messages – this way each time they look at themselves, they will be reminded of your message. WaterAid tried incorporating a simple mirror into the IEC materials they distributed to mothers during routine immunisation for newborn children. This approach may prolong the duration that the IEC materials are kept in the households.
When promoting good hygiene behaviour, Malteser International put their key hygiene messages on a fan so that the material would continue to be used by populations.
Source: Malteser International
This hospital in the Philippines organised a drawing competition for staff to create the IEC materials on hygiene that were displayed throughout the hospital.
Source: Ciudad Medical de Zamboanga
In this case study from Kenya, murals using local slang were produced in busy areas like markets and urban settings, in order to trigger preventive behaviour changes for COVID-19.
Source: Hygiene Hub
In this case study from Nepal, Wateraid provided patients with stickers to take home, which outlined key preventive behaviours for COVID-19.
Source: Hygiene Hub
6. Design multiple IEC materials and link them with similar branding
In most cases. one poster, billboard or advert will not be sufficient to communicate the complexity of the focal disease, and materials may need to be added during different stages of the outbreak. In general, posters and billboards are recommended for raising awareness about one behaviour, because people only glance at them briefly. Leaflets and flyers may be more useful for illustrating more complicated behaviours as there is space to break these down into small steps.
One way to unify multiple support materials under a common umbrella is through common branding. This could be a common colour scheme, format or an iconic character that populations can identify with. For example, in Sierra Leone, a consortium of partners decided to develop a family of superhero characters that they felt people would identify with and defined the personalities of each character. These were later used throughout their hygiene promotion campaign.
7. Quote reputable sources that people trust
Including the source of the information behind the epidemiological information on your IEC material could enhance its credibility. UN agencies, trusted government authorities, established non-government organisations or science or community leaders are typically seen as reliable sources (but do verify this with your population). Also consider including information about where people can find other reliable information (e.g. a phone hotline or website). You may also want to include something that can help identify who produced the IEC material (e.g. organization and country/location), in order to help populations know whether the IEC materials they are exposed to are applicable to them in their location and produced by an accountable organisation.
During outbreaks, IEC materials might quickly become outdated, as guidelines change to reflect the latest information on the focal disease. Including a date of production on your IEC material will help users identify whether the information shared on the IEC materials are up to date.
The IEC material below was developed by World Vision for the COVID-19 response in the Philippines and contains basic production information about the IEC in the bottom left hand corner.
Source: World Vision
8. Pre-test IEC materials with populations
Before you deliver IEC materials at scale, make sure to pre-test materials with a small but diverse group of individuals. People with disabilities should be included in this group (for more tips on improving the accessibility of disease response programmes, read this article on inclusive programming). This evaluation checklist outlines seven communicative aspects to measure your IEC materials against. Take time to learn from the community about how they interpret the messages, whether anything is unclear, whether the messages seem relevant to them and how the materials make them feel. Adjust materials based on this feedback.
For further tips on IEC development, see various resources from Compass or this resource from BehaviourChange.net.
Is it safe to distribute printed IEC materials to the public during an outbreak?
Is it useful to use printed IEC materials?
Before distributing IEC materials, ask yourself what you plan to achieve by doing so and think about how members of your community will use the materials you intend to distribute. In many settings, IEC materials are quickly discarded and create unnecessary waste. Printed materials are not always suitable for engaging all members of the population. For example, they can easily be misinterpreted by community members with limited literacy and may not be accessible by children or people with visual impairment. Given these limitations, we would discourage using printed IEC materials as your only means of communicating prevention messages. When planning your response, we recommend incorporating IEC materials to support specific intervention activities that form the community engagement component of your COVID-19 behaviour change strategy.
Producing and distributing IECs materials safely – example of COVID-19:
Note that whilst this section was written with COVID-19 in mind, principles and activities can be applied to other diseases with surface transmission routes, such as influenza and Ebola.
SARS-CoV-2 can survive on surfaces, including paper for some time. One study conducted in 2022 found that in controlled laboratory conditions, SARS-CoV-2 can survive on inkjet paper for approximately 6.5 hours, compared to around 59.8 hours on plain paper. However, survival time depends on a range of conditions (and in real-life settings is likely to be lower).
