Using Film to Convey Critical Reproductive Health Information to Those Who Need It Most

K4Health thanks Josie Gallo, Content Development Manager at Medical Aid Films, for contributing this story. Josie’s passion is using film for education and development, particularly within health communication. Thank you also to Dr Neil Pakenham-Walsh, HIFA Coordinator, for contributing to this story.

Every day, tens of thousands of children, women, and men die needlessly for want of simple, low-cost interventions — interventions that are often already locally available. Too often, though, mothers, family caregivers, and health workers do not have access to the knowledge they need, when they need it, in a format in which they can understand and use it, to make appropriate decisions and save lives.

In 2006, while midwife Fiona Laird was working in a refugee camp in Darfur, she witnessed babies dying needlessly from tetanus because their umbilical cords had been cut with dirty knives. Fiona organized a simple training about how to deliver and care for a newborn baby safely, and thousands of women came from far and wide. But Fiona soon realized that demand for training far outweighed the resources available.

Struck by the enormous need, Fiona approached her colleagues Professor Eric Jauniaux and Dr. Natalie Greenwold, both experts in the field of obstetrics and gynecology with training experience in low-income countries. They believed that film could be an accessible solution. And so Medical Aid Films was born. We went on to produce a library of films, all available free of charge, on basic health education topics, as well as training films for health workers.

As interest in Medical Aid Films grew, we began to build partnerships around the world. In 2013, leading medical technology firm GE Healthcare reached out to partner with us on a new innovative project providing women in low- and middle-income countries with access to critical information about pregnancy and childbirth. The project would build Medical Aid Films’ pregnancy and reproductive health content into low-cost portable ultrasound scanners in order to reach pregnant women across Southeast Asia and sub-Saharan Africa with crucial health information.

We worked with GE to select four of the existing films we had created for communities in sub-Saharan Africa. The films covered topics including warning signs in pregnancy, nutrition during pregnancy, safe delivery, and family planning. We first adapted the original 10-to-15-minute-films to new 5-minute versions — the optimal length for the GE devices — essentially focusing on the key concepts and simplifying the level of detail. With feedback from the medical advisors and local partners, we edited the films to produce a suite of short ultrasound device-enabled pieces, translating them into French, Swahili, and Portuguese for GE’s focus countries in sub-Saharan Africa.

The next goal was to adapt the film content for Southeast Asia. This was our first time adapting content for another region, and it proved to be an effective way to scale up content delivery. We shared the films with existing local health partners in Cambodia, Vietnam, Indonesia, and Burma, collecting feedback on how the films should be modified to suit country guidelines, local practices, and sociocultural contexts.

Our modifications included changes to nutrition advice (based on locally available recommended foods) and local language and terminology. (For example, the use of “kanga” in the original films became “cloth.”) We worked with our animators to adapt the characters in the film, changing facial features, skin tones, and clothing. With local filmmakers in Thailand, Burma, and Indonesia, we filmed new footage in health clinics, capturing midwives, pregnant mothers, and babies in everyday settings such as food markets. We included some stock footage to ensure the films were culturally and geographically diverse. The local health partner organizations reviewed the films at each stage, in keeping with our standard production process. Finally, the films were translated and dubbed into Khmer, Vietnamese, Bahasa Indonesia, and Burmese.

GE Healthcare deployed the films to 200 pilot sites in Tanzania, Nigeria, Malaysia, and Burma, supporting health workers and empowering women with vital knowledge.

“Government stakeholders are impressed with the multimedia educational capabilities of the device and the multitude of languages and cultures represented in the videos.” — GE Healthcare

We learned some valuable lessons from the process of adapting our films for different needs and contexts. If you’re considering adapting your own film content for new audiences, you may want to keep the following points in mind:

• Localizing and adapting content is a cost-effective way to leverage products you’ve already created and make them engaging, appropriate, and accessible for new audiences.
• Writing technical medical content in simple language can be challenging. Doing it successfully requires a multi-agency consultative review process of health experts in order to ensure accessibility.
• Work with local production crews whenever possible. Their understanding of the local language and context is invaluable to the content adaptation process.
• Translation and dubbing of film content into new languages can be difficult, particularly when medical or health information does not have a direct translation (for example, there is no word for “breech” in Burmese). However, doing so is valuable, because it increases reach and engagement with new audiences — and that is the goal of content adaptation.

This piece is the third in a series on content adaptation. We hope that this series encourages others to share their own experiences adapting educational content for the field — especially key lessons learned and best practices.

• Read part 1, Adaptation as Innovation: Making Content Meaningful, and part 2, Repackaging eLearning Content as a Mobile App for Community Health Workers in Ghana.
• Access K4Health’s Making Content Meaningful guide.

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The Exchange is a K4Health publication. The Knowledge for Health (K4Health) Project is supported by the United States Agency for International Development (USAID) Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreement #AID-OAA-A-13–00068 with the Johns Hopkins University.

The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the U.S. Government.