The following points should be taken into consideration when distributing IEC materials when dealing with a pathogen which is transmissible via surfaces:
Make sure that any staff involved in producing or distributing leaflets are not currently experiencing disease symptoms.
Before printing of IEC materials commence, wash hands thoroughly with soap. After printing, take the leaflets out of the printer and put the printed leaflets directly into a sealable plastic bag or folder (e.g. a ziplock bag or paper envelope) so that they are ready for distribution.
If you need to organise the printed IEC materials in any way (e.g. stapling), make sure that you clean the surface you will work on with a disinfectant before starting. You should also wear a facemask while you are handling the materials.
Give each staff member a set of leaflets in the sealed bag or folder and encourage them to reseal the bag between distribution locations. Only one staff member should handle the leaflets from their assigned zip-locked bag or sealed folder.
Wear appropriate personal protective equipment and maintain physical distancing throughout the distribution period and avoid going into any homes or buildings.
A safe way to decontaminate the printed IEC materials before distribution, is to leave them in a clean sealed space and keep them there, untouched for 24 hrs.
Communities might rightfully be sceptical about receiving printed materials because of the risk of surface transmission. You can leave the material for them on an infrequently touched surface and advise them to allow 24 hrs before picking up to read or share. Be ready to explain the reasons for your recommendation.
What options are there for IEC distribution?
During outbreaks, it is likely that countries and regions will be responding to a different phase of the disease in their context. The feasibility, safety and acceptability of different IEC delivery mechanisms will also vary based on this. Repeatedly sharing your IEC materials using different delivery channels will increase your target population's recall and belief in the information you are sharing. Delivering or displaying materials at the point of action, e.g. hanging a poster by a handwashing facility, is an effective way of encouraging the behaviour. See this resource for more information on engaging communities at a distance.
1. Door to door distribution of posters or flyers
Distributing IEC materials from door-to-door is a time-intensive process. But in some cases, where your distribution is hyper-targeted, it might be necessary to interact with every household within your target community. This approach can also be useful if you are trying to deliver a specific message to a specific group of the population (for example, guidance for older people who may be more vulnerable to the focal disease). Depending on the mode of transmission, distributing IEC materials at the household level, might require measures such as physical distancing to reduce the risk of contamination to the printed materials. Do not enter people’s homes but take the time to explain to them the information you are providing, what you would like them to do with it (e.g. put it up on their walls) and what behaviours they should practice. For instance, during the Ebola crisis in Liberia, BBC Media Action and UNICEF trained and deployed a group of adolescents, who conducted door-to-door visits to deliver education on preventive behaviours.
2. Use of billboards, posters or large TV screens in public areas
Identify areas where people frequently go (even during outbreaks). This may include markets, bus stations or transportation hubs, health centres, schools (if open), sports venues (if open), religious centres (if open) or other key service locations within your community. You should choose the location for the distribution of IEC materials based on who your target population is. You may also want to tailor the IEC materials to the location where they are being placed. For example, in religious centres, the IECs could guide people on recommendations for how they can pray and worship safely. Whenever you are putting up materials in public spaces, consider where people will commonly look and aim to place your IEC material in their eye-line so that you capture their attention.
Keep in mind that before you hang up IEC materials, you might require approval from local authorities or those who own and run each premises
You may want to distribute IEC materials by postal mail. There are specific services or ‘mailing houses’ that can be hired to manage sending out large quantities of IEC materials by postal mail.
IEC materials can be shared via multiple channels on the internet. For example, they could be shared as pictures or videos on social media, or published on websites or uploaded to resource hubs. Sharing IEC materials on social media platforms allows for ongoing discussion with your target audience, but it also means that you can’t always control how images are shared and interpreted. See below for an example of an educational video on cholera.
5. Mass Media
IEC materials can also be shared as content for TV and radio shows, or printed in newspapers or magazines. If you are planning to share information this way, take time to identify how much radio or TV slots may cost to air your advert or public service announcement. Also consider which stations and programmes are most viewed or listened to by your target population and at what times of day. This way you can ensure that your messages reach more of your intended audience.
Author: Astrid Hasund Thorseth
Review: Kondwani Chidziwisano, Ammar Fawzi and Elli Leontsini
Last update: 06.07.2020